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Background: Most head and neck (H&N) cancer patients receive high-dose external beam radiation therapy (RT), often in combination with surgery and/or chemotherapy. Unfortunately, high-dose RT has significant adverse effects on the oral and maxillofacial tissues, some of which persist for the life of the patient. However, dental management of these patients is based largely on individual and expert opinion, as few studies have followed patients prospectively to determine factors that predict adverse oral sequelae. In addition, many previous studies were conducted before wide-spread adoption of intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy. The objective of this multi-center study is to systematically evaluate the oral health of subjects for 2 years after commencement of RT, with the goal of identifying risk factors that predict adverse oral outcomes post-RT., Methods: This is a prospective multi-center longitudinal cohort study of H&N cancer patients who receive high-dose RT with curative intent. Planned enrollment is 756 subjects at 6 primary clinical sites (and their affiliated sites) in the USA. A baseline visit is conducted prior to the beginning of RT. Follow-up visits are conducted at 6, 12, 18 and 24 months from the start of RT. The primary outcome measure is the 2-year rate of tooth loss in patients who have received at least one session of external beam RT for H&N cancer. Secondary outcome measures include the incidence of exposed intraoral bone; incidence of post-extraction complications; change in Decayed Missing and Filled Surfaces (DMFS); change in periodontal measures; change in stimulated whole salivary flow rates; change in mouth opening; topical fluoride utilization; chronic oral mucositis incidence; changes in RT-specific quality of life measures; and change in oral pain scores., Discussion: This study will contribute to a better understanding of the dental complications experienced by these patients. It will also enable identification of risk factors associated with adverse outcomes such as tooth loss and osteoradionecrosis. These findings will support the development of evidence-based guidelines and inform the planning of future interventional studies, with the goal of advancing improvements in patient care and outcomes., Trial Registration: ClinicalTrials.gov Identifier NCT02057510 , registered 5 February 2014.

Objective: Compare the safety and efficacy of topical gentian violet with that of nystatin oral suspension (NYS) for the treatment of oropharyngeal candidiasis in HIV-1-infected adults in resource-limited settings., Design: Multicenter, open-label, evaluator-blinded, randomized clinical trial at eight international sites, within the AIDS Clinical Trials Group., Study Participants and Intervention: Adult HIV-infected participants with oropharyngeal candidiasis, stratified by CD4 cell counts and antiretroviral therapy status at study entry, were randomized to receive either gentian violet (0.00165%, BID) or NYS (500 000 units, QID) for 14 days., Main Outcome Measure(s): Cure or improvement after 14 days of treatment. Signs and symptoms of oropharyngeal candidiasis were evaluated in an evaluator-blinded manner., Results: The study was closed early per Data Safety Monitoring Board after enrolling 221 participants (target = 494). Among the 182 participants eligible for efficacy analysis, 63 (68.5%) in the gentian violet arm had cure or improvement of oropharyngeal candidiasis versus 61 (67.8%) in the NYS arm, resulting in a nonsizable difference of 0.007 (95% confidence interval: -0.129, 0.143). There was no sizable difference in cure rates between the two arms (-0.0007; 95% confidence interval: -0.146, 0.131). No gentian violet-related adverse events were noted. No sizable differences were identified in tolerance, adherence, quality of life, or acceptability of study drugs. In gentian violet arm, 61 and 39% of participants reported 'no' and 'mild-to-moderate' staining, respectively. Cost for medication procurement was significantly lower for gentian violet versus NYS (median $2.51 and 19.42, respectively, P = 0.01)., Conclusion: Efficacy of gentian violet was not statistically different than NYS, was well tolerated, and its procurement cost was substantially less than NYS.

Empirical support for the factor structure of the Child Oral Health Impact Profile (COHIP) has not been fully established. The purposes of this study were to evaluate the factor structure of the Korean version of the COHIP (COHIP-K) empirically using confirmatory factor analysis (CFA) based on the theoretical framework and then to assess whether any of the factors in the structure could be grouped into a simpler single second-order factor. Data were collected through self-reported COHIP-K responses from a representative community sample of 2,236 Korean children, 8-15 yr of age. Because a large inter-factor correlation of 0.92 was estimated in the original five-factor structure, the two strongly correlated factors were combined into one factor, resulting in a four-factor structure. The revised four-factor model showed a reasonable fit with appropriate inter-factor correlations. Additionally, the second-order model with four sub-factors was reasonable with sufficient fit and showed equal fit to the revised four-factor model. A cross-validation procedure confirmed the appropriateness of the findings. Our analysis empirically supported a four-factor structure of COHIP-K, a summarized second-order model, and the use of an integrated summary COHIP score., (© 2016 Eur J Oral Sci.)

