Oral Diseases (Oral Dis)

Publications in this journal

• Article: Dendritic cells and their role in periodontal disease.

  A Wilensky, H Segev, G Mizraji, Y Shaul, T Capucha, M Shacham, A-H Hovav
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  ABSTRACT: T cells, particularly CD4(+) T cells, play a central role in both progression and control of periodontal disease, whereas the contribution of the various CD4(+) T helper subsets to periodontal destruction remains controversial, the activation, and regulation of these cells is orchestrated by dendritic cells. As sentinels of the oral mucosa, dendritic cells encounter and capture oral microbes, then migrate to the lymph node where they regulate the differentiation of CD4(+) T cells. It is thus clear that dendritic cells are of major importance in the course of periodontitis, as they hold the immunological cues delivered by the pathogen and the surrounding environment, allowing them to induce destructive immunity. In recent years, advanced immunological techniques and new mouse models have facilitated in vivo studies that have provided new insights into the developmental and functional aspects of dendritic cells. This progress has also benefited the characterization of oral dendritic cells, as well as to their function in periodontitis. Here, we provide an overview of the various gingival dendritic cell subsets and their distribution, while focusing on their role in periodontal bone loss.
  Oral Diseases 04/2013;
• Article: Spinal and bulbar muscular atrophy: pathogenesis and clinical management.

  C Grunseich, C Rinaldi, Kh Fischbeck
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  ABSTRACT: Spinal and bulbar muscular atrophy, or Kennedy's disease, is an X-linked motor neuron disease caused by polyglutamine repeat expansion in the androgen receptor. The disease is characterised by weakness, atrophy and fasciculations in the limb and bulbar muscles. Affected males may have signs of androgen insensitivity, such as gynaecomastia and reduced fertility. Neurophysiological studies are typically consistent with diffuse denervation atrophy, and serum creatine kinase is usually elevated 2-5 times above normal. Progression of the disease is slow, and the focus of spinal and bulbar muscular atrophy (SBMA) management is to prevent complications.
  Oral Diseases 04/2013;
• Article: Prevalence of Candida spp., xerostomia, and hyposalivation in oral lichen planus - A controlled study.

  G Artico, Rs Freitas, Am Santos Filho, G Benard, R Romiti, DA Migliari
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  ABSTRACT: OBJECTIVE: To determine the frequency of Candida spp., xerostomia, and salivary flow rate (SFR) in three different groups: patients with OLP (OLP group), patients with oral mucosal lesions other than OLP (non-OLP group), and subjects without oral mucosal lesions (control group). MATERIAL AND METHODS: Xerostomia as well as SFR was investigated in the three groups. Samples for isolation of Candida spp. were collected from OLP lesions (38 patients), non-OLP lesions (28 patients), and healthy subjects (32 subjects). RESULTS: There was no statistically significant difference regarding the frequency of xerostomia and hyposalivation among the three groups (P > 0.05). A higher prevalence for colonization by Candida spp. was found in the healthy subject as compared to that of patients with OLP (P = 0.03) and non-OLP (P = 0.02) groups. Low SFR was not a factor for colonization by Candida spp. CONCLUSIONS: Xerostomia and hyposalivation occur with similar frequency in subjects with and without oral lesions; also, the presence of oral lesions does not increase the susceptibility to colonization by Candida spp. It seems that any study implicating Candida spp. in the malignant transformation of oral lesions should be carried out mostly on a biochemical basis, that is, by testing the capability of Candida spp. to produce carcinogenic enzyme.
  Oral Diseases 04/2013;
• Article: Dysregulation of miR-31 and miR-375 expression is associated with clinical outcomes in oral carcinoma.

