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Oral pain is a common complaint in patients with cancer. This review aims to summarize the knowledge on the causes and approach to management of oral pain garnered over the past 2 years.A systematic review and meta-analysis included in the review, assessed cannabinoid versus placebo and showed only a small effect on pain, physical function, and sleep quality. Another review showed that chemical neurolysis as an adjunctive therapy, is effective in patients with pain of shorter chronicity and refractory head and neck cancer-related pain.Patients with cancer frequently experience oral pain because of a variety of factors. Factors inherent in the type and location of the malignancy, the modality of cancer treatment, and a holistic approach to management together contribute to their overall pain experience. Basic oral care should be implemented wherever possible, before, during, and after cancer treatment.

To understand the risk factors that may be associated with the development of oral lichen planus (OLP) and its progression.We conducted retrospective chart reviews of adult patients with OLP who presented to oral medicine and oral pathology clinics in 2 provinces between September 2016 and January 2020. Data regarding age, sex, disease duration, sites of involvement, comorbidities, medications, allergies, smoking, alcohol use, treatment and follow up were collected. Descriptive statistics were assessed.Among the 94 patients with OLP, mean age was 62 years and most were female (73%). Mean disease duration was 3.1 years. Hypertension, thyroid disorders and diabetes were present in 32%, 28% and 17% of patients, respectively. A significant proportion of patients reported a major surgical procedure (47%) as a preceding event and an additional 7% reported a preceding stressful life event. Three OLP patients (3%) developed squamous cell carcinoma or dysplasia. The mean disease duration for these patients was 4.06 years and the frequency of biopsy in our study was approximately 14%.Female sex, endocrine and immunological comorbidities, such as thyroid disease and diabetes, and psychological stress may play a role in the development of OLP in the Canadian population. A small percentage of patients may develop malignant transformation and, thus, require long-term monitoring.

Addison's disease or primary adrenal insufficiency (hypoadrenocorticism) is an endocrine disease characterized by a deficiency in the production of the adrenal cortex hormones, particularly cortisol and aldosterone. Patients affected by Addison's disease develop anorexia, weight loss, hypoglycemia, fatigue, nausea, vomiting, skin, and mucosal pigmentation. Skin pigmentation is considered a commonly encountered manifestation of the disease; however, oral mucous membrane pigmentation is rarely noticed early enough for diagnosis. This case report demonstrates a case where oral pigmentation was an early diagnostic sign of Addison's disease.

Oral cancer continues to be diagnosed in advanced stages, giving patients lower chances of survival. The objective of this study was to explore reasons for delayed diagnosis of oral cancer in Alberta. A retrospective qualitative design was implemented through seven steps suggested for conducting a narrative clinical document. Data was retrieved from the Alberta Cancer Registry database between 2005 and 2017. A sample of initial consultation notes (ICN) of oral and oropharyngeal cancer patients were identified through a purposeful sampling method and added to the study until saturation was achieved. A deductive analysis approach inspired by the model pathways to treatment health care provider (HCP) was employed. From the 34 ICN included in our analysis, five main categories were identified: appraisal interval, help-seeking interval, diagnosis interval, pre-treatment interval, and other contributing factors such as health-related behaviours, system delay, and tumor characteristics. These factors negatively contributed to early detection of oral and oropharyngeal cancers and affect treatment wait time with patients, providers, and the healthcare system. Patient’s lack of awareness, provider’s oversight and prolonged access to care were the main reasons of delay in cancer diagnosis and management in our study. A sustainable plan for public awareness interventions and implementation of a solid curriculum for medical and dental students is needed to enhance their related knowledge, competence in clinical judgement, and treatment managements.

Whiplash-associated disorder (WAD) has a close relationship to and functional linkage with the neck and jaw. Studies show an association between orofacial pain and cervical pain and confirm intersegmental nociceptive connections between the trigeminal regions and the cervical spine. We present six cases of WAD-associated orofacial neuralgia. The objective of this study is to present a series of cases of neuralgia-like pain following WAD. Six cases of WAD-associated orofacial neuralgic pain are presented. Neuralgia was identified based upon history, examination, and successful pain management with specific medications for neuralgia. Five out of the six cases were initially diagnosed and treated with limited efficacy as temporomandibular joint disorder (TMD) with continuing pain and were subsequently diagnosed and treated with efficacy as trigeminal neuralgia. MRI and CT scan may suggest cervical spine changes mostly at C2–3, C3–4, and C5–6. Traditional therapy for musculoskeletal pain had no impact upon orofacial pain in patients with neuralgia-like pain following WAD. These cases show that development of neuralgia-like pain may have delayed onset following WAD. Clinical presentation and diagnosis of neuralgia were confirmed upon control of pain with use of carbamazepine or oxcarbazepine. To our knowledge, these cases represent the first report of WAD-related orofacial neuralgia and suggest the potential for neuralgia-like pain to occur following WAD and that clinical diagnosis is needed to lead to effective therapy.

