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The success of evidence-based medicine depends on the integration of the best research evidence. It is a blend of our patient’s unique values and circumstances with our clinical expertise. Evidence-based dentistry is a new paradigm in medicine, meaning that a therapy should be based on evidence gathered from scientifi c studies, preferentially based on randomized clinical trials involving a substantial number of patients. There are three main inter-related aspects to the practice of oral medicine. They are clinical care, research, learning, and teaching. Most of the oral diseases are complex, chronic problems that do not have defi nitive etiology. Many diagnostic tests are costly and need to be critically evaluated for their sensitivity, specifi city and cost benefi ts analysis. Most treatment protocols are opinion based, and prognosis of many oral diseases is diffi cult to predict. Hence, practice of evidence-based health care in oral medicine will defi nitely be helpful when clinical decisions are made.

Background: Pyogenic granuloma (PG) is a benign non-neoplastic mucocutaneous lesion. PG is manifested as a sessile or pedunculated, resilient, erythematous, exophytic and painful papule or nodule with a smooth or lobulated surface that bleeds easily. PG preferentially affects the gingiva, but may also occur on the lips, tongue, oral mucosa and palate. .This paper presents an unusual case report where pyogenic granuloma was present on the upper labial mucosa .Besides , the clinical presentation presents a platform to discuss some unusual differential diagnosis of PG like Squamous Papilloma, Mucocele with PG and Traumatic eosinophilic granuloma.

To report a case of fi xed drug eruption (FDE) due to paracetamol intake. FDE is cutaneous reactions in already sensitized individuals. The characteristic of FDE is recurrence at same site on repeated insults with the off ending drug. Paracetamol induced FDE is widely reported in children and adolescents but not among elderly individuals. A 62-year-old male patient had a chief complaint of burning sensation in lips and oral cavity since 3 days. History revealed intake of paracetamol. Encrusted lesions were present on the cutaneous surfaces of lips, and erythematous areas were present on the anterior third of the hard palate. Based on Naranjo’s casualty assessment scale, provisional diagnosis of adverse drug reaction (ADR) was given. All drugs were stopped, but the patient had a similar episode of such lesions on the same site after 8 weeks. This establishes the diagnosis of FDE due to paracetamol ingestion. Though paracetamol is widely used and is considered a safe drug, ADR to it are possible and reported earlier. Clinical signifi cance: Reporting of FDE to dentist is uncommon. But on encountering such a situation, the dentist should be able to identify FDE and isolate the causative drug by means of history. A simple clinical assessment scale like Naranjo’s casualty assessment scale can establish the presence of ADR.