  My Siow, Lp Karen Ng, Vk Vincent Chong, M Jamaludin, Mt Abraham, Za Abdul Rahman, Tg Kallarakkal, Y-H Yang, Sc Cheong, Rb Zain
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  ABSTRACT: OBJECTIVES: To identify differentially expressed miRNA between oral squamous cell carcinoma (OSCC) and non-cancer (NC) and to associate these with clinico-pathological parameters. MATERIALS AND METHODS: miRNA microarray profiling was utilized to obtain the expression profile of miRNAs in four OSCC and four NC samples. The expression of miR-31 and miR-375 was further validated in 26 OSCC and three NC samples using real-time-PCR. The association between miRNA expression and clinico-pathological parameters was tested by univariate and multivariate analyses. RESULTS: Microarray profiling demonstrated that 15 and four miRNAs were up-regulated and down-regulated, respectively, in OSCC as compared with NC. miR-31 and miR-375 were validated as up- and down-regulated miRNAs, respectively. In univariate analyses, expression of miR-31 was significantly elevated in early stage, tumours with no metastatic nodes and those from the buccal mucosa. By contrast, low miR-375 expression was significantly associated with late stage disease, larger tumour size and the non-cohesive type of pattern of invasion in OSCC. The association between miR-31 expression with tumour staging and site and miR-375 with tumour staging remained significant in multivariate analyses. CONCLUSIONS: This study has identified 19 miRNAs significantly associated with OSCC, and expressions of miR-31 and miR-375 were significantly related with clinico-pathological parameters suggesting they could be important in driving oral tumourigenesis.
  Oral Diseases 04/2013;
• Article: Neurogenic differentiation of human dental pulp stem cells using different induction protocols.

  T Osathanon, C Sawangmake, N Nowwarote, P Pavasant
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  ABSTRACT: OBJECTIVE: An investigation on neuronal differentiation capacity of human dental pulp stem cells (DPSCs) was still lacking. In this study, two different neuronal induction protocols were investigated and compared. METHODS: The neuronal differentiation was induced using chemical or growth factor induction protocol. The differentiation was confirmed by the neurogenic mRNA and protein expression using polymerase chain reaction and immunocytochemistry, respectively. RESULTS: Chemical-induced neuronal differentiation protocol promoted morphological change and β3-TUBULIN protein expression. Though, SOX2, SOX9, and β3-TUBULIN mRNA levels were not different compared with the control, indicating a defective differentiation. For growth factor induction protocol, the cells were exhibited neurite-like cellular process and positively stained with β3-TUBULIN. In addition, the increase in intracellular calcium was noted upon NMDA stimulation, implying the neuronal function. A dramatic increased mRNA expression of neurogenic markers [SOX2, SOX9, β3-TUBULIN, and gamma-aminobutyric acid (GABA receptors)] was noted as compared to the control. In addition, a remarkable increased expression of Notch signaling target gene, HEY1, was observed in growth factor-induced DPSCs derived neuronal-like cells compared with the control. CONCLUSION: These data indicate that growth factor induction method is a preferable protocol for neuronal differentiation by DPSCs.
  Oral Diseases 04/2013;
• Article: An anti-c-Fms antibody inhibits osteoclastogenesis in a mouse periodontitis model.

  K Kimura, H Kitaura, T Fujii, M Ishida, Zw Hakami, T Takano-Yamamoto
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  ABSTRACT: OBJECTIVE: Bacterial lipopolysaccharide (LPS) can induce inflammatory bone loss such as periodontal disease. The formation of osteoclasts depends on macrophage colony-stimulating factor (M-CSF) and receptor activator of nuclear factor kb ligand (RANKL). It has recently been reported that administration of an antibody of the M-CSF receptor c-Fms completely blocked osteoclastogenesis and bone erosion induced by LPS in mouse calvaria. In this study, the effect of antibody against c-Fms in the mouse periodontitis model by injection of LPS was investigated. MATERIALS AND METHODS: C57BL6/J mice were injected with LPS and anti-c-Fms antibody into the mesial gingiva of the first molar in the left mandible. Histological sections of periodontal tissue were stained for tartrate-resistant acid phosphatase, and osteoclast numbers and ratio of alveolar bone resorption determined. RESULTS: The number of osteoclasts and ratio of alveolar bone resorption in mice administered both LPS and anti-c-Fms antibody was lower than those in mice administered LPS alone. The expression of RANKL receptor, RANK, was inhibited by the anti-c-Fms antibody in periodontal tissue. CONCLUSION: M-CSF and/or its receptor are potential therapeutic targets for the treatment of bone resorption, caused by LPS, in periodontitis. Injection of an anti-c-Fms antibody might be useful for inhibition of pathological bone resorption in periodontitis.
  Oral Diseases 04/2013;
• Article: HCV clearance from saliva of HIV-HCV-coinfected patients on treatment with interferon plus ribavirin.