Objectives: Strategies to prevent new-onset and recurrent oral manifestations of human immunodeficiency virus (HIV), including fungal, viral, neoplastic, and idiopathic mucosal diseases and destructive periodontal conditions, are poorly understood., Study Design: A structured review of the English language literature in PubMed through March 2015 was conducted to identify current prevention strategies for initial and recurrent oral manifestations of HIV., Results: Pharmacologic approaches, including combination antiretroviral therapy or other targeted therapies for prevention of oropharyngeal candidiasis, orolabial herpes, oral hairy leukoplakia, oral Kaposi sarcoma, linear gingival erythema and necrotizing ulcerative periodontitis were found. Nonpharmacologic approaches for prevention of oropharyngeal candidiasis, orolabial herpes, oral hairy leukoplakia, and necrotizing ulcerative periodontitis are presented., Conclusions: Current strategies for the prevention of oral manifestations of HIV include pharmacologic and nonpharmacologic therapies. Immune reconstitution inflammatory syndrome, future vaccine therapy for pathogens causing oral mucosal disease, and the possible role of oral inflammatory disease prevention in controlling HIV disease progression are discussed., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objectives: Dosimetric distribution of intensity-modulated radiotherapy (IMRT) to tooth-bearing areas for common head and neck (H&N) cancer sites were analyzed to facilitate minimization of osteoradionecrosis (ORN) risk through preradiation dental treatment planning., Study Design: Fifty-four patients received IMRT with prescribed doses ranging from 6000 centigrays (cGy) (adjuvant) to 6930 cGy (primary) to treat base of tongue (BOT), tonsil, larynx, nasopharynx, and hypopharynx cancers. The average maximal radiation dose delivered was recorded in tooth-bearing areas (anteriors, premolars, and first, second, and third molars) of the maxilla and mandible., Results: All tooth-bearing areas in laryngeal cancer cases received less than 2500 cGy. Maxillary and mandibular molar regions for BOT, tonsil, and hypopharynx cancers received 5000 cGy or higher. In nasopharynx cancers, maxillary teeth received higher doses than mandibular teeth., Conclusions: Among 5 H&N subsites, mandibular molar regions for BOT, tonsil, and hypopharynx cancers received higher IMRT doses on average, posing the greatest ORN risk., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: Oropharyngeal candidiasis (OPC) is a major cause of morbidity in patients with malignancies. It is a common complication of head and neck radiation therapy and can result in pain, dysgeusia (taste changes), anorexia, malnutrition, and esophageal or systemic dissemination. Clinicians should be aware of current epidemiology, elements of diagnosis, and therapeutic trials guiding the recent recommendations for prophylaxis and management of OPC, a disease often incorrectly perceived as benign.Methods: This review discusses OPC with focus in head and neck cancer patients receiving radiotherapy.Results: Local treatments are recommended as first-line therapy in milder forms of OPC. In the setting of local therapy, products that provide prolonged contact time and are not sucrose sweetened may result in successful prevention and management with low risk of oral/dental complications.Conclusion: Diagnosis and management of OPC is required in head and neck cancer patients treated with radiation. Local therapy is suggested as first-line treatment for OPC, unless severe clinical infection or high risk immune suppression necessitate systemic therapy. The availability of effective locally delivered (topical) medications may provide potential for prophylaxis for carriers of Candida species in head and cancer patients during radiation therapy. [ABSTRACT FROM AUTHOR]

PURPOSES: To investigate the distribution of modifiable oral and general health risk behaviors according to socioeconomic status and to examine the extent of clustering of risk behaviors among Korean adolescents. METHODS: Self-reported data from 71,404 adolescents were obtained using a stratified cluster sample of students in the 7th to 12th grades who participated in the Korea Youth Risk Behavior Web-based Survey. Multiple logistic regression analysis was used to determine the influence of family affluence on health behaviors and the strength of associations of general health behaviors in models for oral health behaviors. RESULTS: Adolescents of high family affluence level were more likely to frequently brush their teeth, receive preventive dental care, eat breakfast, exercise regularly and become drunk, and were less likely to frequently smoke compared with those from less affluent families. Those who brush their teeth frequently were 19% less likely to smoke, 1.26 times more likely to eat breakfast, and 1.15 times more likely to do exercise. Those who received preventive dental care during the past year were 1.1 times more likely to smoke frequently and 1.38 times more likely to experience drunkenness once or more during the past year. CONCLUSIONS: The co-occurrence of oral and general health risk behaviors among Korean adolescents and relatedness to the underlying socioeconomic environment suggest that clustering of health behaviors occurs before adulthood. Integrated efforts toward oral and general health promotion in the socioeconomic construct of the family environment may be needed to effect change in health risk behaviors among adolescents. [ABSTRACT FROM AUTHOR]

Purpose: The aims of this systematic review were to determine, in patients receiving cancer therapy, the prevalence of clinical oral fungal infection and fungal colonization, to determine the impact on quality of life and cost of care, and to review current management strategies for oral fungal infections.Methods: Thirty-nine articles that met the inclusion/exclusion criteria were independently reviewed by two calibrated reviewers, each using a standard form. Information was extracted on a number of variables, including study design, study population, sample size, interventions, blinding, outcome measures, methods, results, and conclusions for each article. Areas of discrepancy between the two reviews were resolved by consensus. Studies were weighted as to the quality of the study design, and recommendations were based on the relative strength of each paper. Statistical analyses were performed to determine the weighted prevalence of clinical oral fungal infection and fungal colonization.Results: For all cancer treatments, the weighted prevalence of clinical oral fungal infection was found to be 7.5% pre-treatment, 39.1% during treatment, and 32.6% after the end of cancer therapy. Head and neck radiotherapy and chemotherapy were each independently associated with a significantly increased risk for oral fungal infection. For all cancer treatments, the prevalence of oral colonization with fungal organisms was 48.2% before treatment, 72.2% during treatment, and 70.1% after treatment. The prophylactic use of fluconazole during cancer therapy resulted in a prevalence of clinical fungal infection of 1.9%. No information specific to oral fungal infections was found on quality of life or cost of care.Conclusions: There is an increased risk of clinically significant oral fungal infection during cancer therapy. Systemic antifungals are effective in the prevention of clinical oral fungal infection in patients receiving cancer therapy. Currently available topical antifungal agents are less efficacious, suggesting a need for better topical agents. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To establish incidence rates and risk factors for HIV-associated oral candidiasis (OC), oral hairy leukoplakia (OHL), and any HIV-associated oral diseases (HIV-OD). DESIGN: This prospective, cumulative case-control study followed 283 initially oral disease-free HIV-1-infected men and women for 2 years. Incidence rate ratios (IRR) and incidence proportions for OC, OHL, and HIV-OD were estimated. Multivariable analyses using Poisson regression determined the most parsimonious best-fitting model explaining the outcomes. RESULTS: Incidence rate (per 1000 person-months) was 9.3 for OC, 6.8 for OHL, and 13.5 for HIV-OD. Incidence of OC was associated with low CD4 count (adjusted IRR = 3.0 (95% CI = 1.7, 5.1)), smoking (IRR = 1.9 (1.0, 3.8)) and combination antiretroviral therapy (IRR = 0.3 (0.1, 0.8)). Incidence of OHL was associated with low CD4 count, conditional upon smoking status. Conclusions Low CD4 count and smoking are important risk factors for HIV-associated OC and OHL. Antiretroviral medications are protective for OC but not for OHL. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To assess the accuracy of HIV/AIDS patients' self-diagnosis of common HIV-related oral opportunistic infections. METHODS: 245 HIV/AIDS patients were interviewed regarding the current presence of oral candidiasis (OC), oral hairy leukoplakia (OHL), and oral ulcers prior to an oral examination by an oral medicine trained dentist examiner. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) are reported for the patient's oral lesion diagnosis compared to the dentist's diagnosis based on established presumptive clinical criteria as the gold standard. RESULTS: Self-diagnosis accuracy was greatest for pseudomembraneous OC (PPV 42.9%; NPV 93.5%), followed by oral ulcers (PPV 35.7%; NPV 98.3%) and OHL (PPV 23.5%; NPV 86.4%). Past experience with the lesion improved diagnostic accuracy, and bothersome symptoms accompanying the lesion had significant impact only for pseudomembraneous OC and oral ulcers. CONCLUSIONS: Moderate accuracy of patient self-assessment of oral lesions, with tendency to under rather than over report lesion presence, supports the use of patient self-assessment of these lesions to augment clinician diagnosis in clinical trials. Additionally, HIV/AIDS patients are unlikely to believe they have active OC that would lead to on-demand antifungal use, unless they have had prior experience with the lesion or it is at least moderately bothersome. [ABSTRACT FROM AUTHOR]