PURPOSE: Patients undergoing hematopoietic stem cell transplantation (HSCT) are at high risk of oral complications with the potential of causing significant morbidity and mortality. Dental professionals should play a fundamental role in the prevention and treatment of oral sequelae of HSCT. However, the dental community is not well informed and experienced in providing oral care of the oral complications for HSCT patients. This narrative review attempts to fill the knowledge gap through reviewing the oral complications and current recommendations for oral and dental care for the patient before, during and after HSCT. RESULTS: Oral care in the HSCT process was divided into five stages with the goal being to provide practical guidance for dental care providers to assist in managing these patients. It is well known that the maintenance of good oral health is important in cancer patients, including patients with hematologic malignancies. In addition to negatively impacting quality of life, oral pain and/or infections can cause delays, modification and discontinuation of life-saving cancer treatment. Oral complications can lead to new or extended hospitalization. By providing a preventive and treatment algorithm based on currently available literature reports and expert opinion, we can hope to achieve better patient outcomes. CONCLUSION: We present oral and dental management recommendations with a focus on oral health maintenance, infection prevention, pain control and oral complication management to support oral and general health of this medically complex patient population prior to, during and following HSCT.

Erythema multiforme (EM) is an acute, immune-mediated disorder affecting the skin and/or mucous membranes, including the oral cavity. Target or iris lesions distributed symmetrically on the extremities and trunk characterize the condition. Infections are the most common cause of EM and the most frequently implicated infectious agent causing clinical disease is the herpes simplex virus. The diagnosis of EM is typically based on the patient's history and clinical findings. Management involves controlling the underlying infection or causative agent, symptom control, and adequate hydration. The epidemiology, pathogenesis, clinical features, diagnosis, and treatment of EM are reviewed in this article.

Therapeutic improvements and epidemiologic changes in head and neck cancer (HNC) over the last three decades have led to increased numbers of survivors, resulting in greater need for continuing management of oral and dental health in this population. Generally, the HNC patient oral health needs are complex, requiring multidisciplinary collaboration among oncologists and dental professionals with special knowledge and training in the field of oral oncology. In this review, we focus on the impact of cancer treatment on oral health, and the oral care protocols recommended prior to, during and after cancer therapy. The management of oral complications such as mucositis, pain, infection, salivary function, taste and dental needs are briefly reviewed. Other complications and their management, including osteonecrosis of the jaw and recurrent/new primary malignancies are also described. This review offers clinical protocols and information for medical providers to assist in understanding oral complications and their management in HNC patients and survivors, and their oral and dental health care needs. Oral and dental care is impacted by the patient’s initial oral and dental status, as well as the specific cancer location, type, and its treatment; thus, close communication between the dental professional and the oncology team is required for appropriate therapy.

doi: 10.1111/j.1741-2358.2010.00442.x A conventional microwave oven for denture cleaning: a critical review Introduction: Denture cleaning should be quick and easy to perform, especially in long-term care facilities. The lack of proper oral hygiene can put older adults at higher risk from opportunistic oral infections, particularly fungal. As an alternative to regular brushing, the use of a microwave oven has been suggested for cleaning and disinfecting dentures. Objectives: To synthesise and discuss the advantages and disadvantages of the use of a conventional microwave oven for cleaning and disinfecting complete dentures. Methods: A brief literature search focused on papers dealing with microwave therapy for denture cleaning through PubMed Central, Cochrane Database of Systematic Reviews, Google Scholar, Ovid MEDLINE(R) In-Process, and Scifinder Scholar. Results: One hundred and sixty-seven manuscripts published in English with full text were found, and 28 were accepted and discussed in the light of the advantages and disadvantages of the use of conventional microwave oven for cleaning and disinfecting complete dentures. Conclusions: There was no standardisation for microwave use for denture cleaning. Manual cleaning still seemed to be the optimal method for controlling fungal infection and denture stomatitis. However, such a daily routine appeared to be underused, particularly in long-term care facilities.

Erythema multiforme (EM) is an acute, immune-mediated disorder affecting the skin and/or mucous membranes, including the oral cavity. Target or iris lesions distributed symmetrically on the extremities and trunk characterize the condition. Infections are the most common cause of EM and the most frequently implicated infectious agent causing clinical disease is the herpes simplex virus. The diagnosis of EM is typically based on the patient's history and clinical findings. Management involves controlling the underlying infection or causative agent, symptom control, and adequate hydration. The epidemiology, pathogenesis, clinical features, diagnosis, and treatment of EM are reviewed in this article.

Denture cleaning should be quick and easy to perform, especially in long-term care facilities. The lack of proper oral hygiene can put older adults at higher risk from opportunistic oral infections, particularly fungal. As an alternative to regular brushing, the use of a microwave oven has been suggested for cleaning and disinfecting dentures.To synthesise and discuss the advantages and disadvantages of the use of a conventional microwave oven for cleaning and disinfecting complete dentures.A brief literature search focused on papers dealing with microwave therapy for denture cleaning through PubMed Central, Cochrane Database of Systematic Reviews, Google Scholar, Ovid MEDLINE(R) In-Process, and Scifinder Scholar.One hundred and sixty-seven manuscripts published in English with full text were found, and 28 were accepted and discussed in the light of the advantages and disadvantages of the use of conventional microwave oven for cleaning and disinfecting complete dentures.There was no standardisation for microwave use for denture cleaning. Manual cleaning still seemed to be the optimal method for controlling fungal infection and denture stomatitis. However, such a daily routine appeared to be underused, particularly in long-term care facilities.