  J Feijoo, M Eirea, J Limeres, M Abeleira, I Ramos, A Ocampo, P Diz
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  ABSTRACT: OBJECTIVE: To determine hepatitis C virus (HCV) RNA clearance from blood and saliva of HIV-HCV-coinfected patients undergoing combined therapy with pegylated interferon plus ribavirin (PEG-IFN-RIB). SUBJECTS AND METHODS: Study group was formed of 60 HIV-infected patients with chronic hepatitis C who were starting treatment with PEG-IFN-RIB. Blood and saliva samples were taken at baseline, at the end of treatment and 24 and 48 weeks later. A nested RT-PCR technique was used to detect HCV-RNA in saliva. RESULTS: HCV-RNA was detected in saliva at baseline in 64.7% of patients. Thirty-four patients completed follow-up. The response rate (undetectable HCV-RNA) in blood was 79.4% at the end of treatment; 55.8% at 24 weeks after the end of treatment and 50% at 48 weeks. HCV was detected in saliva of 13 (38.2%) patients at the end of treatment and in 18 (52.9%) patients at 24 and 48 weeks later. Concordance of HCV clearance from blood and saliva reached its maximum value at 48 weeks after the end of treatment (odds ratio, 112.51). CONCLUSION: In HIV-HCV-coinfected patients responders to PEG-IFN-RIB, the salivary glands do not appear to be a sanctuary site for HCV, although viral clearance from saliva may be slower than from blood.
  Oral Diseases 04/2013;
• Article: Mandibular symphysis and ramus as sources of osteoblastic cells for bone tissue engineering.

  Ep Ferraz, Sp Xavier, Pt de Oliveira, Mm Beloti, Al Rosa
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  ABSTRACT: OBJECTIVES: Autografts from mandibular symphysis and ramus are often used for bone reconstruction. Based on this, we hypothesized that these sites could be useful cell sources for bone tissue engineering approaches. Thus, our study aimed at evaluating the proliferation and osteoblast phenotype development of cells derived from mandibular symphysis and ramus. MATERIALS AND METHODS: Cells were isolated from bone fragments of four patients by enzymatic digestion and cultured under osteogenic condition for up to 17 days. Cultures were assayed for cell proliferation, gene expression of key bone markers runt-related transcription factor 2 (Runx2), distal-less homeobox 5 (DLX5), SATB homeobox 2 (SATB2), Osterix (OSX), family with sequence similarity 20, member C (FAM20C), bone sialoprotein (BSP), osteopontin (OPN) and osteocalcin (OC), alkaline phosphatase (ALP) expression and activity, and extracellular matrix mineralization. Data were compared by two-way ANOVA or t-test for independent samples when appropriate. RESULTS: Cells derived from ramus displayed lower proliferative activity and higher gene expression of Runx2, DLX5, SATB2, OSX, FAM20C, BSP, OPN and OC, ALP protein expression and activity and extracellular matrix mineralization compared with symphysis-derived cells. CONCLUSION: Symphysis and ramus may be considered as cell sources for bone tissue engineering approaches but due to the higher osteogenic potential, ramus-derived cells are more appealing for constructing cell-based biomaterials.
  Oral Diseases 04/2013;
• Article: Aloe vera herbal dentifrices for plaque and gingivitis control: a systematic review.

  K Dhingra
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  ABSTRACT: OBJECTIVES: To evaluate the effectiveness of aloe vera containing herbal dentifrices in improving plaque control and gingival health. METHODS: A manual and electronic literature (MEDLINE and Cochrane Central Register of Controlled Trials) search was performed up to July 2012, for randomized controlled trials presenting clinical, microbiological, immunological, and patient-centered data for the efficacy of aloe vera herbal dentifrices for controlling plaque and gingival inflammation in patients with gingivitis. RESULTS: From 79 titles and abstracts, eight full-text articles were screened and finally two randomized controlled trials were selected. These randomized controlled trials reported that aloe vera dentifrices were similar in efficacy to control dentifrices in effectively reducing plaque and gingival inflammation in gingivitis patients based on the assessment of clinical, microbiological, and patient-centered treatment outcomes. However, many important details (composition and characteristics of aloe vera and control dentifrices along with appropriate randomization, blinding, and outcomes assessed) were lacking in these trials, and therefore, the quality of reporting and methods was generally flawed with high risk of bias. CONCLUSION: Even though there are some promising results, the clinical effectiveness of aloe vera herbal dentifrices is not sufficiently defined at present and warrants further investigations based on reporting guidelines of herbal CONSORT statement.
  Oral Diseases 04/2013;
• Article: The effects of ErhBMP-2-/EGCG-coated BCP bone substitute on dehiscence around dental implants in dogs.