Purpose: Oral complications are common in children undergoing head and neck radiation and chemotherapy. The purpose of this study is to examine the knowledge, perceived ability and practice behaviors of pediatric oncology and hematology nurses in assisting with the various oral health care needs of pediatric oncology patients and to identify pediatric oncology nurses' previous training/education, practice types and other demographic characteristics that are related to their oral health competencies., Methods: A survey of a convenience sample of Pediatric Oncology and Hematology Nurses was conducted during the Association of Pediatric Oncology and Hematology Nurses' (APHON) 36(th) Annual Conference and Exhibit. Descriptive analysis and the exploratory factor analyses were performed using SAS version 9.2 (SAS Institute, Inc., Cary, NC)., Results: Among the 300 surveys that were distributed, 235 surveys were completed (78% response rate) by pediatric oncology or hematology nurses who provide direct patient care in the U.S. Approximately 75% reported receiving less than 3 hours of oral health related education/training. Sixty percent did not have a clinical requirement regarding the assessment of the teeth and gums during their nursing school education. Bivariate analyses indicated that nurses who had clinical requirements regarding oral health assessment during nursing education/training presented greater overall oral health competencies including having greater confidence in examining oral complications than those who did not., Conclusion: Pediatric oncology nurses' knowledge, perceived ability and practice in assisting patient's oral hygiene care, preventing and managing oral complications vary by topic and might reflect their educational preparedness. This study may provide valuable information pertaining to the need and opportunity for interprofessional oral health care education and collaboration with nursing and dental professionals, in order to increase access to comprehensive oral care for pediatric cancer patients., (Copyright © 2015 The American Dental Hygienists’ Association.)

This study aimed to assess the perception of the family's primary caregiver on the oral health-related quality of life (OHRQoL), and the impact on family dynamics, of dental treatment under general anesthesia (GA) in adolescent and adult patients with intellectual and developmental disabilities (IDD) and neurocognitive disorders. Self-administered questionnaires were completed, before dental treatment, by 116 primary family caregivers of patients who received dental treatment under GA, and 102 (88%) of these caregivers completed the same questionnaires within 4 wk after treatment. The Child Oral Health Impact Profile (COHIP) and the Family Impact Scale (FIS) were shortened to a 14-item COHIP (COHIP-14) and a 12-item FIS (FIS-12) based on the limitations of patients' communication. The COHIP-14 and FIS-12 scores and each subscale improved after treatment. The baseline scores varied based on certain characteristics of the patients, such as age, disabilities, medications, caregivers, meal types, cooperation levels, and treatment needs. The postoperative improvement in OHRQoL was significant in the patients who were older than 30 yr of age, originally eating soft meals, displaying no or very low levels of cooperation, or receiving endodontic treatment. Based on the primary caregiver perceptions, the OHRQoL of adolescents and adults with IDD and neurocognitive disorders was improved by dental treatment under GA., (© 2014 Eur J Oral Sci.)

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Oral ulcers are a common oral mucosal disease that seriously affect the quality of life. Traditional drug treatments have shown unsatisfactory efficacy and potential adverse reactions. In this study, curcumin-loaded multifunctional magnesium metal–organic framework-embedded hyaluronic acid-soluble microneedles patches were developed to optimize treatment strategies for oral ulcers. This microneedles patch achieves efficient release of curcumin and Mg2+ in the ulcer through precisely targeted delivery and controllable release mechanism, significantly regulates inflammation, promotes cell migration and angiogenesis, and accelerates the ulcer healing process. At the same time, the synergistic effect of curcumin and gallic acid effectively alleviated oxidative stress, while the backplate ε-poly-l-lysine and needle tip Mg2+ jointly constructed an antibacterial barrier to effectively inhibit pathogens. Verification using an oral ulcer rat model showed that the microneedles patch exhibited excellent therapeutic effects. This not only opens up a new avenue for clinical oral treatment but also marks a breakthrough in nanobiomaterials science and drug delivery technology and heralds a broad prospect in the field of oral ulcer treatment in the future. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review aimed to analyse the published evidence for the use of non-invasive methods for the early detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs). Methods: The literature was systematically searched through several databases: PubMed, Cochrane Library, and Web of Science. Additional exploration was performed through cross-checks on the bibliographies of selected reviews. The inclusion criteria involved studies assessing the application of non-invasive tests on humans in the screening, diagnosis, or surveillance of OSCC or OPMDs and reporting sensitivity (SE) and specificity (SP). The Newcastle–Ottawa scale (NOS) was applied to assess the quality of the studies included. Results: The search strategy resulted in 8012 preliminary records. After a duplicate check, 116 titles remained. After abstract analysis, 70 papers remained. After full text analysis, only 54 of the 70 papers fit the inclusion criteria (28 were original articles and 26 were reviews). Those 26 reviews were used to manually search for further original articles. From this last search, 33 original articles were found. Thus, a total of 61 original studies were included and investigated. Findings from this systematic review indicate useful information, such as a description of the mechanisms, ease of use, limitations, and SE and SP values, to drive the choice of the optimal minimally invasive method to be utilized as an adjunctive tool to examine the suspicious lesions. Conclusions: Each of the analysed tools can be improved or implemented, considering their high SE and low SP. Despite advancements, incisional biopsy continues to be the gold standard for the definitive diagnosis of oral cancer and precancerous lesions. Further research and development are essential to improving the sensitivity, specificity, and reliability of non-invasive tools for widespread clinical application. [ABSTRACT FROM AUTHOR]

