[The impact of childhood caries]. / Carie du biberon: un caillou dans la chaussure de la santé.

The early childhood caries affect primary dentition before the eruption of the permanent teeth. It is set to extended use of a bottle containing fermentable carbohydrates. The early childhood caries is not only a dental disease: it is a social, cultural and behavioral condition that reflects the practices and beliefs around the child. Swiss data indicate that in aged 2 children, one of for could be affected by this devastating oral disease, mainly in vulnerable populations. The primary care physician has an important role in the screening of preschool children, in determining the risk level of the child for early childhood caries. Physicians can advise families, especially pregnant women, about preventive measures and behavior, leading to a dramatic drop of early childhood caries prevalence.

Mandibular osteoradionecrosis in squamous cell carcinoma of the oral cavity and oropharynx: incidence and risk factors.

OBJECTIVE: Mandibular osteoradionecrosis (ORN) is a serious complication of radiotherapy (RT) in head and neck cancer patients. The aim of this study was to analyze the incidence of and risk factors for mandibular ORN in squamous cell carcinoma (SCC) of the oral cavity and oropharynx. STUDY DESIGN: Case series with chart review. SETTING: University tertiary care center for head and neck oncology. SUBJECTS AND METHODS: Seventy-three patients treated for stage I to IV SCC of the oral cavity and oropharynx between 2000 and 2007, with a minimum follow-up of 2 years, were included in the study. Treatment modalities included both RT with curative intent and adjuvant RT following tumor surgery. The log-rank test and Cox model were used for univariate and multivariate analyses. RESULTS: The incidence of mandibular ORN was 40% at 5 years. Using univariate analysis, the following risk factors were identified: oral cavity tumors (P < .01), bone invasion (P < .02), any surgery prior to RT (P < .04), and bone surgery (P < .0001). By multivariate analysis, mandibular surgery proved to be the most important risk factor and the only one reaching statistical significance (P < .0002). CONCLUSION: Mandibular ORN is a frequent long-term complication of RT for oral cavity and oropharynx cancers. Mandibular surgery before irradiation is the only independent risk factor. These aspects must be considered when planning treatment for these tumors.

Melanotic neuroectodermal tumour of infancy: A case report and review of the aetiopathogenic hypotheses

The case of a 2-month-old healthy infant without relevant medical history. The patient was referred due to the aggravation of a swelling occupying the left half of the anterior maxilla. This lesion became visible approximately one month ago; it involved the buccal gingiva and alveolar bone, including the deciduous tooth germs 6.1 and 6.2.The swelling had dimensions of 20 mm x 20 mm. The surgical excision was performed under general anesthesia.The tooth buds of 6.1 and 6.2 were closely related to the tumour and so were removed. The lesion was entirely enucleated. The pathology of the lesion confirmed a melanotic neuroectodermal tumour of infancy. The melanotic neuroectodermal tumour of infancy (MNTI) has been described as a rare benign pigmented painless swelling that usually occurs in the anterior region of the maxilla and in the incisor region. The histological examination showed small basophilic cells, many containing melanin pigmentation within the cytoplasm, with a second population of larger cubical cells with abundant cytoplasm, arranged in alveolar or adenoid clusters. According to Krompecher this tumour derives from epithelial nests evolved at the time of embryonic fusion of the facial processes. It has also been suggested that the tumour arises from the retinal anlage by a pinching-off process of neuroepithelium during the formation of embryonic eye. More recently, the presence of high levels of vanillylmandelic acid suggest a neural origin of the tumour (AU)

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[An interface between pediatrics and oral medicine: oral manifestations of gastroesophageal reflux in children]. / Lésions buccales du reflux gastro-oesophagien de l'enfant: des réalités et quelques mythes.

Gastro-oesophageal reflux (GOR) is a common disorder in the pediatric population. In association with esophagitis, GOR may impair children's quality of life. Extra-oesophageal manifestations are of specific interest in oral medicine because the refluxate may reach impair both oral mucosa and hard dental tissues. Some oral symptoms are so specific that they should raise the attention for other GOR symptoms. Dental erosion is a potential risk in children with gastroesophageal reflux: the pediatrician should routinely refer children with gastroesophageal reflux to a pediatric dentist to diagnose erosions and if needed restore the teeth. Conversely, in the presence of unexplained dental erosions the dentist and/or the pediatrician should discuss the possibility of an occult GOR.

Melanotic neuroectodermal tumour of infancy: a case report and review of the aetiopathogenic hypotheses.

The case of a 2-month-old healthy infant without relevant medical history. The patient was referred due to the aggravation of a swelling occupying the left half of the anterior maxilla. This lesion became visible approximately one month ago; it involved the buccal gingiva and alveolar bone, including the deciduous tooth germs 6.1 and 6.2. The swelling had dimensions of 20 mm x 20 mm. The surgical excision was performed under general anesthesia. The tooth buds of 6.1 and 6.2 were closely related to the tumour and so were removed. The lesion was entirely enucleated. The pathology of the lesion confirmed a melanotic neuroectodermal tumour of infancy. The melanotic neuroectodermal tumour of infancy (MNTI) has been described as a rare benign pigmented painless swelling that usually occurs in the anterior region of the maxilla and in the incisor region. The histological examination showed small basophilic cells, many containing melanin pigmentation within the cytoplasm, with a second population of larger cubical cells with abundant cytoplasm, arranged in alveolar or adenoid clusters. According to Krompecher this tumour derives from epithelial nests evolved at the time of embryonic fusion of the facial processes. It has also been suggested that the tumour arises from the retinal anlage by a pinching-off process of neuroepithelium during the formation of embryonic eye. More recently, the presence of high levels of vanillylmandelic acid suggest a neural origin of the tumour.

[Is atherosclerosis a periodontally-induced disease?]. / L'athérosclérose est-elle une maladie gingivo-induite?

Traditional risk factors do not explain all of cases of ischemic cardiovascular disease. The literature now identifies periodontal disease, a chronic oral infection, as a potential risk factor of atherosclerosis. Three plausible biologic pathways have been proposed to explain this link: a direct action of periodontal bacteria migrating by bacteriemia, an indirect action by inflammation, mediators an immunopathogenic pathway related to heat shock proteins. Clinical studies show an increase in the CRP or recirculating specific immunoglobulins in presence of advanced periodontal disease. Other interventional studies show a reduction in cardiovascular risk factors when intensive periodontal therapy is used in patients with advanced periodontal disease. Literature therefore confirms a modest link between periodontal and cardiovascular diseases even if causality is not confirmed so far.

[Why try a docter when you need a dentist? Oral health and primary care medicine: what are the issues?]. / Pourquoi voir un docteur? C'est un dentiste qu'il vous faut! Santé buccale et médecine de premier recours: quels enjeux?

Oral conditions have some of the highest prevalence and incidences rates of all health problems in industrialized countries. They are associated with pain, functional limitations, interferences with usual activities and life-threatening complications. Most people experiencing oral symptoms visit a dentist. But how many and why are patients with oral conditions presenting to general practitioners? Despite early separated training curriculum, there is an overlap with regard to clinicians in medicine and dentistry, who are called to treat patients seeking care for non dental problems of the maxillofacial region. This paper aims to get a fix on oral conditions in which primary care doctors have unmistakably to play a role in. However, studies have shown that physicians lack knowledge to promote oral health in their patients what lead universities to develop recently an oral health curriculum for medical students.