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1.
Oral Dis ; 17(6): 550-9, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21306481

ABSTRACT

While treatment for cancer in terms of chemotherapy and radiation therapy have evolved significantly since their inception, both of these cancer treatment modalities, especially if used in combination (e.g., as with head and neck cancers), have a very real potential to result in painful and debilitating adverse effects that clearly decrease quality of life and, potentially, increase mortality due to cancer. Herein, we discuss the prevalence and etiology of three broad categories of oral complications found during the treatment of cancer patients: mucositis, dysgeusia, and infectious disease. Lastly, we present therapeutic options that may be helpful in ameliorating these uncomfortable and, sometimes, life-threatening oral complications.


Subject(s)
Head and Neck Neoplasms/therapy , Mouth Diseases/etiology , Antineoplastic Agents/adverse effects , Candidiasis, Oral/etiology , Dysgeusia/etiology , Herpesviridae Infections/etiology , Humans , Immunocompromised Host , Mouth Diseases/therapy , Opportunistic Infections/etiology , Radiation Injuries/etiology , Stomatitis/etiology
2.
J Dent Res ; 86(7): 581-5, 2007 Jul.
Article in English | MEDLINE | ID: mdl-17586701

ABSTRACT

Our objective was to evaluate changes in curriculum and culture within a research non-intensive dental school after implementation of programs supported by the NIH-NIDCR R25 Oral Health Research Curriculum Grant. We designed new curricular elements to foster an appreciation of research/discovery, an interest in academic/research careers, and application of biomedical/clinical advances to patient care. Funding was utilized to develop, implement, and assess a dedicated curricular track of continuous student research/scholarly activity throughout the four years of dental education. This track represented mandatory hours of didactic time exposing students to topics not traditionally included in dental curricula. Additionally, students were provided with customized flexible schedules to participate in elective "hands-on" mentored research/scholarly experiences at local, national, and international sites, including linkages to certificate, MS, and PhD programs. Funding was also used to support a wide array of faculty development activities that provided skill sets required to deliver integrated biomedical/clinical content, research-oriented evidence-based approaches to dental education, and translational case-based teaching methods emphasizing the application of new science/technologies to patient care. We measured changes in student, faculty, and institutional profiles/attitudes using traditional benchmarks, surveys, and focus groups. Comparisons were made between baseline data prior to R25 program initiation and data collected after years 3-4 of program implementation. Significant increases were demonstrated in: (1) student participation in research/scholarship, attendance at national meetings, research awards, publication of manuscripts, pursuit of advanced training/degrees, and expressions of interest in academic/research careers; (2) faculty participation in development activities, publication of manuscripts, and mentoring of students; and (3) increased institutional credibility within the university, supportive infrastructure for research/scholarship, and cultural expectations for academic excellence. Thus, we believe that the R25 programming changed the culture of our dental school, creating a supportive environment for research/scholarship, increasing academic productivity, and altering the attitudes of faculty/students.


Subject(s)
Dental Research/education , Financing, Government , National Institutes of Health (U.S.)/economics , Research Support as Topic , Schools, Dental/economics , Curriculum , Dental Research/economics , Education, Dental/economics , Faculty, Dental , Humans , Organizational Culture , Students, Dental , United States , Wisconsin
3.
Cutis ; 68(3): 201-6, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11579786

ABSTRACT

Recurrent aphthous stomatitis (RAS) is one of the most common oral diseases worldwide. Although the exact etiology of RAS remains unknown, a variety of topical and systemic preparations may be used for palliation or prevention. In most patients with RAS, topical agents, including over-the-counter preparations such as amlexanox, prescribed corticosteroids, or antimicrobial agents, are sufficient to control the disease. Patients with frequent exacerbations or those with a severe form of RAS that is unresponsive to topical treatments often require systemic agents to control their disease. These include corticosteroids, colchicine, dapsone, pentoxifylline, and thalidomide. All therapies are palliative, and none result in permanent remission.