Background: This study evaluates a three-dimensional (3D) visualisation design combined with customized surgical guides to assist anterior maxillary segmental distraction osteogenesis (AMSDO) in correcting maxillary hypoplasia in adolescents with cleft lip and palate (CLP), focusing on treatment outcomes, satisfaction and the validity of 3D planning. Methods: This retrospective cohort study was conducted at a single hospital in China. Between January 2020 and December 2023, 12 adolescents with CLP with maxillary hypoplasia were included. An advanced 3D simulation was used to convey the treatment strategy to the patients and their families. A customized surgical guide and distraction osteogenesis device were designed. Cephalometric analysis evaluated AMSDO changes and long-term stability. Patient satisfaction was assessed. The Chinese version of the Child Oral Health Impact Profile was used to evaluate the children's oral health-related quality of life before and after treatment. The postoperative outcomes were compared with the planned outcomes by superimposing the actual postoperative data onto the simulated soft tissue models and calculating the linear and angular differences between them. Results: One patient experienced postoperative gingivitis, yielding an 8.33% complication rate. Most patients (83.33%) were highly satisfied with the target position, with the rest content. Cephalometric analysis showed significant improvements in various indices post-traction. Quality-of-life scores significantly improved post-treatment. The discrepancies in facial soft tissue between the simulated and actual results were within clinically satisfactory ranges. Conclusions: Digitally designed surgical guides effectively treat maxillary hypoplasia in adolescents with CLP, ensuring stability, reducing complications, reducing dependency on operator experience, and enhancing satisfaction and health outcomes. Although the simulated results were clinically acceptable, it is important to inform patients of potential variations in the predicted soft tissue. [ABSTRACT FROM AUTHOR]

Background: European wildcats (Felis silvestris) are widely distributed in Europe and a strictly protected species in Germany. Lately, anthropogenic protective efforts lead to increasing numbers of wildcats in southwestern Germany. Moreover, in recent years the numbers of domestic cats are increasing. Thus, the contact between domestic and wildcats may lead to the spread of zoonotic pathogens in both animal species. As data on vector-borne pathogens (VBPs) in wildcats from Germany are limited to date, the objective of this study was to investigate the presence and current distribution of VBPs in wildcats from southwestern Germany. Methods: Skin and spleen samples from 117 European wildcats, originating from a regional carcass-monitoring program in southwestern Germany, were examined by real-time and conventional polymerase chain reaction (PCR) for the presence of Anaplasma phagocytophilum, Neoehrlichia mikurensis, Rickettsia spp., Bartonella spp., and Piroplasmida. Results: In total, 6.8% (n = 8) of the wildcats were Rickettsia-positive, specified as R. helvetica. Three wildcats were positive for A. phagocytophilum (2.6%), one for Bartonella spp., namely B. taylorii (0.8%), and 84 for Cytauxzoon spp. (71.8%). Out of these 84 samples, 23 were further sequenced revealing very high identity levels (99.84–100%) to C. europaeus, which is considered to be pathogenic for domestic cats. All wildcats were negative for the presence of N. mikurensis DNA. Conclusions: European wildcats in southwestern Germany are hosting several VBPs. With the exception of Cytauxzoon spp., low prevalence rates of most examined pathogens suggest that wildcats are primarily incidental hosts for sylvatic pathogens associated with rodents, in contrast to domestic cats. However, the high prevalence of the cat-associated pathogen C. europaeus suggests that wildcats in southwestern Germany may serve as reservoirs for this pathogen. [ABSTRACT FROM AUTHOR]

Key Clinical Message: The purpose of this article is to highlight that oral Kaposi's disease can be indicative of a high viral load of HIV, either in the case of primary infection or therapeutic failure. We report two cases of Kaposi Disease associated with HIV. The first case was a 30‐year‐old patient who unaware of her HIV‐positive status, and who was diagnosed with AIDS stage because of the biopsy revealed a gingival location of Kaposi disease. The second case was a 34‐year‐old patient who was referred to our department with a history of palatal lesion and claimed at first having no previous known medical conditions although his overall health condition seemed deteriorated. Our clinical examination was evocative of Kaposi Disease, which was confirmed by an emergency blood assessment and histological examination. Our diagnosis led us to disclose the HIV‐positive status of the patient and identify a progression to the AIDS stage, which allowed us to reintroduce the patient in the hospital framework. This case emphasizes the role of the oral surgeon as a key actor thanks to their knowledge of the clinical buccal manifestations of sexually transmitted infections (STI), in an era of resurgence of those conditions in vulnerable key populations. [ABSTRACT FROM AUTHOR]

