It was the evening of 28th November 2008 , I was sitting in my
Dental Office " Smile Maker" when I received a call from
a patient of mine. He said, Hey doc , look up the sky , its smiling
at you. I was like - what exactly this good gentleman means by it .
But I did turn to my window and I captured it on my Olympus what I
India had just come out of the catastrophe that had hit its
financial capital Mumbai and indeed we were looking for a better
day. The smile in the sky indeed was a "Smile Maker" for all of us.
I read in newspaper later that it was Venus, Mars and the crescent
that was positioned to smile at us.
Getting you some articles which may help you all make your patients
smile is this edition of Dental Follicle. I hope you enjoy this
Perimenopausal and postmenopausal women demonstrated estrogen
deficiency which were diagnosed with oral symptoms of burning alone
(43%), strange tastes (27%) and both (30%).
Grushka et al. found nearly 50% of patients with BMS were found to
have some clinically evident immunologically mediated disease.
Antinuclear antibody and rheumatoid factor imbalances were noted.
HIV and AIDS afflictions have also been correlated with BMS.
Xerostomia has also been reported as a frequent symptom in patients
with immunologic disorders and has been associated with the
diagnosis of BMS.
factors After deficiency disorders, depression has been noted as
the next most frequent etiologic factor. Browing et al. found that
44% of patients with BMS demonstrated a psychiatric diagnosis of
which depression and generalized anxiety were the two most common
diagnoses. A complex spectrum of social and psychological
disturbances were found in patients with BMS with linked diagnoses.
Cancerphobia and anxiety have been documented as etiologic factors.
A study conducted by Lamey and Lamb on 74 patients using Hospital
Anxiety and Depression (HAD) scale found that the somatic symptoms
of burning mouth are at least partly the psychological result of
restlessness, tension and an inherent to relax.
Other etiologic factors
Many alternative causes have been proposed for the burning mouth
symptoms experienced by patients, inclusive of inflammed lymphoid
tissue within the lingual foliate papillae, temporal or giant cell
arteritis, myeloblastic syndrome, reflux esophagitis, acoustic nerve
neuroma and referred myofacial pain. However, no direct causal
relationship to these factors has been supported.
Contributing factors of oral burning sensations
with oral burning
erythematous or speudomembranous lesions
Fungal culture from
oral swab or collected saliva
If culture is
positive treat with antifungal medication
antihypertensive, antidepressants drugs, onset related to
medications and identify potential adverse effects
If xerostomic drug
or ACE inhibitor taken, consult with physician to change
cervical caries, altered taste, enlarged major salivary glands,
difficulty in swallowing food, mouth breathing
salivary flow rate
If low, rule out
medications and Sjogrenís syndrome. Institute protocol to
alleviate low salivary flow (Eg; sialogogues) and complications
White, red or
ulcerative mucosal lesion present
abnormality is identified, biopsy to obtain histologic diagnosis
Dry mouth, frequent
urination, change in weight, parasthesia, blurred vision
If > or =126mg/dl,
refer to endocrinologist
pallor, atrophic mucosa, bald tongue
count (CBC), vitamin B levels
If anemic, consult
with physician to rule out deficiency states and
reflux disorder (GERD)
History of stomach
acid reflux, erosion of tooth enamel
If abnormal, refer
to physician for appropriate treatment
White or red
mucosal lesion or ulcer
Allergy testing by
from oral environment
Traumatic ulcer or
lesion adjacent to prosthetic defect
elevated level of anxiety, depression or somatization
If abnormal, obtain
To Be Continued -
HPV16 Oral Cancer Link Tied to E6
and E7 Oncogenes
Journal of notional cancer institute in its March 18th issue
reported " Repressing E6 and E7
oncogene expression on the
malignant phenotype of
human papillomavirus (HPV)-16-positive oropharyngeal
cancer cell lines induces apoptosis"
.The team found that by using retroviruses that expressed short
hairpin (sh) RNA targeting the E6 and E7 genes, they were able to
infect human oropharyngeal squamous cell cancer harboring integrated
HPV-16 DNA. Control cells were exposed to scrambled-sequence shRNA.
There was a greater than 85% reduction in E6 and E7 mRNA levels and
restoration of p53 and retinoblastoma protein expression in the
targeted cells. Moreover, apoptosis, which was as low as 3.3% in
controls, reached as much as 84.3% in infected lines. The role of
HPV-16 in disabling the supressor pathways may have the potential to
treat these cancers.
Dentists Say Bad Economy Is
Causing Tooth Pain
Dentists across Massachusetts have reported that more and more
patients are reporting with teeth attrition since the days of
recession have started. The nations recession has started showing
signs on oral health. Dental attrition which could further lead to
associated problems like headaches and TMD's are the next big
worries people could face.
Further such oral findings by our esteemed readers of Dental
Follicle could take this story further.