Effectiveness of Pentoxifylline in the treatment of oral submucous fibrosis patients: a case-control study

Background: Oral submucous fibrosis (OSMF) is a potentially malignant disorder largely seen in the South-Asian countries where areca nut is found to be the main predisposing factor. Pentoxifylline, a methylxanthine derivative, has vasodilating properties and is believed to increase the vascularity of the mucosal layer. This study was designed to determine the effect of pentoxifylline (Trental) on the clinical progression of oral submucous fibrosis. Aim: The present study was aimed to evaluate the effectiveness of drug pentoxifylline in the management of OSMF and to correlate the clinical parameters evaluated before and after treatment. Methods: Study Design: This investigation was conducted as a case-control study incorporating a Control Group in comparison to a Study Group where pentoxifylline 400 mg was administered 3 times daily, as coated, sustainedrelease tablets for prescribed for 3 months. The stipulated period for the study was 8 months and a total of 80 cases of oral submucous fibrosis (40 test subjects and 40 controls) were included in this study and 100% acquiescence was reported at the end of the test period. Results: Mild dizziness and gastric irritation were the only untoward symptoms reported in 2 of the volunteers in the study group during this trial. These were managed by diet protocols. A review of the patients and controls was done at an interval of every 4 weeks for 3 months. The subjective and objective measurements were recorded. The follow-up data at each visit concerning each other and to base-line values were calibrated using nonparametric tests of the Chi-Square test and Mann-Whitney. Significant comparisons with regard to improvement were recorded as objective criteria of mouth opening (u value =1.137, p = 0.260), tongue protrusion (u value = 0.262, p = 0.794 and cheek flexibility (u value =0.990, p = 0.326). Subjective symptoms of burning sensation of mouth (U value = 2.673, p = 0.008), pain on opening the mouth (U value = 4.320, p < 0.0001), difficulty in swallowing and difficulty in the speech were also recorded. Conclusion: This study showed the effectiveness of pentoxifylline as an additional therapy in the routine management of oral submucous fibrosis.

Tobacco cessation and counseling: A dentists' perspective in Bhopal city, Madhya Pradesh.

Introduction: Dental team has high potential to help smokers to better oral/general health but to achieve this; they need to be clear about their role. Considering the importance of tobacco cessation, the authors carried out this study aimed at assessing the role, knowledge, current practices, different barriers, and tools to overcome the same as perceived by dentists in Bhopal city. Materials and Methods: A self-administered structured, coded questionnaire was distributed to 200 private practitioners and the teaching staff in all the dental colleges in Bhopal city. Results: Out of 200 dentists to whom questionnaire was administered, 168 responded within a week's time resulting in a high response rate of 84%. A total of 97% of the dentists agreed that it is the duty of every dentist to advice patients about tobacco cessation. A total of 58% strongly agree that formal training will be an effective tool to provide the guidelines to dentists in tobacco cessation and counseling. Conclusion: Monitoring of effective planning and execution of these programs by appropriate authorities at regular intervals is vital for successful achievement of the goal of "Tobacco Free Society."

Brief intervention for smokeless tobacco users by dentist.

The dental team has an important role to play in tobacco cessation and counselling. The present study was conducted to evaluate the effectiveness of the brief intervention for smokeless tobacco users as a longitudinal study. Ninty patients who were assessed to be in the Pre contemplation phase based on the Transtheoretical model, were included in the study. The nicotine dependence was graded according to Talwar et al (2004). Their follow up was done for 1 year. During the inception of the study all the participants showed heavy nicotine dependence. By the end of one year 10 males and 19 females became light nicotine dependent. Our study showed a reduction of 32% in the prevalence of tobacco use after the implementation of the programme using the “5 A” model.

Child, hypertension and oral health.

Hypertension is a major public health issue in industrialized nations. Many efforts have focused on the primary prevention and control of hypertension in adults. Nevertheless, the increasing incidence of hypertension in younger age groups has drawn attention to the severity and complications of the disease in children and adolescents. Public health implications of hypertension in children are overwhelming because many of these individuals will eventually face medical squeal into adulthood. Reproducibility of blood pressure in children can be challenging, especially in younger individuals, and the practitioner should be alert for shallow reading ranges in young children. Safe provision of dental care to hypertensive children requires knowledge about the aetiology of the elevation in blood pressure, oral manifestations, target organ damage, and possible drug interactions. This article provides an overview of hypertensive children and their oral health management. The recommendations presented in this article have been formulated using the available data regarding hypertension in children.