Introduction: The quality of life based on oral health has been a vital factor affecting health outcomes. It is an overall factor that influences functional well-being, as disabled individuals may have predisposing factors that could impact their quality of life. Aim: To assess Oral Health-Related Quality of Life (OHrQoL) in disabled and non-disabled individuals after receiving dental treatment in the Al-Baha region, Kingdom of Saudi Arabia. Materials and Methods: A cross-sectional study was conducted between September and December 2023. A total of 86 disabled and 129 non-disabled participants underwent clinical examinations, and dental treatments were performed. The Oral Health Impact Profile (OHIP-14) was utilised to evaluate OHrQoL using a validated Arabic version of the questionnaire. Data related to all variables in OHIP-14 were analysed in association with oral diseases using Statistical Package for Social Sciences (SPSS) Software version 20.0. Results: A total of 215 patients with and without disabilities were included in the study. Among these, 124 (57.5%) were females and 91 (42.3%) were males. Females reported significantly higher OHrQoL scores than males after dental therapy (p-value<0.001). No significant differences in OHrQoL were observed between patients with and without disabilities (p-value 0.389). However, quality of life significantly improved after dental treatment in disabled and non-disabled individuals across all sections or domains (p-value<0.05). Conclusion: Oral disorders had a negative impact on quality of life, as post-treatment OHrQoL scores were significantly lower than pre-treatment scores. [ABSTRACT FROM AUTHOR]

Introduction: The Visually Enhanced Lesion Scope (VELscope®) is a handheld medical device that can be used to clinically visualise and diagnose oral mucosal lesions. It works by the application of direct fluorescence and the loss of fluorescence in visible and non visible high-risk oral lesions. Numerous publications have offered insights on the possible use of VELscope® for identifying oral mucosal lesions. By analysing patterns in publication outputs, citation metrics and collaborative networks, researchers can gain insights into the development, influence and key contributors in the field of VELscope®, guiding future research directions and policy decisions. Aim: To track down and analyse all studies published on the application of VELscope® in the diagnosis of oral mucosal lesions and to assist future researchers by highlighting the most cited earlier publications. Materials and Methods: This bibliometric analysis was conducted using articles published on the applications of VELscope® in detecting oral mucosal lesions between 2006 and 2022. In December 2023, a comprehensive search was performed on PubMed and Scopus databases using medical subject heading terms like "VELscope®," "Autofluorescence imaging system," and "Oral" in several combinations. Bibliographic data regarding the top 100 most cited articles were extracted and collated. Results: The analysis showed that the most contributions came from the journals "Oral Oncology," "Oral Diseases," and "Photodiagnosis and Photodynamic Therapy," with significant contributions from researchers in the USA and India. The highest number of publications occurred in 2015, with a notable peak in the decade 2011-2020. The articles were cumulatively cited 4,559 times. Conclusion: The current bibliographic analysis provided valuable insights into the development and impact of research on the applications of VELscope® in dentistry by highlighting publication trends, influential works, leading authors and collaborative networks. These insights can guide future research directions, inform policy decisions and enhance understanding of the evolution and scholarly influence. [ABSTRACT FROM AUTHOR]

Objective: This study assessed content, quality, and readability of patient-directed Internet materials about dental care support and oral toxicities/complications of cancer therapy., Study Design: A total of 32 websites meeting inclusion criteria from a Google search using terms "cancer>dental>care" were categorized for parameters of content, benchmarks for website quality as defined by JAMA (Journal of the American Medical Association), display of the Health on the Net (HON) seal, and Flesch Reading Ease Score (FRES)., Results: Treatment modalities included radiation therapy, chemotherapy, stem cell transplant, and surgery. Dental care was discussed before, during, or after cancer treatment, or a combination of those. The most common oral toxicities/complications discussed were xerostomia, rampant caries, and mucositis. Only 1 site met all 4 JAMA benchmarks; 2 displayed the HON seal; only 9% were written at the 9th-grade FRES reading level; and none were written at the 6th- to 7th-grade level., Conclusions: Websites addressing dental care for patients with cancer are broad in content yet are limited in quality and are written at difficult reading levels., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Photobiomodulation therapy (PBMT) is widely used in oncology settings, but lack of assessment standardization is the main barrier to optimization of clinical protocols. This study analyzed three PBMT protocols for preventing oral and oropharyngeal mucositis (OM) in patients undergoing chemotherapy (CT) and/or hematopoietic stem cell transplantation (HSCT). This is a preliminary randomized blind clinical trial. Group 1 received intraoral prophylactic PBMT, Group 2 received intraoral and oropharyngeal PBMT, and Group 3 received intraoral, oropharyngeal, and extraoral PBMT. The applications were from the first day of CT to day + 10. Clinicodemographic data, CT regimens, types of HSCT, hematological exams, occurrence/severity of OM, odynophagia, and OM-related opportunistic infections were assessed. Sixty participants (age range: 18-74 years) were included; 70% of them underwent CT and 30% HSCT. About 43.3% of patients had OM, while odynophagia was reported by 23.3%. Both Groups 1 and 2 revealed better results. Multivariate analysis showed that HSCT directly influenced the occurrence of OM. Individuals who had undergone allogeneic HSCT were 1.93 times more likely to develop OM (p < 0.001). Group 3 exhibited a higher frequency of OM, albeit of lower grades. This group consisted of half the population who had undergone HSCT, had the highest percentage of melphalan use, and had the lowest mean leukocyte count. The three proposed protocols were effective in preventing and reducing OM, with good tolerance and no reported adverse effects. PBMT is a safe and effective approach to OM prophylaxis in adults undergoing CT/HSCT., (© 2023. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Human immunodeficiency virus (HIV)-associated oral disease among people living with HIV infection includes oral candidiasis, oral hairy leukoplakia, Kaposi sarcoma, oral warts, herpes simplex virus ulcers, major aphthous ulcers or ulcers not otherwise specified, HIV salivary gland disease, and atypical gingival and periodontal diseases. Diagnosis of some oral lesions is based on clinical appearance and behavior, whereas others require biopsy, culture, or imaging for definitive diagnosis. Management strategies including pharmacologic and nonpharmacologic approaches are discussed in this article. Dentists also need to be cognizant of the potential oral side effects of HIV antiretroviral medications., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objectives: This study aims to comprehensively assess the association of subjective and objective oral health status and oral health behaviors with happiness, under consideration of demographic, socioeconomic, and general health-related factors. This study also aims to test whether subjective oral health outcomes are better predictors of happiness compared with objective oral health outcomes., Methods: The data were collected from 479 community-dwelling elders aged 65 years or over selected by a cluster sampling method. A questionnaire and an oral examination were implemented. A multiple regression method was conducted to assess associations with happiness index (HI)., Results: The mean age of the elders was 74.6 years. Mean (standard deviation, SD) HI, EuroQol-visual analog scale (EQ-VAS) and 14-item oral health impact profile (OHIP-14) index were 5.7 (SD 2.3), 59.8 (SD 21.1), and 16.3 (SD 13.1). In the final model, a significant association with HI of the OHIP-14 index (P = 0.091) among all the participants and significant associations of oral symptoms (P = 0.038), wearing a removable denture (P = 0.039), and of the oral health behavior of daily toothbrushing (P = 0.007) among poorer oral health QoL group were confirmed under consideration of other related factors. While correlations of HI to subjective measures of health, EQ-VAS and OHIP-14 score were moderate to weak, those to objective measures of health were only weak or insignificant., Conclusions: Oral impacts which might persistently affect one's daily life need to be considered in designing and delivering public services aimed to promote people's happiness. With oral health impacts and behaviors accounting for 10% of happiness among elders, public and community services for the elderly that support oral health and daily toothbrushing for the dentate are critical for the well-being of our elders., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Oral candidiasis is a clinical fungal infection that is the most common opportunistic infection affecting the human oral cavity. This article reviews the pathogenesis, clinical presentations, diagnosis and treatmentstrategies for oral candidiasis.

