Oral Diseases - Science topic

Oral and maxillofacial area has some diseases related to the occupation

Common examples :

1. Broken teeth and enamel : professional tailors who use to hold the thread needle with their teeth repeatedly damages their teeth enamel

2. TMJ subluxation or partial dislocation may happens in professional speakers, politicians and singers who open the mouth wide repeatedly for singing or saying speech.

For original research or reviews?

@zorica popovic, Than it means that an effective study on Access to dental health care is needed that would reflect the actual problem of your region about the public private partnership on health care provision. That can be published, disseminated and use in policy making on Oral Health.

Dear sir, diseases such as Periodontitis, surely have negative effect on the occlusal pressure and will show statistically significant difference in Tek-scan reading in normal patient and patient with periodontitis. However, diagnosing periodontitis only on the basis of occlusal analysis wont be possible. Since, periodontitis is an inflammatory disease and its diagnosis is based on clinical findings such as changes in color, consistency of gingiva, pocket formation and more specifically clinical attachment loss. Depending on the severity of periodontitis, there could be varying degree of underlying bone loss that would affect the tooth's capacity to bear occlusal forces.

Hence, you can compare cases of severe full mouth periodontitis, with bone loss in multipe teeth with those with mild to moderate periodontitis and also keep healthy periodontium as control group to prove that with increasing in severity of periodontitis, the occlusal load bearing capacity is affected.

I hope i was albe to clear you query, let me know if you want to ask something more. We have done a similar study in our department and have published an e-book on the same. Following is the link for same.

@ Samaresh Changdar Is the facility available now?

Hello, Antioxidants & Oral mucosal lesions: The evidence in support of a chemopreventive role for the so-called antioxidant nutrients, β- carotene and vitamin E, against oral cavity cancer. In several epidemiologic studies, low intakes of vitamin E, carotenoids, or both have been associated with a higher cancer risk.

Dear Dr.Milorad,

I came to understand few cases in which patients developed and bacterial fungal infections of the oral cavity after visiting Dental Clinics. It was unfortunate that my wife got two times infections after getting treatment from Dental Doctor. The improper sterilization of instruments can be the major reason of introducing the infection as microbes are widely prevalent in our environment including Dental Clinics. I know few Dental Doctors and I advised them to strictly follow the sanitary and hygienic measures in their Clinics so that no patients can get any infection during dental treatment.

With kind regards,

Prof.Dr.Mahendra Pal

Founder Director of Narayan Consultancy

The AJCC cancer staging manual has become the standard for cancer staging.

folk remedy - to grease a thumb with mustard

I do not see how carrs would be a preservative. They are added as texturizers. In other words to either make a gel or modify the flow of the products.

But isn't aloe already a viscous product?

Regarding carrs safety . . . The battle is still going on. Industry claims carrs are safe to ingest and a bunch of others claim it is not.

The important issue here is that we could not generalized the way of treatment for all open bite cases,either by extrusion of anteriors or intrusion of posteriors or may be both as combination..there are several factors which make  the  decision of treatment.and i think that the most important one is the incisor show at rest and smile,in which if there was a good or enough incisor show,so we cant do further extrusion of anterios at all , in addition to the compromized alveolar bone height as Dr.Jenkins mention3d in the previous comment ..

Regarding to stability in the available evidence. i think there is no evidence to prefer extrusion or intrusion in the literatue ..

Thank you .

Dr. Nadlhem Sallam. You can use ImageJ program (NIH, Bethesda) for radiographic standarization (pre-operative and follow-up radiograph alignment) with subsequent quantitative analyses. 

As a clinician, to have an active periodontal condition with out calculus formation  is a bad sign. Also a good sign is to start having calculus formation as the biofilm of the pocket returns to a healthy flora with treatment. Calculus formation is a defence mechanism against periodontal pathogens. Calcified bacterial plaque never hurt anyone. The niches  its presence creates for unhealthy bio-film to establish itself  is the problem.

The first option is the dermocorticoid considering the increased knowledge of long-term side effects.

However the 0.1% tacrolimus oinment or 1% orabase are also effective but it should be considered that the drug is relatively new and there neoplasia reports (Radfar et al. 2008) with extended use.

I also remember the pimecrolimus, cyclosporine and aloe vera as an alternative to topical treatment

I could not find studies with evidence on this subject. GB has been used for many different diseases from tinnitus to Alzheimer's disease and erectile dysfunction. The empirical prescription should take into account the potential medication use damage. Please take a look at link

 Thank you. 

The immunological profile in these patients should be also considered well in the treatment of them.

