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Objectives: Reports on stress-associated halitosis are scarce and have only focused on intraoral halitosis. This work aimed to study stress-associated extraoral halitosis (EOH) and further investigate its potential association with stress-induced intestinal inflammation., Methods: This retrospective study included 664 white-collar employees with self-reported stress-associated halitosis. They underwent the organoleptic score (OLS) to assess halitosis, modified Brief Job Stress Questionnaire (BJSQ) score to assess job stress, OralChroma breath test to measure volatile sulfur compounds (VSCs) in breath, and hydrogen/methane breath test (HMBT) and nitric oxide breath test (NOBT) to detect intestinal inflammation. They were classified into high-stress and low-stress groups based on their modified BJSQ score., Results: Totally, 106 eligible patients were identified as having stress-associated EOH, and 61 of them had high stress. Additionally, 70 (66.04%) and 73 (68.87%) of them tested positive for HMB and NOBT, respectively. Dimethyl sulfide (DMS) was found to be the predominant VSC in breath. High-stress patients had significantly higher positivity rates for HMBT and NOBT, OLS, and exhaled DMS levels compared to low-stress patients. HMBT-positive patients and NOBT-positive patients had significantly higher OLS and exhaled DMS levels compared to their respective negative counterparts., Conclusions: Job stress can lead to intestinal inflammation and subsequent gut-originated EOH., (© 2024 John Wiley & Sons Ltd.)

Objective: This study aimed to explore perceived barriers to early diagnosis and management of oral cancer, as well as potential pathways for improvement in Latin America and the Caribbean (LAC)., Methods: This cross-sectional study used a self-administered online questionnaire created via the Research Electronic Data Capture platform. The survey was distributed to health professionals trained in Oral Medicine, Oral Pathology, Oral and Maxillofacial Surgery, and Dentists with clinical and academic expertise in oral potentially malignant disorder (OPMD) and oral cancer. Data obtained were systematically organized and analyzed descriptively using Microsoft Excel., Results: Twenty-three professionals from 21 LAC countries participated. Major barriers included the limited implementation of OPMD and oral cancer control plans (17.4%), low compulsory reporting for OPMD (8.7%) and oral cancer (34.8%), unclear referral pathways for OPMD (34.8%) and oral cancer (43.5%), and a shortage of trained professionals (8.7%). Participants endorsed the utility of online education (100%) and telemedicine (91.3%)., Conclusion: The survey highlights major perceived barriers to early diagnosis and management of OPMD and oral cancer in LAC, as well as potential avenues for improvement., (© 2024 Wiley Periodicals LLC.)

Objective: Proper identification of oral potentially malignant disorders (OPMDs) provides an opportunity for oral cancer prevention. This study aims to assess the competency of dental health professionals in identifying OPMDs and, in turn, reducing the incidence of oral malignancy by early detection., Methods: A 26-case online questionnaire of oral mucosal lesions was distributed to cohorts of 363 dental health professionals and dental students in Australia. The participants were asked to provide their provisional diagnosis for each case based on the available information., Results: The overall accuracy in identifying oral mucosal lesions was 65.9%. There were no significant differences in the overall diagnostic accuracies between dental specialists, general dental practitioners and final-year dental students (p > 0.05). The lowest diagnostic accuracies were associated with normal mucosal variations and OPMDs. The predoctoral dental curriculum showed statistically significant values in terms of improving skills in diagnosing oral mucosal lesions., Conclusions: Lack of adequate knowledge in identifying OPMDs was evident among the participants, highlighting a non-promising figure in reducing the incidence of oral cancers in Australia. Comprehensive modifications of the current continuing professional development system are required to ensure adequate knowledge among dental health providers in Australia., (© 2023 The Authors. Oral Diseases published by Wiley Periodicals LLC.)

Objective: To determine the frequency of oral squamous cell carcinoma (OSCC) associated or not with oral potentially malignant disorders (OPMD), and the epidemiological profile and traditional risk factors in Latin America., Methods: A retrospective observational study was conducted in 17 Latin American centres. There were included cases of OSCC, analysing age, gender, OSCC and their association with previous OPMD. Clinicopathological variables were retrieved. The condition of sequential-OSCC versus OSCC-de novo (OSCC-dn) was analysed concerning the aforementioned variables. Quantitative variables were analysed using Student's t-test, and qualitative variables with chi-square., Results: In total, 2705 OSCC were included with a mean age of 62.8 years old. 55.8% were men. 53.75% of the patients were smokers and 38% were common drinkers. The lateral tongue border was the most affected site (24.65%). There were regional variations in OPMD, being leukoplakia the most frequent. Of the overall 2705 OSCC cases, 81.4% corresponded to OSCC-dn, while s-OSCC were 18.6%. Regarding lip vermillion SCC, 35.7% corresponded to de novo lip SCC and 64.3% were associated with previous OPMD., Conclusions: In Latin America, OSCC-dn seems to be more frequent with regional variations of some clinical and histopathological features. Further prospective studies are needed to analyse this phenomenon., (© 2023 Wiley Periodicals LLC.)