Objective: We aimed to examine if smoking is an independent predictor of oral candidiasis (OC) among HIV-1 infected persons., Methods: The cross-sectional part of this study evaluated 631 adult dentate HIV-1 seropositive persons examined for OC from 1995-2000 at the University of North Carolina Hospitals in Chapel Hill, NC. In the second part, from the above sample, a total of 283 individuals who were free of HIV-associated oral diseases at baseline were followed up for 2 years to assess incident OC events. Data collected from medical record review, interview questionnaires, and clinical examinations were analyzed using chi-squared tests and t-tests. Logistic regression models were developed for prevalent OC employing the likelihood ratio test, whereas Poisson regression models were developed for assessing cumulative incidence of OC. These models included a variety of independent variables to adjust for confounding., Results: Thirteen percent of participants had OC only; 4.6% had OC with Oral Hairy Leukoplakia; and 69.7% had neither. Smoking was associated with OC in all models [prevalent OC - current smokers: logistic regression - Odd ratio (95% CI) = 2.5 (1.3, 4.8); Incident OC - current smokers: Poisson regression (main effects model) - Incidence rate ratio (95% CI) = 1.9 (1.1, 3.8)]. Other Poisson regression models suggested evidence for effect modification between CD4 cell count and incident OC by smoking., Conclusion: Smoking is an independent risk factor for the development of OC in HIV-1 infected persons, and the risk of OC is modified by CD4 cell count which measures strength of the immune system., (© 2012 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.)

Cytauxzoon felis, a tick-borne protozoan parasite, is the causative agent of cytauxzoonosis in domestic cats in the United States. The natural reservoir for this parasite is the bobcat (Lynx rufus), which typically does not develop clinical signs. Although not likely important reservoirs, C. felis has also been detected in pumas (Puma concolor) in Florida and Louisiana. Recent studies suggest that specific genotypes of C. felis that circulate in domestic cats may be associated with variable clinical outcomes and specific spatial locations. In the current study, we investigated the intraspecific variation of the C. felis internal transcribed spacer (ITS)-1 and ITS-2 rRNA regions from 145 wild felids (139 bobcats and six pumas) from 11 states (Florida, Georgia, Kansas, Kentucky, Louisiana, Missouri, North Carolina, North Dakota, South Carolina, Oklahoma, and Pennsylvania). Unambiguous ITS-1 and ITS-2 data were obtained for 144 and 112 samples, respectively, and both ITS-1 and ITS-2 sequences were obtained for 111 (77%) samples. For the ITS-1 region, sequences from 65 samples collected from wild felids were identical to those previously reported in domestic cats, while the other 79 sequences were unique. C. felis from 45 bobcats and one puma had ITS-1 sequences identical to the most common sequence reported from domestic cats. Within the ITS-2 region, sequences from 49 bobcats were identical to those previously reported in domestic cats and 63 sequences were unique (with some occurring in more than one bobcat). The most common ITS-2 sequence from domestic cats was also common in wild felids (31 bobcats and a puma). Samples from three pumas from Florida and two bobcats from Missouri had a 40- or 41-bp insert in the ITS-2 similar to one described previously in a domestic cat from Arkansas. Additionally, a previously undescribed 198- or 199-bp insert was detected in the ITS-2 sequence from four bobcats. Collectively, based on combined ITS-1 and ITS-2 sequences, five different genotypes were detected in the wild felids. Genotype ITSa was the most common genotype (11 bobcats and one puma) and fewer numbers of ITSb, ITSe, ITSg, and ITSi were detected in bobcats. These data indicate that, based on ITS-1 and ITS-2 sequences, numerous C. felis strains may circulate in wild felids., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Objectives: The purpose of this study was to assess reliability, discriminant validity, and convergent validity of the Oral Health Impact Profile (COHIP) Korean version in a representative community sample of 8- to 15-year-old Korean children., Methods: A Korean version of COHIP was developed according to the standard procedure of cross-cultural adaptation of self-reported instruments. A representative community sample of 2236 schoolchildren was selected by cluster sampling method., Results: Mean age of the participants was 11.8 years. Mean and median of the overall COHIP score were 103.3 (SD 13.3) and 106, respectively. Internal reliability and retest reliability were excellent with Chronbach's alpha 0.88 and intraclass correlation coefficient 0.88. Face validity was confirmed with 98% of participants reporting the COHIP questionnaire was easy to answer. Nonclinical factors such as self-rated oral health or satisfaction with oral health were significantly related with overall COHIP score and five subscale scores (P < 0.001) in a consistent manner. Children with carious permanent teeth and with orthodontic treatment need had highly significantly lower overall COHIP score (P < 0.01)., Conclusion: The Korean version of the COHIP was successfully developed. The internal reliability, retest reliability, face validity, discriminant validity, and convergent validity of the COHIP Korean version were confirmed., (© 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.)

