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Synthetic corticosteroids are used widely for the treatment of a variety of diseases of the mouth. However, little is known as to whether the oral mucosa is able to modulate the local concentration of active corticosteroids or to produce steroids de novo. This has important clinical implications, because tissue-specific regulation of glucocorticoids is a key determinant of the clinical efficacy of these drugs. In the present study, we show that oral fibroblasts and keratinocytes expressed ACTH receptor (MC2R), glucocorticoid receptor (GR), and 11β-hydroxysteroid dehydrogenases (11β-HSDs). Unlike keratinocytes, fibroblasts lacked 11β-HSD2 and could not effectively deactivate exogenously administered cortisol. However, both cell types were able not only to activate cortisone into the active form cortisol, but also to synthesize cortisol de novo following stimulation with ACTH. 11β-HSD2, the enzyme controlling cortisol deactivation, exhibited different patterns of expression in normal (squamous epithelium and salivary glands) and diseased oral mucosa (squamous cell carcinoma and mucoepidermoid carcinoma). Blocking of endogenous cortisol catabolism in keratinocytes with the 11β-HSD2 inhibitor 18β-glycyrrhetinic acid mimicked the effect of exogenous administration of hydrocortisone and partially prevented the detrimental effects induced by pemphigus vulgaris sera. Analysis of the data demonstrates that a novel, non-adrenal glucocorticoid system is present in the oral mucosa that may play an important role in disease. [ABSTRACT FROM PUBLISHER]

Background: With the increasing popularity of online sources for health information, parents may seek information related to early childhood caries (ECC) from artificial intelligence-based chatbots., Aim: The aim of this article was to evaluate the usefulness, quality, reliability, and readability of ChatGPT answers to parents' questions about ECC., Design: Eighty questions commonly asked about ECC were compiled from experts and keyword research tools. ChatGPT 3.5 was asked these questions independently. The answers were evaluated by experts in paediatric dentistry., Results: ChatGPT provided "very useful" and "useful" responses to 82.5% of the questions. The mean global quality score was 4.3 ± 1 (good quality). The mean reliability score was 18.5 ± 8.9 (average to very good). The mean understandability score was 59.5% ± 13.8 (not highly understandable), and the mean actionability score was 40.5% ± 12.8 (low actionability). The mean Flesch-Kincaid reading ease score was 32% ± 25.7, and the mean Simple Measure of Gobbledygook index readability score was 15.3 ± 9.1(indicating poor readability for the lay person). Misleading and false information were detected in some answers., Conclusion: ChatGPT has significant potential as a tool for answering parent's questions about ECC. Concerns, however, do exist about the readability and actionability of the answers. The presence of false information should not be overlooked., (© 2024 BSPD, IAPD and John Wiley & Sons Ltd.)

Introduction: The use of the internet has surged significantly over the years. Patients and caregivers of patients with autism spectrum disorder (ASD) might consult the internet for oral health-related information. Hence, this study aimed to assess the quality and readability of online information available in the English language regarding oral health in ASD., Methods: Online search using Google.com was conducted using the terms "Autism and dental care," "Autism and oral health," and "Autism and dentistry". The first 100 websites for each term were screened. Quality of information was assessed using the Patient Education Materials Assessment Tool for printed material (PEMAT-P) and the Journal of American Medical Association (JAMA) benchmarks. A PEMAT score higher than 70% is considered acceptable for readability and actionability. The JAMA benchmarks are authorship, attribution, disclosure, and currency. Readability was evaluated using the Flesch reading ease score and Simple Measure of Gobbledygook (SMOG) readability formula., Results: Out of the 300 screened websites, 66 were eventually included. The mean PEMAT understandability and actionability scores were 77.13%, and 42.12%, respectively. Only 12.1% of the websites displayed all four JAMA benchmarks. The mean Flesch score was 10th-12th grade level, and the mean SMOG score was 10th grade level., Conclusion: While the understandability of the information was acceptable, the readability and actionability were too challenging for lay people. Health care professionals and organizations involved in patient education should place more efforts in promoting the quality of online information targeting patients with ASD., (© 2024 Special Care Dentistry Association and Wiley Periodicals LLC.)

Objective: To examine the content of Instagram posts about oral cancer and assess its usefulness in promoting oral cancer awareness and early detection practices., Methods: A systematic search of Instagram for posts about oral (mouth) cancer was conducted using the hashtags #oral cancer and #mouth cancer. Posts usefulness in promoting awareness and early detection was assessed using the early detection usefulness score, and caption readability was assessed using the Flesch Kincaid readability score., Results: A total of 81,000 posts were identified, and 200 posts were thoroughly evaluated. Included posts gathered a total of 48,118 (mean = 420.59 likes) and 27,898 views. Most posts (81.5%) were educational to the lay person, and India and the UK were the major contributors. The most discussed topics were prevention and early detection (55%). Representative clinical images were present in 35.5% of posts. Only 9.5% of posts mentioned the source of information, and the mean usefulness score was only 2.1 out of 10. The mean reading ease score was 56.7 ± 43.8 (range from 1 to 98 out of 100)., Conclusion: Instagram shows potential for promoting oral cancer awareness, particularly in prevention and early detection. However, concerns regarding content quality, scientific validity, and clarity persist., (© 2024 Wiley Periodicals LLC.)