Objectives: Evaluate whether regular follow-up of oral leukoplakia (OL) resulted in early detection of malignant transformation (MT)., Method: Two hundred and twenty-two consecutive patients with OL (147 females, 75 males); median follow-up period of 64 months (range: 12-300). Three groups were distinguished: group A (n = 92) follow-up at the hospital; group B (n = 84) follow-up by their dentist; group C (n = 46) lost to follow-up., Results: OLs in group B compared to group A, were smaller in size (<2 cm; p < 0.001), showed more hyperkeratosis (p < 0.001) and less moderate/severe dysplasia (p < 0.001). MT occurred in 45 (20%) patients: 32 (35%) in group A, five (6%) in group B and eight (17%) in group C. There was no significant difference in clinical tumour size between group A (median: 15 mm, range: 1-40) and group B (median: 10 mm, range: 3-25; p = 0.496). Tumour size was smaller for patients in groups A and B (median: 10 mm, range 1-40) compared to group C (median: 33 mm, range: 3-100; p = 0.003). There was a positive correlation between tumour size and interval between the last visit in all patients (p = 0.022)., Conclusion: Regular follow-up of OL resulted in early detection of MT. If properly selected, follow-up of OL performed by the dentist seems feasible., (© 2023 The Authors. Oral Diseases published by Wiley Periodicals LLC.)

Background: Oral cancer and Oral Potentially Malignant Disorders (OPMD) are major health problems in South and Southeast Asia., Aims: To describe and discuss the clinical aspects of Oral Cancer and OPMD in South and Southeast Asia., Materials and Methods: Literature review of concepts and data over the last four decades., Discussion: Asian countries account for about two-thirds of new cases of oral cancer (OC) globally, with the highest burden in the South and Southeast Asian countries, including Pakistan and India. Habits, dietary patterns, socioeconomic status, and access to routine dental care play a crucial role in defining the demographics and clinical presentation of OC in these regions and significantly influence the morbidity and mortality of the disease. This region sees the use of different types of tobacco with or without areca nut (AN), such as pan masala, gutka, gul, snuff, mawa, and mishri. Tobacco use is high among men in Sri Lanka, Myanmar, Maldives, Bangladesh, Nepal, India and Bhutan. Areca nut is the fourth most common addictive substance globally and is frequently used in South and Southeast Asian countries, including Southeast China, Hainan Island, India, Taiwan, and the Pacific Islands, and immigrants from these regions in Africa, Europe, and North America. The use of these products results in mucosal alterations with varied clinical presentation of Oral Potentially Malignant Disorders (OPMDs) and OC. We discuss here the different types of OPMD and OC, the diagnostic aids and their relevance in clinical practice, and factors that influence their prognosis., (© 2024 Wiley Periodicals LLC.)

The article offers information on the impact of the Covid-19 pandemic on oral biopsies in the Brazilian National Health System. It mentions that healthcare community concentrated its efforts in the development of biosafety protocols. It discusses that diagnosis of oral cancer in early stages as one of the most critical factors related to the patient's survival.