Objective: The aim of this study was to assess the association between oral health-related quality of life (OHRQoL) measured by the oral impacts on daily performances (OIDP) inventory and chewing ability., Methods: The cluster sampling method was used to select a sample of 634 socially active independent community-dwelling elders. An oral examination was conducted and a questionnaire was implemented. After bivariate comparisons, a multivariable two-level logistic model was developed for the dichotomous OIDP indicator using the generalised linear mixed model., Results: The mean age of the participants was 74 years and 56.6% were women. Eight percent were edentulous, and the mean number of teeth was 17.7. Overall, 39.3% of participants had one or more oral impacts on daily performance. Elders with chewing ability of 0-49, 50-74 and 75-99% were approximately 120, 20 and seven times more likely to have oral impacts compared with those with full chewing ability, respectively. Elders reporting their oral health as 'fair' or 'better' were 68% less likely to have oral impacts than those with poor or very poor self-reported oral health., Conclusion: Among independent elders, amelioration of chewing ability including delivery of appropriate prosthodontic care might independently contribute to improving OHRQoL of elders by improving their physical, psychological and social wellbeing., (© 2012 The Gerodontology Society and John Wiley & Sons A/S.)

Background: This article presents evidence-based clinical recommendations developed by a panel convened by the American Dental Association Council on Scientific Affairs. This report addresses the potential benefits and potential risks of screening for oral squamous cell carcinomas and the use of adjunctive screening aids to visualize and detect potentially malignant and malignant oral lesions., Types of Studies Reviewed: The panel members conducted a systematic search of MEDLINE, identifying 332 systematic reviews and 1,499 recent clinical studies. They selected 5 systematic reviews and 4 clinical studies to use as a basis for developing recommendations., Results: The panel concluded that screening by means of visual and tactile examination to detect potentially malignant and malignant lesions may result in detection of oral cancers at early stages of development, but that there is insufficient evidence to determine if screening alters disease-specific mortality in asymptomatic people seeking dental care., Clinical Implications: The panel suggested that clinicians remain alert for signs of potentially malignant lesions or early-stage cancers while performing routine visual and tactile examinations in all patients, but particularly in those who use tobacco or who consume alcohol heavily. Additional research regarding oral cancer screening and the use of adjuncts is needed.

The oral mucosa's accessibility, excellent blood supply, by-pass of hepatic first-pass metabolism, rapid repair and permeability profile make it an attractive site for local and systemic drug delivery. Technological advances in mucoadhesives, sustained drug release, permeability enhancers and drug delivery vectors are increasing the efficient delivery of drugs to treat oral and systemic diseases. When treating oral diseases, these advances result in enhanced therapeutic efficacy, reduced drug wastage and the prospect of using biological agents such as genes, peptides and antibodies. These technologies are also increasing the repertoire of drugs that can be delivered across the oral mucosa to treat systemic diseases. Trans-mucosal delivery is now a favoured route for non-parenteral administration of emergency drugs and agents where a rapid onset of action is required. Furthermore, advances in drug delivery technology are bringing forward the likelihood of transmucosal systemic delivery of biological agents., (Copyright © 2011 Elsevier B.V. All rights reserved.)

This workshop reviewed aspects of the following: oral fungal disease in HIV-infected patients and the predictive value of oral mucosal disease in HIV progression; the role of the oral biofilms in mucosal disease; microbial virulence factors and the pseudomembranous oral mucosal disease process; the role that oral mucosal disease may have in HIV transmission; and the available topical antifungal treatment. This article summarizes the ensuing discussions and raises pertinent problems and potential research directions associated with oral fungal disease in HIV-infected patients, including the frequency of oral candidosis, the role of the intraoral biofilm in the development of oral mucosal disease, and host-pathogen interactions, as well as the development of the fetal oral mucosa, neonatal nutrition, and the role of oral candidosis in this setting. Finally, discussions are summarized on the use of inexpensive effective antifungal mouthwashes in resource-poor countries, the potential stigmata that may be associated with their use, as well as novel topical medications that may have clinical applicability in managing oral candidal infections in HIV-infected patients.

The workshop considered 5 questions related to oral lesions, HIV phenotypes, and the management of HIV-related disease, with a focus on evidence and challenges in resource-poor settings. First, are oral lesions unique with respect to geographic location or phenotype? Second, how useful would an oral lesion index be to predict HIV in resource-poor countries with no access to CD4 counts or viral load? Third, what are the latest methods and delivery modes for drugs used to treat oral lesions associated with HIV? Fourth, what is the role of the oral health care worker in rapid diagnostic testing for HIV? Fifth, what ethical and legal issues are to be considered when managing the HIV patient? The consensus of the workshop was the need for additional research in 4 key areas in developing countries: (1) additional investigation of comorbidities associated with HIV infection that may affect oral lesion presentation and distribution, especially in pediatric populations; (2) the development of region-specific algorithms involving HIV oral lesions, indicating cumulative risk of immune suppression and the presence of HIV disease; (3) well-designed clinical trials to test new therapies for oral lesions, new treatments for resistant oral fungal and viral diseases, effectiveness of therapies in children, and new drug delivery systems; and (4) the role of the oral health care worker in rapid diagnostic testing for HIV in various regions of the world.

