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Objectives: To investigate the role of oral lichen planus (OLP) on the long‐term prognosis of oral epithelial dysplasia (OED). Methods: Retrospective single‐centre cohort study using the 2007–2019 database of the Head and Neck Cancer and Oral Medicine units of University College London Hospital. The exposure of interest was the presence of OLP, and the prognostic outcomes included the development of new primary episodes of OED, progression to malignancy and mortality. Cox proportional hazard and Poisson regression models were performed. Results: A total of 299 patients, of whom 144 had OED arising on the background of OLP (OLP/OED) and 155 had OED without underlying OLP (non‐OLP/OED), were included. A pre‐existing diagnosis of OLP was significantly associated with a twofold increased risk of subsequent primary OED events (HR = 2.02, p = 0.04), which also developed faster (1.46 vs. 2.96 years, p = 0.04) and with more involvement of non‐cancer‐prone sites (p = 0.001) than in the non‐OLP/OED group. There was no difference between groups in the progression to malignancy or mortality. Conclusions: Oral lichen planus/OED patients are at higher risk of multiple episodes of primary OED, which can develop faster and at non‐cancer‐prone sites as compared to non‐OLP/OED individuals. Further research is needed to clarify the effects of OLP upon progression to OSCC and mortality. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this cross‐sectional study was to explore the structural validity and internal consistency reliability of General Anxiety Disorder‐7, Patient Health Questionnaire‐8, 15 and Jaw Functional Limitation Scale‐20 in patients with chronic pain of temporomandibular disorders. Materials and Methods: Validity and reliability were assessed in 129 patients diagnosed according to the diagnostic criteria for temporomandibular disorders. Structural validity was explored using factor analysis, and internal consistency by calculating Cronbach α. Results: Confirmatory factor analysis revealed a suitable 2‐factor model for Patient Health Questionnaire‐8, with Cronbach α of 0.89, and 0.86. One and 2‐factor models were suitable for General Anxiety Disorder‐7, with overall Cronbach α of 0.93 for the 1‐factor model, and 0.91 and 0.84 for both factors in a 2‐factor model. A 4‐factor solution was appropriate for Patient Health Questionnaire‐15, with Cronbach α of 0.72, 0.57, 0.71 and 0.73 for each factor separately. Exploratory factor analysis was conducted to explore the factor structure of Jaw Functional Limitation Scale 20, and a 3‐factor solution was appropriate. Conclusions: This study provides positive evidence of structural validity and internal consistency of these questionnaires in patients with pain of temporomandibular disorders. However, additional testing is required to explore further psychometric properties. [ABSTRACT FROM AUTHOR]

Objectives: To explore the experiences of patients with temporomandibular disorders (TMDs) with the National Health Service and to discover their healthcare priorities when seeking treatment. Methods: Semi‐structured interviews were used. They were directed using a topic guide covering subjects such as initial visits in primary care, referrals to secondary care, and the effect on symptoms. The discussions were audiotaped and transcribed verbatim. Thematic analysis was utilised to analyse the data. Results: In total, 15 participants took part in three focus groups. Six themes were identified: "access to appropriate care", "organised and coordinated care", "receiving a diagnosis and enough information", "interaction with the clinical staff", "treatment strategies and having an 'action plan'" and "support and social networks". Conclusions: The participants gave accounts of the difficulties encountered in healthcare in general terms and specific to TMD. Most notable was the struggle to access appropriate care, receive a diagnosis and be understood. Our findings suggest that delays in delivering appointments with people of expertise may have caused the worsening of symptoms. However, when a pleasant experience was encountered, access to care was fast, the clinician was understanding and communication with the clinical team was good. These provided positive experiences and were appreciated by the patients. [ABSTRACT FROM AUTHOR]

Objective: To preliminary evaluate the clinical effects of probiotics in individuals with symptomatic oral lichen planus and the possible mechanisms of action. Subjects and Methods: A group of 30 individuals with symptomatic oral lichen planus were recruited in a randomised double‐blind parallel group controlled (1:1) proof‐of‐concept pilot trial of probiotic VSL#3 vs placebo. Efficacy outcomes included changes in pain numeric rating scale, oral disease severity score and the chronic oral mucosal disease questionnaire. Adverse effects, home diary and withdrawals were assessed as feasibility outcomes. Mechanistic outcomes included changes in salivary and serum levels of CXCL10 and IFN‐γ and in oral microbial composition. Results: The probiotic VSL#3 was safe and well tolerated. We observed no statistically significant change in pain, disease activity, quality of life, serum/salivary CXCL10 or oral microbial composition with respect to placebo. Salivary IFN‐γ levels demonstrate a trend for a reduced level in the active group (p = 0.082) after 30 days of probiotic consumption. Conclusions: The present proof‐of‐concept study provides some weak not convincing indication of biological and clinical effects of probiotic VSL#3 in individuals with painful oral lichen planus. Further research in this field is needed, with the current study providing useful information to the design of future clinical trials. [ABSTRACT FROM AUTHOR]