Early diagnosis and radical surgical excision of oral squamous cell carcinomas are essential for achieving optimal treatment outcomes. To date, diagnostic tools that rely on anatomical anomalies provide limited information and resolution in clinical practice. As a result, oral cancer is often detected in an advanced stage. Also, no reliable real‐time intraoperative tools are readily available for the evaluation of surgical resection margins. Fluorescence imaging visualises biological processes that occur in early carcinogenesis and could, therefore, enable detection of small tumours in early stages. Furthermore, due to the high sensitivity and spatial resolution, fluorescence imaging could assist in resection margin assessment during surgery. In this review, we discuss several techniques that employ fluorescence for early diagnosis and surgical guidance in oral squamous cell carcinoma and present future perspectives on the potential of fluorescence imaging in oral cancer in the near future. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to examine the association between hyperglycemia and the malignant transformation of oral leukoplakia (OLK). Patients and Methods: This retrospective case–control study involved 133 patients with the malignant transformation of OLK into oral squamous cell carcinoma (case group) and 266 patients with untransformed OLK (control group). The clinical history and follow‐up data included age, gender, lesion size and location, and fasting plasma glucose. Logistic regression analysis, Kaplan–Meier survival analysis, and univariate and multivariate Cox regression analyses were used to assess the effects of risk factors on the malignant transformation of OLK. Results: Hyperglycemia (adjusted hazard ratio [AHR] = 4.7, p =.001), non‐homogenous OLK (AHR = 3.0, p <.001), location of the lesion on the ventral surface of the tongue or floor of the mouth (AHR = 3.6, p <.001), and epithelial dysplasia (AHR = 2.8, p =.005) had significant effects on the malignant transformation of OLK. Conclusion: Hyperglycemia, non‐homogenous OLK, location of the lesion on the ventral surface of the tongue or floor of the mouth, and epithelial dysplasia might be associated with malignant transformation of OLK. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to systematically review the efficacy of direct optical fluorescence imaging as an adjunct to comprehensive oral examination in the clinical evaluation, risk assessment and surgical management of oral cancer and potentially malignant disorders. Methods: Studies adopting autofluorescence devices, evaluating the efficacy of comprehensive oral examination and optical fluorescence imaging in detection, visualisation or management of oral squamous cell carcinoma or oral potentially malignant disorders, as well as discriminating oral epithelial dysplasia from other mucosal lesions, were included in the literature search across bibliographic databases until October 2018. Results: Twenty‐seven studies were found to be eligible for inclusion in qualitative analysis. Of these, only six studies demonstrated a low risk of bias across all domains of the methodological assessment tool (QUADAS‐2). Optical fluorescence imaging demonstrated positive results, with higher sensitivity scores, increased lesion detection and visualisation than comprehensive oral examination alone in the clinical evaluation of oral squamous cell carcinoma and oral potentially malignant disorders. Conclusions: This review provides promising evidence for the utilisation of optical fluorescence imaging as an adjunct to comprehensive oral examination in varying clinical settings. It is important that devices utilising optical fluorescence imaging are viewed strictly as clinical adjuncts and not specifically as diagnostic devices. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to distinguish salivary metabolites in oral squamous cell carcinoma (OSCC) from those in oral lichen planus (OLP) to identify practical biomarkers for the discrimination of OSCC from OLP. Subjects and Methods: Whole unstimulated saliva samples were collected from patients with OSCC (n = 34) and OLP (n = 26). Hydrophilic metabolites in the saliva samples were comprehensively analysed by capillary electrophoresis mass spectrometry. To evaluate the discrimination ability of a combination of multiple markers, a multiple logistic regression (MLR) model was developed to differentiate OSCC from OLP. Results: Fourteen metabolites were found to be significantly different between the OSCC and OLP groups. Among them, indole‐3‐acetate and ethanolamine phosphate were used to develop the MLR model. The combination of these two metabolites showed a high area under the receiver operating characteristic curve (0.856, 95% confidential interval: 0.762–0.950; p <.001) for discriminating OSCC from OLP. Conclusions: We identified salivary metabolites for discerning between OSCC and OLP, which is clinically important for detecting the malignant transformation of OLP by both dentists and oral surgery specialists. Our candidate salivary metabolites show potential for non‐invasive screening of OSCC versus OLP. [ABSTRACT FROM AUTHOR]

Objectives: Our aim was to identify and prevalidate a set of salivary proteins that can distinguish oral squamous cell carcinomas (OSCC) patients from healthy individuals and patients with oral potentially malignant disorders (OPMD). Subjects and methods: Proteomes of 60 saliva samples from healthy individuals, OPMD patients, and OSCC patients were assayed using the isobaric tags for relative and absolute quantitation (iTRAQ) method. Enzyme‐linked immunosorbent assay (ELISA) was used to prevalidate the candidate biomarkers in an independent sample set (n = 90). Results: In total, 246 differentially expressed proteins were identified by comparing each two groups, and 21 proteins were differentially expressed when OSCC was compared with both OPMD and Control. Three proteins, namely, solute carrier family 3 member 2 (SLC3A2), S100 calcium‐binding protein A2 (S100A2), and interleukin‐1 receptor antagonist protein (IL1RN), were selected as candidate biomarkers. Comparing the OSCC group with the healthy group, the area under curve (AUC) of the three combined biomarkers was 0.89, with a sensitivity of 83.33% and a specificity of 83.33%. Comparing the OSCC group with the OPMD group, the AUC value was 0.87, with a sensitivity of 93.33% and a specificity of 70.00%. Conclusion: Our study indicates that salivary proteomics is promising for the discovery of OSCC biomarkers. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the impact of more open access to health services by Thailand's universal health coverage (UHC) on diagnostic delay of oral squamous cell carcinomas (OSCC) by comparing results with our previous study prior to the UHC. Reasons for delay in attending healthcare professional (HCP) consultation were also investigated. Methods: A structure questionnaire was employed to interview 154 OSCC consecutive patients. Variables were included for Cox proportional regression models to conclude the hazard ratio of each delay. Results: Regarding patient delay, those who had more than 12‐year education showed less delay (HR 0.46, 95% CI: 0.21–1.01) while longer delay was found in farmers (HR 1.49, 95% CI: 1.05–2.11). Compared with the previous study, there was no association between herbal medication and patient delay, herbal medication and total delay, nor religion and total delay. Professional delay showed no association with any variable. Only half of the patients received initial proper HCP management in both studies. Patient delay was mostly (89.9%) due to unawareness of the lesion severity. Conclusions: Open access to the healthcare system had an influence on diagnostic delay. Public education and precise clinical acumen by HCPs in OSCC diagnosis are needed for early detection. [ABSTRACT FROM AUTHOR]