Check these articles

Best regards

Hi dear,  interestingly I had a clinical trial in treatment of localized aggressive periodotitis using demineralized bone matrix combined with low level gallium - aluminium - arsenide didode laser.

Immediately after surgery,  our patients were irradiated by laser application on the lingual & buccal side ( 90 min. using 100 me power continous mode) for 3 successive days.

Our patients were assessed using pocket depth,  clinical attachment level & digital radiographs parameters. 

Significant clinical improvement has been obtained after 6 months.

My best wishes

 Sorry the poor answer... I believe that a doctor can answer it better for you... As a speech language pathologist who works with swallowing disorders in patients only severe cases come to my practice... If you find any books from Mara Behlau or Silvia Pinho you may find a proper answer too... those are the most famous researchers  in voice field of knowledge inside brazilian speech language pathology. 

You are most welcome 

In the referred article the diagnoses were based on WHO's classification system modified by Andreasen JO, described in M&M. There is no classification system by Ingeborg Jacobsen.

Dear Dr

The best, easiest, and fastest is the 810nm diode laser. 

Dear Yasmine

Its an interesting question and I have been brainstorming and searching for your answer. Nothing evidence based I could find in literature but possible explanation that I can suggest ...

Yes!! ameloblastoma can occur mainly in middle aged people long after odontogenesis has ceased.. because sources of epithelium require a stimulus to multiply. These sources are entrapped or aberrantly present as n when conditions are appropriate... they grow at rapid pace thereby producing a tumor. All these tumours have 3 most imp properties: 1. they rarely out side jaws, 2. they are aggressive, 3. they seldom metastasise.

I also thank Dr Arvind to provide a very interesting review article by Carolina et al on current concepts of ameloblastoma. The review, discusses molecular nature: clonality, cell cycle proliferation, apoptosis, tumour suppressor genes, ameloblastin and other enamel matrix proteins, osteoclastic mechanism and matrix metalloproteinases and other signalling molecules. but surely evidence is required regarding concerns raised by Yasmin.

Regards

Preimplantitis is the inflammation around implant and involves bone tissue. The possible bacteria that involve in such inflammation are red complex members such as Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola. These bacteria are strictly anaerobic. Thus to simulate such condition for in vitro we need to have life bone tissue and implant and the previous complex members and anaerobic condition for the growth and production of toxins that lead to inflammation of bone tissue around implant,

There is only weak research evidence for homeopathy in this condition. Two non-peer reviewed projects have been published, both by Chebel IFO in 2012. Title: "Acoa do tratamento homeopatico na sintomalogia da sindrome da ardencia bucal em duas fases: estudo duplo cego placebo controlado e estudo alberto. Thesis, Universidade de Sao Paulo, Brazil." One was an open uncontrolled observational study of individualised homeopathy in burning mouth syndrome with 28 participants, showing a reduction in burning measured using VAS by 64.6%. The second was a double-blind trial comparing homeopathic Arsenicum album with placebo, including 31 participants, showing a reduction of burning measured using VAS by 44.5% in the verum group and 12.7% in the placebo group.

Dear Dr Leonardo Silva,

When multiple stones exist in the salivary glands, its important to look for underlying causes. The standard causes mentioned are medication intake like Diuretics and Anti-cholinergic medications, Gout and smoking. I assume that these causes have been ruled out. Hypercalcemia has been suggested in literature as a cause but you have stated that Calcium and PTH levels are normal.

I have seen a couple of patients of Sjogrens syndrome who had multiple sialolithiasis. It would be worth asking if your patient had sicca symptoms and evaluate for Sjogren's by evaluating for tear formation (Scirmer's test), testing for ANA, RF and a possible minor salivary gland biopsy. If it does indeed turn out to be Sjogrens, a variety of treatment options exist.

Hope this helps

regards

Shankar

Yes. Some of the etiological factors seems to be ill-fitting dentures, poor oral hygiene  , sensitivity to denture base materials, smoking, age-related changes, and systemic conditions .

According to Emin Murat CANGER, Peruze CELENK, Saadettin KAYIPMAZ "Denture-Related Hyperplasia: A Clinical Study of a Turkish Population Group" , the incidence of IPH was 6.9% in women, and 20.5% in men.

 While there were not any statistically significant differences within the age groups in IFH and IPH (p>0.05), in the IFH+IPH group, there were differences between the 30-60 year old group and the 61-80 year group (p<0.05)

Topical calcineurin inhibitors, such as tacrolimus and pimecrolimus (Elidel), are second-line therapies for oral lichen planus.

use of turmeric etc have been proven to be effective against OLP. FILES HAVE BEEN ADDED 

I do agree with Martin and African Americans are more prone for this and risk may vary from individual to individual.

yes Dr.Nalini, one of my student did thesis on topical aloe Vera gel on OLP. She approached a Ayurveda company for that.