  Y-S Shin, J-Y Seo, S-H Oh, J-H Kim, S-T Kim, Y-B Park, H-S Moon
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  ABSTRACT: OBJECTIVES: The purpose was to evaluate the effect of Escherichia coli-derived recombinant human bone morphogenetic protein-2 (ErhBMP-2)-/epigallocatechin-3-gallate (EGCG)-coated biphasic calcium phosphate (BCP) and titanium barrier membrane on dehiscence defects in dogs. MATERIALS AND METHODS: In five mongrel dogs, the dehiscence bony defects around dental implants were surgically created and in total three implants were placed at edentulous ridge of which teeth had been extracted 12 weeks before. For the control group, BCP was applied to the dehiscence defect. For experimental groups, ErhBMP-2-coated BCP and ErhBMP-2-/EGCG-coated BCP were applied. The newly designed titanium barrier membrane was used to apply all the defects. The defects were evaluated histologically and histometrically after 12 weeks. The comparative statistics of the groups were obtained through Kruskal-Wallis test. RESULTS: In bone-to-implant contact (BIC), bone density (BD), bone regeneration height (BRH), and bone mineralization apposition rate (BMAR), differences among groups were not found. ErhBMP-2/EGCG group appeared to have higher value. In fluorescence analysis, bone remodeling around graft material was more active in the ErhBMP-2/EGCG group. CONCLUSION: Within the limit of this study, it is reasonable to assume that BMP-2-/EGCG-coated biphasic BCP and the newly designed titanium membrane were more beneficial in dehiscence defect healing with increased bone remodeling.
  Oral Diseases 04/2013;
• Article: Cartilage degradation in temporomandibular joint induced by unilateral anterior crossbite prosthesis.

  Y-L Wang, J Zhang, M Zhang, L Lu, X Wang, M Guo, X Zhang, M-Q Wang
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  ABSTRACT: OBJECTIVE: To investigate the pathological effects on temporomandibular joint cartilage of an experimentally created unilateral anterior crossbite prosthesis. METHODS: Six-week-old female Sprague-Dawley rats were divided into experimental and control groups and further divided into three subgroups for three time points (n = 9). In experimental groups, the unilateral anterior crossbite was created by bonding two metal tubes on left maxillary and mandibular incisors. 2, 4, or 8 weeks after operation, the histomorphological changes and the expression changes of PCNA, COL II, aggrecan, MMP-3, MMP-9, MMP-13, and TIMP-1 in condylar cartilage were investigated by hematoxylin-eosin and toluidine blue staining, real-time PCR, and immunohistochemistry. RESULTS: In experimental groups, decreasing in chondrocytes, cell-free areas, reduction in the thickness of hypertrophic layer, and loss of extracellular matrix were noticed. The expression level of PCNA was decreased at week 2 and week 4. The mRNA expression of COL II was decreased at 4 week and that of aggrecan was increased at 2 week but decreased at 4 and 8 week. The expression of MMP-9, MMP-13, and TIMP-1 was increased at 2-week and decreased at 4- and 8-week, while that of MMP-3 was increased at 4- and 8-week. CONCLUSIONS: The present unilateral anterior crossbite prosthesis led to degradation of mandibular condylar cartilage.
  Oral Diseases 04/2013;
• Article: Role of human papillomavirus infection and other factors in patients with head and neck squamous cell carcinoma.

  A Iqbal, R Warraich, Se Udeabor, M Rana, Am Eckardt, N-C Gellrich
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  ABSTRACT: OBJECTIVE: To analyse the association between high-risk human papillomavirus (HR-HPV) and other risk factors in the aetiology of head and neck squamous cell carcinoma (HNSCC) in an Asian population. STUDY DESIGN: This study is a cross-sectional analysis of 80 patients who were diagnosed with HNSCC. Patients' demographics, dietary habit, medical and social history were obtained. Surgical specimens from these patients were then histologically analysed using H&E stain and immunohistochemistry (IHC) for the presence of HR-HPV primary antibody. RESULTS: High-risk human papillomavirus was detected in 41 patients, representing 51.3% of the 80 paraffin-embedded tissues of HNSCC; 27.5% of these were weak positive, 10.0% medium positive and 13.8% were strongly positive for the HR-HPV on IHC. The tongue lesions had the highest HR-HPV infection of 72.2%. No association existed between HR-HPV and patient's demographics, dietary habit and other predisposing factors. CONCLUSION: The place of HR-HPV as a possible aetiological factor for HNSCC has further been established from this study.
  Oral Diseases 04/2013;
• Article: Role of nuclear factor kappa-B in phenytoin-induced gingival overgrowth.