Objectives: To examine the quality, reliability, readability, and usefulness of ChatGPT in promoting oral cancer early detection., Study Design: About 108 patient-oriented questions about oral cancer early detection were compiled from expert panels, professional societies, and web-based tools. Questions were categorized into 4 topic domains and ChatGPT 3.5 was asked each question independently. ChatGPT answers were evaluated regarding quality, readability, actionability, and usefulness using. Two experienced reviewers independently assessed each response., Results: Questions related to clinical appearance constituted 36.1% (n = 39) of the total questions. ChatGPT provided "very useful" responses to the majority of questions (75%; n = 81). The mean Global Quality Score was 4.24 ± 1.3 of 5. The mean reliability score was 23.17 ± 9.87 of 25. The mean understandability score was 76.6% ± 25.9% of 100, while the mean actionability score was 47.3% ± 18.9% of 100. The mean FKS reading ease score was 38.4% ± 29.9%, while the mean SMOG index readability score was 11.65 ± 8.4. No misleading information was identified among ChatGPT responses., Conclusion: ChatGPT is an attractive and potentially useful resource for informing patients about early detection of oral cancer. Nevertheless, concerns do exist about readability and actionability of the offered information., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: Oro-dental manifestations of hyperoxaluria and dental management of affected patients are rarely reported in the literature. We describe a new oral presentation of primary hyperoxaluria (PH) and review relevant literature about oro-dental manifestations and management of dental complications of hyperoxaluria., Methods: A case report of a 44-year-old female who presented with symptoms of temporomandibular joint dysfunction due to hyperoxaluria was described according to the CARE guidelines. In addition, an extensive search of biomedical databases (PubMed, Medline, Google Scholar, and Embase) for articles describing oro-dental manifestations and/or dental management in patients with hyperoxaluria was performed using the key words ("oral" and/or "hyperoxaluria" and/or "dental" and/or "oxalosis"). Included articles were reviewed and data about patient demographics, disease type and stage, oral and dental manifestations, and dental treatment outcome were retrieved and analyzed., Results: A total of 14 articles describing the oral and dental manifestations in 15 patients with hyperoxaluria were included. Tooth mobility, root resorption, and radiographic alterations were consistently described in all cases. Oral manifestations were described mainly in PH at late stages, and only after the onset of chronic renal disease. Dental management in all reported cases was palliative and aimed to relive pain and treat periodontal infection. Tooth loss due to extraction or uncontrolled mobility was the ultimate outcome in almost all reported cases., Conclusion: Oral and dental manifestations in hyperoxaluria are rarely reported in the literature. Management of tooth mobility and root resorption in hyperoxaluria is challenging and clinical guidelines and evidence-based recommendations are lacking. Early diagnosis and treatment of hyperoxaluria might be the only effective approach to prevent dental and periodontal complications of the disease., (© 2024 Special Care Dentistry Association and Wiley Periodicals LLC.)

Background: Pitt-Hopkins syndrome (PTHS) is a rare neurodevelopmental disorder with physical, cognitive, and behavioral characteristics that is caused by heterozygous mutations in the TCF4 gene. Patients with PTHS might present a unique challenge for oral healthcare professionals because of the associated comorbidities., Case Report: Here we describe a new case of PTHS in a 13-year-old girl with particular emphasis on oro-dental findings and oral healthcare management. Observed oro-dental findings in our case included shallow palate, absence of lingual frenum, gingival enlargement, thick lips and relative microdontia. The patient was unable to tolerate dental care under local anesthesia. Therefore, comprehensive dental treatment was performed under general anesthesia after a careful pre-anesthetic cardio-respiratory, neurological, and hematological evaluation. The patient was closely monitored intra-operatively for breathing rhythm, O2 saturation, and signs of respiratory distress. The patient was observed for 24 h post-op for respiratory distress and was discharged then uneventfully., Conclusion: Dental treatment under general anesthesia in these patients might be complicated by the abnormal breathing rhythm, and close monitoring and follow up for signs of respiratory distress after general anesthesia is necessary. Recognition of oral and dental findings might help to expand the phenotype and better characterize rare syndromes., (© 2024. The Author(s).)

Background: Factitious disorder imposed on self (FDIS), also known as Munchausen's syndrome, is a psychological disorder characterized by falsification of physical or psychological symptoms without an obvious external incentive. Oral presentations of FDIS are infrequently reported, and diagnosis might be challenging because affected patients often have impressive skills in fabricating symptoms and deceiving healthcare professionals., Aim: To describe the diagnostic dilemma and management challenges in a female patient who presented with tooth ache and oral ulcers., Case Description: A 53-year-old female presented with complex medical history, vague symptoms and confusing dental history regarding persistent toothache and generalized oral ulcers. She underwent extensive investigations and multiple dental and oral surgical procedures without reaching a confirmed diagnosis or achieving symptomatic improvement. Thorough review of her medical records revealed multiple admissions to various hospitals across the country and abroad for various reasons, and failed to find any laboratory, clinical, or radiographic evidence of her "claimed" symptoms., Conclusion: Oral healthcare professionals should suspect FDIS in patients presenting with vague and complex history that is not explained by clinical or radiographic findings. Consultation with psychiatric department and hospital administration might be needed to confirm diagnosis and plan appropriate management of the case., (© 2023 Special Care Dentistry Association and Wiley Periodicals LLC.)

This review aims to present a detailed analysis of the most common developmental and acquired dental abnormalities, including caries, resorptive lesions, and congenital anomalies of teeth number, size, form, and structure. This review highlights how diagnostic imaging can aid in the accurate identification and management of these conditions., Competing Interests: Disclosure None of the authors have any commercial or financial conflicts of interest and any funding sources., (Copyright © 2023 Elsevier Inc. All rights reserved.)