ORAL MEDICINE

The aim was to systematically review the efficacy of photodynamic therapy (PDT) in the management of oral premalignant lesions. The addressed focused question was "Is PDT effective in the management of oral premalignant lesions?" PubMed/Medline, Google-Scholar, EMBASE and ISI Web of Knowledge databases were searched from 1984 till June 2014 using different combinations of the following keywords: photodynamic therapy; oral premalignant lesions; leukoplakia; erythroplakia; erythroleukoplakia; verrucous hyperplasia; and submucous fibrosis. Review articles, experimental studies, case-reports, commentaries, letters to the Editor, unpublished articles and articles published in languages other than English were not sought. The pattern of the present study was customized to mainly summarize the relevant information. Thirteen studies were included. In these studies, the number of patients ranged between 5 patients and 147 individuals with mean ages ranging between 51 years and 62.2...

Betel-quid (BQ) contains biologically psychoactive ingredients; however, data are limited concerning the symptoms and syndrome of BQ dependence among chewers. The aims of this study were to evaluate the ingredients-associated BQ dependence syndrome and country-specific chewing features and behaviour for BQ dependence among chewers from six Asian communities. An intercountry Asian Betel-quid Consortium study. Six Asian general communities in Taiwan, Mainland China, Indonesia, Malaysia, Sri Lanka and Nepal. Six multi-stage random samples of BQ chewers in the Asian Betel-quid Consortium study (n = 2078). All chewers were evaluated for BQ dependence using the DSM-IV and ICD-10 criteria. The 12-month BQ dependence rate was 12.5-92.6% and 47.9-99.3% (P = 0.023) among tobacco-free and tobacco-added BQ chewers across the six Asian communities, with a higher dependence rate in chewers who used tobacco-free BQ with lime added than without (23.3-95.6% versus 4.0%, P ≤ 0.001). Taiwanese and Hunanese BQ chewers both notably endorsed the dependency domain of 'time spent chewing'. 'Tolerance' and 'withdrawal' were the major dependence domains associated with the Nepalese and Indonesian chewers, with high BQ dependence rates. Malaysian and Sri Lankan chewers formed a BQ dependence cluster linked closely to…

To explore the early responses of young oral cancer patients in Scotland to the symptoms of their emerging condition, to understand the ways they seek help and to inquire into delay caused by not recognising symptoms associated with cancer. The survey was carried out in Maggie's Centres or in patients' own homes in Glasgow and Edinburgh among young patients diagnosed with oral cancer in the three years (2004-7) before the study. This study employed qualitative methods. Data were collected by interview using a semi-structured interview schedule. The interview transcripts were analysed using a thematic framework and with the aid of NVivo qualitative analysis software (Version 8). Most of the cohort knew that smoking and alcohol could cause oral cancer. None thought it would happen to them. Descriptions of symptoms varied widely and several had used self-treatment provided from a pharmacy. There were various causes of 'patient delay' and self-treatment was not the only cause. Reinterpretation of symptoms without seeking professional help was not uncommon. Nobody suspected they had oral cancer until it was confirmed by their GP or GDP. All thought that something so small and painless couldn't be a serious problem. The study further confirms gaps in understanding and awareness of oral cancer. Most had heard of oral cancer but they didn't think their symptoms were indicative of cancer and they self managed the problem. The culture of not bothering the GP/GDP unless it was perceived as serious is a barrier to earlier access. Findings support that further public awareness of oral cancer and its symptoms is required to alert the public that if their symptoms persist beyond three weeks they need a professional opinion.

Oral Diseases (2012) doi: 10.1111/j.1601-0825.2012.01935.x Background:  The value of chairside adjunctive tests in the detection of oral potentially malignant disorders (OPMDs) remains uncertain. Objectives:  To determine the effectiveness of toluidine blue in detecting leukoplakia and erythroplakia and its accuracy in identifying cases with oral epithelial dysplasia. Materials and Methods:  Ninety-two patients attending two oral medicine clinics in London, presenting with white and red patches of the oral mucosa, were investigated by the application of toluidine blue. Eighty-two patients were clinically diagnosed as OPMDs and 10 were frictional keratoses. A surgical biopsy was performed to assess epithelial dysplasia. Results:  Of 64 oral leukoplakias, 34 (53.1%) were positive for toluidine blue and among nine erythroplakias seven stained positive. Of 41 oral dysplasia cases, a little more than half of the lesions (n = 23) were stain positive, an estimated sensitivity of 56.1%. TBl...