  T Arabaci, O Köse, A Kizildağ, M Albayrak, Y Ciçek, A Kara
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  ABSTRACT: OBJECTIVE: This study investigates the expression of transcription factor nuclear factor-kappa B (NF-κB) and its relation to various cellular mediators that act in the pathogenesis of phenytoin-induced gingival overgrowth. MATERIALS AND METHODS: Eighteen epileptic patients had phenytoin-induced gingival overgrowth (PHT-GO), 20 patients with plaque-induced gingivitis (Gingivitis), and 20 periodontally and systemically healthy individuals (Control) were included in this study. The expression of activated NF-κB subunits (p50 and p65), IL-1β, TNF-α and TGFβ-1 levels were examined in the gingival sections obtained from each participant. RESULTS: The results demonstrated a significantly higher expression of p65 in fibroblasts in PHT-GO group with respect to Gingivitis (P < 0.05) and control groups (P < 0.01). However, we found no statistically significant differences between PHT-GO and Gingivitis groups according to the immunohistochemical staining in macrophages (P > 0.05). Immune-reactive TGFβ-1 levels in the gingival connective tissue cells were statistically higher in PHT-GO group with respect to Gingivitis group(P < 0.05). Statistically significant correlations were found between the HI and activated TGFβ-1 and p65 levels in PHT-GO group. CONCLUSION: The results of this study showed that NF-κB is activated in PHT-related gingival overgrowth. This study may provide a basis for future research into specific NF-κB inhibition for preventing of the side effects of this drug.
  Oral Diseases 04/2013;
• Article: Osteopontin gene SNPs (rs9138, rs11730582) mediate susceptibility to external root resorption in orthodontic patients.

  A Iglesias-Linares, Rm Yañez-Vico, Am Moreno-Fernández, A Mendoza-Mendoza, A Orce-Romero, E Solano-Reina
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  ABSTRACT: OBJECTIVE: External apical root resorption (EARR) is a frequent iatrogenic effect of orthodontic treatment. Substantial variability in responses to postorthodontic EARR has been observed among patients even when similar treatment protocols were used. This observation suggests that environmental and/or genetic variations between individuals may confer susceptibility or resistance to developing EARR. The objective of this study is to determine whether variants in the osteopontin gene, an essential mediator in the odontoclast fusion and attachment process, are positively/negatively associated with postorthodontic EARR. MATERIALS AND METHODS: Genetic screening of eighty-seven orthodontic patients was performed for two polymorphisms in the osteopontin gene cluster (rs9138 and rs11730582). Subjects were divided into groups, according to the presence or absence of EARR (>2 mm). Genotype distributions and allelic frequencies were calculated using the chi-square test. Logistic regression analysis was used to assess the extent to which clinical-related parameters interfered with the EARR. Odds ratios (OR) and 95% confidence intervals were also calculated. RESULTS: Data from this study show that subjects heterozygous and homozygous for the most frequent allele of the osteopontin gene at position 89261521 [OR: 0.035 (P = 0.035*) (allele A)] and 89253600 [OR: 0.20 (P = 0.025*) (allele T)], respectively, are protected against postorthodontic EARR. Nevertheless, a highly significant association was found in the comparative analysis of homozygous subjects [2/2 (CC)] for the osteopontin gene (rs9138), resulting in an increased risk of suffering postorthodontic EARR[OR: 4.10; P = 0.045*;CI: 95%]. Subjects who were homozygous [2/2 (CC)] for the osteopontin gene (rs11730582) were more likely, and to a greater extent, to be affected with EARR [OR: 11.68; P < 0.039*;CI: 95%] compared with other genotypes. CONCLUSION: Variations in the osteopontin gene (rs9138 and rs11730582) are determinants of a genetic predisposition to suffer EARR secondary to orthodontic treatment.
  Oral Diseases 04/2013;
• Article: HSP27 as a potential preneoplastic marker in patients with chronic kidney disease.