Cytauxzoon felis, a protozoan parasite of wild and domestic felids, is the causative agent of cytauxzoonosis in domestic and some exotic felids in the United States. The bobcat (Lynx rufus) is the natural reservoir for this parasite, but other felids such as Florida panthers (Puma concolor coryii) and domestic cats may maintain long-term parasitemias and serve as reservoirs. Experimentally, two tick species, Dermacentor variabilis and Amblyomma americanum, have demonstrated the ability to transmit C. felis. These two tick species have overlapping distributions throughout much of the southeastern United States. The objective of the current study was to determine the distribution and prevalence of C. felis in free-ranging bobcat populations from 13 states including California, Colorado, Florida, Georgia, Kansas, Kentucky, Missouri, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, and West Virginia. These states were selected because of differential vector presence; D. variabilis is present in each of these states except for the region of Colorado sampled and A. americanum is currently known to be present only in a subset of these states. Blood or spleen samples from 696 bobcats were tested for C. felis infection by a polymerase chain reaction (PCR) assay which targeted the first ribosomal internal transcribed spacer region (ITS-1). Significantly higher prevalences of C. felis were detected from Missouri (79%, n=39), North Carolina (63%, n=8), Oklahoma (60%, n=20), South Carolina (57%, n=7), Kentucky (55%, n=74), Florida (44%, n=45), and Kansas (27%, n=41) compared with Georgia (9%, n=159), North Dakota (2.4%, n=124), Ohio (0%, n=19), West Virginia (0%, n=37), California (0%, n=26), and Colorado (0%, n=67). In addition to bobcats, seven cougars (Puma concolor) from Georgia, Louisiana, and North Dakota and one serval (Leptailurus serval) from Louisiana were tested for C. felis. Only one cougar from Louisiana was PCR positive, which represents the first report of an infected cougar outside of the Florida panther population. These data also indicate that C. felis is present in North Dakota where infection has not been reported in domestic cats. Based on a nonparametric analysis, prevalence rates were significantly higher in states where there are established populations of A. americanum, which supports recent data on the experimental transmission of C. felis by A. americanum and the fact that domestic cat clinical cases are temporally associated with A. americanum activity. Collectively, these data confirm that bobcats are a common reservoir for C. felis and that A. americanum is likely an epidemiologically important vector., (Copyright © 2010 Elsevier B.V. All rights reserved.)

Aims: To investigate the smoking habits and attitudes toward anti-smoking activities of Korean dentists according to their smoking status., Methods: A questionnaire was mailed to a random sample of 2500 currently active Korean dentists in 2008. After 20% of the 1680 returned surveys (response rate 67.2%) were excluded due to missing data, 1443 surveys were analysed., Results: Among the 1443 respondents, most were male (81.8%) and age 40-49 was the most prevalent age group (41.6%). Approximately half of participating dentists were never-smokers, 24.6% were current smokers, and 29% were ex-smokers. Women (95.8%) were significantly more likely to have never smoked than men (35.4%). Prevalence of cigarette smoking of Korean male and female dentists was much lower than that of male and female Korean adults, respectively. Ex-smokers were significantly more likely to show a positive attitude about anti-smoking activities, compared to current smokers (p < .0001)., Conclusions: A majority of respondents agreed dentists should encourage their patients to stop smoking. Further effort is needed to encourage smoking cessation among male Korean dentists who smoke so they benefit from a healthier lifestyle and will subsequently be more likely to provide recommendations for smoking prevention and cessation for their patients.

Background: Oropharyngeal candidiasis (OPC) is the most common opportunistic infection among persons infected with human immunodeficiency virus (HIV). Once-daily miconazole 50 mg buccal tablet (MBT) is a novel delivery system using an extended-spectrum azole with potent in vitro activity against many Candida species, including some that may be resistant to other azoles., Methods: This phase 3, double-blind, double-dummy, multicenter trial evaluated 578 randomized patients with HIV infection and OPC. The study compared the efficacy and safety of MBT once daily with clotrimazole 10 mg troches (CT) 5 times daily for 14 days. The co-primary efficacy endpoints were clinical cure at test of cure (TOC) visit (days 17-22) in the intent-to-treat (ITT) and per protocol (PP) populations., Results: Clinical cure rate at TOC visit for MBT-treated patients was statistically noninferior to CT-treated patients in both the ITT (61% vs 65%) and PP (68% vs 74%) populations. Secondary endpoints, safety, and tolerability were similar between treatment groups., Conclusions: In this large trial, once-daily MBT was shown to be noninferior to CT 5 times daily in the treatment of OPC in HIV-positive patients. MBT offers an effective, safe, and well-tolerated topical treatment option for OPC administered as a convenient once-daily dose.

Objectives: The aims of this study were to assess predictors of global self-ratings of oral health (GSROH) and to examine whether they varied by age among Korean adults aged 18-95 years., Methods: Data from 4,546 adults aged 18-95 years completing the Korean National Oral Health Survey 2006 were included in the analysis., Results: Subjects' mean age was 43.5 years, with 12.1 percent aged > or = 65 years; 47.8 percent were men; and 2.5 percent were edentulous. The predictors of GSROH in adults were number of missing teeth, concern about oral health, and difficulty in chewing. While wearing removable dentures was associated only in elders, perceived treatment need was associated in younger age groups. The number of decayed and filled teeth was significant only in the 18-44 age group., Conclusions: GSROH status was associated with measures of oral disease, oral functional problems, oral health behaviors, concerns, and perceived treatment needs, and it varied by age.

Background: This article presents evidence-based clinical recommendations developed by a panel convened by the American Dental Association Council on Scientific Affairs. This report addresses the potential benefits and potential risks of screening for oral squamous cell carcinomas and the use of adjunctive screening aids to visualize and detect potentially malignant and malignant oral lesions., Types of Studies Reviewed: The panel members conducted a systematic search of MEDLINE, identifying 332 systematic reviews and 1,499 recent clinical studies. They selected five systematic reviews and four clinical studies to use as a basis for developing recommendations., Results: The panel concluded that screening by means of visual and tactile examination to detect potentially malignant and malignant lesions may result in detection of oral cancers at early stages of development, but that there is insufficient evidence to determine if screening alters disease-specific mortality in asymptomatic people seeking dental care., Clinical Implications: The panel suggested that clinicians remain alert for signs of potentially malignant lesions or early-stage cancers while performing routine visual and tactile examinations in all patients, but particularly in those who use tobacco or who consume alcohol heavily. Additional research regarding oral cancer screening and the use of adjuncts is needed.