Subject(s)
Stomatitis, Aphthous/drug therapy , Administration, Topical , Aminopyridines/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Humans , Prednisone/therapeutic use , Recurrence
5.
J Tenn Dent Assoc ; 78(2): 28-31, 1998 Apr.
Article in English | MEDLINE | ID: mdl-9800558

ABSTRACT

The recognition of a pathologic entity is only the first step in the chain of events which must be performed for accurate diagnoses and appropriate patient management. Other steps include selection of the type of biopsy to be performed; proper biopsy technique, instrumentation and specimen handling; appropriate fixation; detailed documentation; and postoperative patient instructions. If the clinician performs each step carefully and correctly, the patient is ensured of receiving an accurate diagnosis in the shortest possible period of time.


Subject(s)
Biopsy/methods , Oral Surgical Procedures/methods , General Practice, Dental , Humans , Mouth Mucosa/pathology , Mouth Neoplasms/diagnosis , Specimen Handling/methods
7.
Article in English | MEDLINE | ID: mdl-9195622

ABSTRACT

A workshop to discuss primary oral melanomas was convened at the annual Western Society of Teachers of Oral Pathology meeting in Bannf, Alberta, Canada. Fifty oral melanomas, identified from the files of the participants, were reviewed in order to better understand the clinical features, histologic spectrum, and natural history of these perplexing lesions. Results confirmed that oral melanomas occur in adults almost three times more frequently in men than women and have a decided predilection for the palate and gingiva. Some lesions exhibit a clinically detectable and prolonged in situ growth phase, whereas others seem to lack this property and exhibit only or predominantly invasive characteristics. Recurrences, metastases, and death from tumor were characteristic of the follow-up of a limited number of patients. Until definitive prospective data are collected that elucidate natural history, oral mucosal melanomas should be tracked separately from cutaneous lesions. All oral pigmented lesions that are not clinically diagnostic should be biopsied. Lesions with equivocal histopathologic features might be referred to as "atypical melanocytic proliferation" and should be excised. Recognition of lesions in an early in situ phase and aggressive treatment should have a favorable effect on prognosis. To enhance future or prospective study of these rare neoplasms, guidelines for reporting oral melanomas are suggested.


Subject(s)
Melanoma/pathology , Mouth Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Alberta , Female , Humans , Male , Melanoma/classification , Melanoma/therapy , Middle Aged , Mouth Neoplasms/classification , Mouth Neoplasms/therapy , Prognosis , Sex Ratio , Terminology as Topic
8.
Semin Cutan Med Surg ; 16(4): 257-64, 1997 Dec.
Article in English | MEDLINE | ID: mdl-9421216

ABSTRACT

More than 40 different oral diseases and conditions have been described in patients infected with human immunodeficiency virus (HIV). The recognition of the oral manifestations of HIV disease is of great significance because they may represent the first signs of the disease and have been shown to be highly predictive markers of severe immune deterioration and disease progression. Although some oral diseases and conditions have a weak association with HIV disease, others are strongly linked with the disorder, and a few are acquired immune deficiency syndrome (AIDS)-defining in nature. The spectrum of oral manifestations of HIV disease is reviewed with emphasis on clinical recognition, diagnosis, and treatment.


Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , HIV Infections/complications , Mouth Diseases/diagnosis , AIDS-Related Opportunistic Infections/immunology , AIDS-Related Opportunistic Infections/physiopathology , AIDS-Related Opportunistic Infections/therapy , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/immunology , Acquired Immunodeficiency Syndrome/physiopathology , Bacterial Infections/diagnosis , Bacterial Infections/physiopathology , Bacterial Infections/therapy , Disease Progression , Forecasting , HIV Infections/immunology , HIV Infections/physiopathology , Humans , Mouth Diseases/immunology , Mouth Diseases/microbiology , Mouth Diseases/physiopathology , Mouth Diseases/therapy , Mouth Diseases/virology , Mouth Neoplasms/diagnosis , Mouth Neoplasms/physiopathology , Mouth Neoplasms/therapy , Mycoses/diagnosis , Mycoses/physiopathology , Mycoses/therapy , Virus Diseases/diagnosis , Virus Diseases/physiopathology , Virus Diseases/therapy
9.
Ann Intern Med ; 125(6): 485-96, 1996 Sep 15.
Article in English | MEDLINE | ID: mdl-8779462