Dear Fethi, that's right. I have divided the reasons in

1. Oral hygiene deficiency - local consequences of disability - low manual power,

2. Infections,

3. Attention Deficit,

4. Retarded ability to swallow or difficulty breathing - open mouth posture,

5. Resulting gingival inflammation with bleeding (fear plastered against bleeding tissues),

6. Exaggerated facial expressions and gestures,

7. Metabolic disorders (cf., diabetes),

8. Imbalance of growth factors, tendency to hyperplasia,

9. Poor mouth hygiene because of nausea with the use of aids and hygiene,

10. Various syndromes with symptoms participation.

My students are sensitized to care against wrong habits of the patient (and in spite to care for their relatives better understanding of the pathogenesis).

current concepts of oral submucous fibrosis may not support the use of arecanut and may associate osmf with elevated copper  content in oral fluids.  In our day to day practice, we come across  most of the osmf cases associated with arecanut just like how we see more cases of leukoplakia associated with use of tobacco either in smoking or in smokeless form though idiopathic leukoplakia has also been reported.

With my  clinical experience I would like to state that osmf is definetely associated with arecant and the elevation of copper content is connected to it

Hi Cajouste. In epidrmoid carcinoma you will find dysplastic and in severe cases anaplastic squamous epithelium invading the connective tissue.

It is not just the vertical alignment of collagen fibres but extensive cross linking / inter locking by excessive copper (from areca nut) in subepithelial tissues which is so refractory to treatment. No well defined data exists as to how much force can be safely used . High end dyanometric studies can be an area of interest to objectively clarify the magnitude of forces for various patient subsets. Any undue force can damage the TMJ or teeth.

Not only the infections and other systematic diseases, there are problems like burning mouth syndromes and reduced salivation which all the more can cause many dental and medical problems

Biofilm is composed of several different kinds of bacteria and their products that develop over the enamel on a layer known as dental pellicle. The process of plaque formation takes several days to weeks and will cause the surrounding environment to become acidic if not removed. Gingivitis and caries lesion appears if there is no disruption of biofilm and this will be established.

The preventive methods should be used daily as a toothbrush, toothpaste and floss, and in the case of children, parents are responsible for the cleaning and feeding, but also by seeking professional guidance. And what's the problem? The problem is that parents are not prepared to care for their children. Socioeconomics, educational and cultural problems interfere with the way parents lead their lives and of their children. See these articles that show different regions of the world and the problem of oral health.

Look at the PhD thesis (which I was the supervisor) University of SDU,faculty of Dentistry.

Fortunately, most of my OLP patients get remission more than active disease. To answer your question two of my patients ( a man and a woman) have been visiting me on a regular basis for relief of symptoms (erosive type). They are content with treatment but they wish to know the cause of the disease.

I just found on the net a table from this article, bringing interesting epidemiological data on the pathologies of the included third molar.

Mr. Santosh Patil is a member of RG, I hope he could join this interesting discussion.

ORIGINAL ARTICLE

Year : 2013 | Volume : 2 | Issue : 1 | Page : 10-15

Prevalence and type of pathological conditions associated with unerupted and retained third molars in the Western Indian population

Santosh Patil

Department of Oral Medicine and Radiology, Jodhpur Dental College, Jodhpur National University, Jodhpur, Rajasthan, India

Dear Cajouste,

As a general rule you shouldn't need to prescribe antibiotics after routine root canal treatment. For example when RCT is performed to treat irreversible pulpitis, periapical periodontitis, etc. With these conditions the bacterial load is contained with the pulp and root canals and therefore the irrigant used during the procedure (e.g. hyochlorite or chlorhexidine) should kill these bacteria and allow the body to fight infection and heal itself apically. We should always be mindful or the impact of prescribing antibiotics upon antibiotic resistance.

The patient should only receive antibiotics if there are signs of systemic infection or gross localised pain and soft tissue swelling (however in this case extraction of the tooth may be a better course of treatment). While it is common practice to give a broad spectrum penicillin such as Amoxicillin (250-500mg three times daily for 5-7 days) you may wish to add more anaerobic bacterial cover such as the addition of Metronidazole or switch to Co-amoxiclav (Amoxicillin and clavulinic acid).

However, in summary you shouldn't prescribe antibiotics after routine root canal treatment. Best practice is to monitor the patient and review your treatment with escalation if necessary.