  K Musiał, D Zwolińska
  Oral Diseases 03/2013;
• Article: Body mass index and periodontal infection in a sample of non-smoking older individuals.

  R Oikarinen, A-Mh Syrjälä, K Komulainen, M Knuuttila, P Ruoppi, S Hartikainen, R Sulkava, P Ylöstalo
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  ABSTRACT: OBJECTIVE: The aim of this study was to investigate the association between BMI and periodontal infection in a sample of non-smoking individuals aged 75 years or older. SUBJECTS AND METHODS: The study sample included 157 non-smoking dentate persons (110 women, 47 men, mean age 80.6 years) belonging to the Geriatric Multidisciplinary Strategy for the Good Care of Older People study in Kuopio, Finland. The data were gathered by interview together with geriatric and oral clinical examination. The outcome variable was the number of teeth with periodontal pockets measuring 4 mm or more in depth. Poisson regression models were used to estimate relative risk (RR) and 95% confidence intervals (CI). RESULTS: After adjustment for confounding factors, the relative risk for the number of teeth with deepened periodontal pockets (≥4 mm) was 0.7 (CI: 0.6-0.9) among those with a BMI 25-29.99 and 1.1 (CI: 0.8-1.4) among those with a BMI ≥30, compared with those having a BMI <25. CONCLUSION: Within the limitations of this study, including small sample size, possibility of confounding and other biases, the results do not provide evidence that elevated body weight would be a risk for periodontal infection among older people.
  Oral Diseases 03/2013;
• Article: Carcinoma-associated fibroblasts, its implication in head and neck squamous cell carcinoma: a mini review.

  S Routray, A Sunkavali, Ka Bari
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  ABSTRACT: The communication between tumor stromal and parenchymal cells provides an insight to tumor progression. One of the main elements of the stroma, a major contributor to the extracellular environment of tumors, is carcinoma-associated fibroblasts. They can originate from either normal fibroblasts in the immediate vicinity of the tumor or from circulating bone marrow-derived mesenchymal stem cells. These myofibroblasts can arise locally from an endothelial-mesenchymal transformation at the invasive edge of the cancer and are physically associated with carcinoma cells, that is, in the development of high-grade malignancies and poor prognosis. These carcinoma-associated fibroblasts feed the epithelial tumor cells in a host-parasite relationship establishing its role in head and neck squamous cell carcinoma progression.
  Oral Diseases 03/2013;
• Article: Oral manifestations and their treatment in Sjögren's syndrome.

  S González, H Sung, D Sepúlveda, Mj González, C Molina
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  ABSTRACT: Sjögren's syndrome (SS) is a complex, chronic, systemic, autoimmune disease that mainly affects the exocrine glands, especially the salivary and lacrimal glands, leading to dryness of the oral and ocular mucosae. Several factors have been studied that could explain the glandular hypofunction primarily related to water transport. Recent reports have shown alterations in secretory route and trafficking in labial salivary glands, explaining alterations in the saliva quality. The decrease in salivary flow and qualitative alterations in saliva could explain many of the oral manifestations. The exocrine manifestations and systemic involvement significantly impact the patient's perception of health-related quality of life. For this reason and given its systemic nature, the treatment of these patients should be multidisciplinary. This review addresses some particular oral health aspects of SS patients and focuses on relevant topics concerning the treatment and prevention of common oral disorders associated with this disease.
  Oral Diseases 03/2013;
• Article: Aging effects on oropharyngeal swallow and the role of dental care in oropharyngeal dysphagia.

  Ja Logemann, Fa Curro, B Pauloski, G Gensler
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  ABSTRACT: Difficulty with oropharyngeal swallow requires careful diagnosis and treatment from a team of professionals including the patients' physicians and the speech-language pathologist specializing in dysphagia. The dentist can be a critical team member in prevention, early identification, and management of oropharyngeal dysphagia. This manuscript reviews the physiology of normal oropharyngeal swallow and the effects of normal aging on this physiology. Typical etiologies for oropharyngeal dysphagia are defined as is the most commonly used physiologic diagnostic procedure, the modified barium swallow (MBS). The critical role of the dentist in identifying risk of oropharyngeal dysphagia, making appropriate referrals, and improving oral hygiene to prevent aspiration pneumonia in the elderly is discussed.
  Oral Diseases 03/2013;