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Assessment of the level of dental literacy of patients diagnosed with pemphigus vulgaris according to the questionnaire
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Pemphigus vulgaris is a chronic autoimmune bullous dermatosis that results from the production of autoantibodies against desmogleins 1 and 3. It is the most frequent and most severe form of pemphigus, occurring universally, usually between 40 and 60 years of age. It usually begins with blisters and erosions on the oral mucosa, followed by lesions on other mucous membranes and flaccid blisters on the skin, which can be disseminated. There is a clinical variant, pemphigus vegetans, which is characterized by the presence of vegetating lesions in the large folds of the skin. Clinical suspicion can be confirmed by cytological examination, histopathological examination, and direct and indirect immunofluorescence tests. The treatment is performed with systemic corticosteroids, and immunosuppressive drugs may be associated, among them azathioprine and mycophenolate mofetil. More severe cases may benefit from corticosteroids in the form of intravenous pulse therapy, and recent studies have shown a beneficial effect of rituximab, an anti-CD20 immunobiological drug. It is a chronic disease with mortality around 10%, and septicemia is the main cause of death. Patients need long-term and multidisciplinary follow-up.
Dental caries is one of the most prevalent disease (about 50%) in children across the globe. If not treated in time, it can affect not only the mastication function but also the speech, smile and psychosocial environment and the quality of life of the child and the family. The treatment of dental diseases is very expensive in all countries and prevention is very simple and effective. The caries in children below 6 y is called early childhood caries (ECC). It is most commonly caused by milk bottle or mother's feed during night. The ECC spreads very fast and can cause severe pain, abscess, swelling, fever and psychological disturbances in children. The treatment of ECC requires multiple appointments and still the prognosis is not very promising in mutilated dentitions. A physician or pediatrician can easily identify early caries and habits of parents leading to caries and can counsel them for prevention and refer them to the specialist. Good oral hygiene, dietary modification with respect to use of sugar and sticky food and healthy diet can help in preventing this disease in children. The need of the time is to appraise all on the methods of dental caries prevention.
Pemphigus diseases are cutaneous and mucous membrane blistering diseases, related to the key antigens of desmoglein 1 and 3. This article reviews the topic, including diagnosis, and provides the physician with guidance on the treatment of these difficult to control disorders.
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Oral Diseases (2010) 17, 90–94
Objective: To evaluate the periodontal status of mucous membrane pemphigoid (MMP) patients and compare it with that of healthy controls.
Methods: A prospective study was undertaken to examine the impact of gingival MMP lesions on the human periodontium of 29 patients. Parameters evaluated included full mouth plaque score (FMPS), full mouth bleeding upon probing scores, probing depths (PD), gingival recession, clinical attachment level (CAL), mobility score, furcation involvement, number of missing teeth and Machtei criteria.
Results: All periodontal parameters recorded were increased in cases when compared to controls in univariate statistics. The mean differences between groups in PD (0.8 ± 0.2 mm, 95% CI 0.3–1.3), CAL (1.3 ± 0.4 mm, 95% CI 0.4–2.2), FMPS (41.0 ± 6.2%, 95% CI 28.7–53.4), FMBS (16.2 ± 6.6%, 95% CI 3.0–29.4) and tooth loss (2 ± 1 teeth, 95% CI 1–3) were all statistically significant (P < 0.01 for all). Substantial differences in domiciliary oral hygiene routines were observed (P < 0.0001). In multivariate models when FMPS was included as covariate the difference between groups in all clinical periodontal parameters was no longer statistically significant.
Conclusions: Our results showed that periodontal status is worse in MMP patients if compared with healthy controls due to a substantial difference in oral hygiene. Oral health should be promoted in MMP.
The aim of this study was to evaluate the periodontal status of pemphigus vulgaris (PV) patients and compare it with that of healthy controls. We also analysed the association between the periodontal condition and the clinical severity of the disease in PV patients.
Twenty patients (nine women, 11 men; mean +/- s.d. age, 42.9+/-9.8 years) with PV and 22 healthy subjects (eight women, 14 men; mean +/- s.d. age, 40.5 +/- 12.1 years) were included in the study. The periodontal status of all subjects was evaluated according to the Community Periodontal Index of Treatment Needs (CPITN). PV patients were also assessed for Clinical Severity Score (CSS).
The mean CPITN values were observed to be higher in PV patients (2.8 +/- 0.7) compared with those of healthy controls (1.0 +/- 0.8) (P < 0.001). Nevertheless, there was no statistically significant difference in CPITN values according to the CSS (P = 0.4). The number of carious teeth was significantly higher in PV patients than that in healthy subjects.
Our results showed that periodontal status is worse in PV patients. Moreover, PV might contribute to the development and / or progression of periodontitis. PV patients should be encouraged for long-term periodontal follow up.
Increasing evidence indicates that systemic conditions are risk factors of periodontitis. Pemphigus is a group of bullous diseases affecting the oral cavity. The aim of this study was to assess the periodontal status of pemphigus vulgaris (PV) patients. The periodontal status of 50 PV patients and 50 healthy subjects was assessed by a single examiner. PV patients were assessed based on the Clinical Severity Score (CSS). Periodontal clinical parameters such as plaque score, full mouth gingival bleeding score, probing depth (PD), clinical attachment level (CAL) and radiological bone loss were recorded. Effects of age, gender, daily tooth brushing habit, oral lesions and treatment duration on the periodontal status of PV patients were also determined. A statistically significant difference was found between the PV group and the healthy group with respect to the plaque score, PD and CAL (P < 0.05). Logistic regression analysis confirmed that age, gender, and treatment did not significantly influence clinical severity of the disease (P > 0.05). Increased PD and CAL were found with an increase in the CSS. The poor periodontal status in PV patients suggests that PV may be involved in the initiation or progression of periodontitis.
Rasprostranennost', etiologiya i klinicheskie proyavleniya puzyrchatki
- A I Bulgakova
- Z R Khismatullina
- G F Gabidullina
Focus on oral pemphigus vulgaris’s management
- M Mezzour
- K Elharti
- W Elwady