Hope this helps,

Karl

I have started the pilot study in bombay.

The findings are sad...most of the patients i have examined are in very poor oral health..

I am now trying to treat them in the charitable facility i am attached to.

Only clinical application of genetically modified phages in periodontal therapy that i an think of is in cases of aggressive periodontitis... In aggressive periodontitis aggregatibacters are known to penetrate into the tissues and cause extensive damage.. By use of targetted bacteriophages one can look for reduction in disease progression...

With more breathing oral, less saliva.

With less saliva, more caries and gingivitis.

Only see other animals, that never Brushing Teeth, but has perfect teeth :)

The saliva, tongue and lips are the power :)

What a rich discussion .. Thanks Dr Najla

But It think we should make a clear difference between patients with residual, poor salivary flow and those with zero function ... since salivary stimulants, in my opinion, can worsen symptoms of those with Zero salivary function .... I found Olive oil and coconut oil are good for the majority of dry mouths ... Moreover we have to make sure that patients who do not have tracheostomy after surgery are not mouth breathers .. understandably this my be an exacerbating factor for dry mouth

Dear Tony, The hydroxyapatite which comprises to be the principle component of bone and which has biologically evolved to be flexible by nature turns to fluorapatite which is brittle and prone to bending exposure to excessive fluoride ove a period of time.

Fluoride also has a differential affect on our skeletal system. It increases the bone density in axial skeletal system like skull and spine but reduces the bone strength of appendicular skelatal system like hands uptill shoulder blades and legs uptil the pelvic gurdles. Hence vertebra fractures is aided by presence of fluoride but hads and legs become brittle in the presence of excess fluoride!

I totally agree with Dr Ghaly's opinion, especially in clinically malignant suspicion. Unfortunately, in all other methods there might be a false diagnosis.

Sir i wanna research for any mining engineering topic and any guys suggest any intresting topic for me.

Amit Sir, do you prescribe the alcohol-based m/w in your practice or verbally support the use of these by patients. Bcoz in both the cases the usage has to be discontinuous and periodic due to the ill effects of alcohol on the oral mucosa however minimal depending on the usage.

One more thing to notice here is that most of the patients use mouthwashes to mask the halitosis which may be due to local factors or systemic. One common local factor may be the use of tobacco or alcohol in their habits which gives added cytological stress to the oral mucosa.

prophylactically using amlexanox gel over areas of prodromal phase has shown to reduce the severity of pain in RAS, then use of the topical antiseptic-anesthetic agents helps a lot in speedy recovery, multivitamins and nutritional supplements should be given to patient as they help the healing process.

Tatini Claudia's reference is correct but Fraction C was later identified as Capsular-polysaccharide. I attach an excerpt from my recent book that explains what C-polysaccharide is and its relevance to inflammation. The reference and URL of the book are: M. Levine, Periodontal disease: Section 13.3.1: Long-term Effects of Persistent PAMP Stimulation, In: Topics in Dental Biochemistry, Chapter 13. Published Online by Springer, 2011. See:http://www.springer.com/medicine/dentistry/book/978-3-540-88115-5)

EXCERPT: Activated leukocytes induce the synthesis and secretion from the liver of an unrelated set of proteins called acute-phase proteins. One such protein, C-reactive protein (CRP) was originally identified as binding to the phosphocholine attachment site of capsular polysaccharide (C-polysaccharide) from Streptococcus pneumoniae. CRP in blood has a half life of less than a day, compared with 4 days for fibrinogen. A continuously elevated CRP content indicates a persistent proinflammatory stimulus in the body. CRP binds to host or bacterial phosphocholine, and the complex activates a group of plasma proteins called complement (Sect. 3.3.2). The complement system resembles the blood clotting system, except that proteolytic cleavage of its components results in peptide fragments that to attract and enhance the phagocytosis (opsonization) of CRP- or antibody-bound material by macrophages (like IL-1 or IL-8). CRP is part of the innate immune response, and the antibody response is part of the acquired immune response (Sect. 12.1.4). For further details see also J Immunol. 1984 Sep;133(3):1424-30. PMID: 6747291

NOTE: PAMPs in the Chapter sub-heading are “Pathogen-Associated Molecular Patterns” whose nature and role in activating inflammation is described in section 13.2.1 and section 13.2.2 of the book.

Thanks for contributions. This article published by Pogrel is really very good and will help us, so thank you Dr Bharkava. When I was in my post-graduate I followed one case reported in this attached paper and the results using calcitonin spray was very good in a growing child and really costed much time like said Dr Varol. Now I´m treating an adult woman with a large CGCG intra-osseous.