ABSTRACT

OBJECTIVE: To provide a comprehensive, literature-based guide to the diagnosis of and the management and referral of patients with oral diseases associated with human immunodeficiency virus (HIV) infection. DATA SOURCES: The literature was reviewed to identify common oral manifestations of HIV infection, the physical and laboratory findings associated with them, and the therapies used to treat them. The National Library of Medicine's AIDSLINE database was searched using the term "mouth diseases." Additional references were identified from the bibliographies of these articles and related textbooks. STUDY SELECTION: English-language abstracts were reviewed to determine each paper's clinical relevance. To be considered clinically relevant, a paper had to describe the physical appearance of oral manifestations, methods used to diagnose oral manifestations, or treatment and referral guidelines. More than 600 abstracts were identified. DATA EXTRACTION: After the abstracts were reviewed, articles were selected and were reviewed for possible inclusion. If both of two reviewers agreed that an article was clinically relevant and dealt with conditions that occurred in more than 1% of HIV-infected patients, the article was included. DATA SYNTHESIS: 16 conditions that occur in more than 1% of HIV-infected patients were identified. Information on these conditions was collected and sorted into three categories: clinical appearance, diagnostic methods, and treatment. CONCLUSIONS: Almost all patients with HIV infection will contract oral diseases. Guidelines for recognizing, diagnosing, and managing these conditions are presented. Most conditions can be treated or alleviated through the combined efforts of the physician and the dentist.


Subject(s)
HIV Infections/complications , Mouth Diseases/etiology , HIV Infections/immunology , Humans , Immunocompromised Host , Mouth Diseases/diagnosis , Mouth Diseases/therapy , Physical Examination
11.
Oral Surg Oral Med Oral Pathol ; 78(2): 189-93, 1994 Aug.
Article in English | MEDLINE | ID: mdl-7936588

ABSTRACT

Candida albicans is a ubiquitous, dimorphous yeast; it has been known for many centuries, and has the potential to cause human disease under specific circumstances and conditions. The actual taxonomy of Candida albicans and related species has only been confirmed within the twentieth century. The oral carriage rate for the organism is high, with nearly one half of the healthy population harboring the organism. Numerous predisposing factors for oral candidiasis have been recognized, including metabolic, dietary, mechanical, and iatrogenic factors. Multiple clinical forms of the disease have been described, including acute, chronic, and mucocutaneous presentations. Although rarely fatal in the absence of other serious underlying disease, oral candidiasis may serve as a useful clinical marker for the presence of significant predisposing conditions.


Subject(s)
Candidiasis, Oral , Age Factors , Candida albicans/classification , Candidiasis, Oral/classification , Candidiasis, Oral/history , Candidiasis, Oral/pathology , Disease Susceptibility , History, 18th Century , History, 19th Century , History, 20th Century , History, Ancient , Humans , Mouth/microbiology , Terminology as Topic
12.
J Am Dent Assoc ; 124(10): 67-74, 1993 Oct.
Article in English | MEDLINE | ID: mdl-8409011

ABSTRACT

Unstimulated whole saliva was collected from 21 HIV-positive men and women before and after dental treatment. The frequency of HIV detection did not increase after dental treatment. Infectious HIV was recovered from only one patient. Study findings raise the possibility that, in most cases, salivary inhibitors render the virus non-infectious.


Subject(s)
Antiviral Agents , HIV Infections/transmission , HIV/isolation & purification , Saliva/microbiology , Salivary Proteins and Peptides/physiology , Adult , Dental Care for Chronically Ill , Female , HIV Core Protein p24/isolation & purification , Humans , Male , Middle Aged , Mucins/physiology , Oral Hemorrhage
13.
Tex Dent J ; 110(2): 5-13, 1993 Feb.
Article in English | MEDLINE | ID: mdl-8332954

ABSTRACT

Human Immunodeficiency Virus (HIV) infection and the Acquired Immune Deficiency Syndrome (AIDS) are significant public health problems in Texas. This paper summarizes the most recent information on HIV infection and AIDS from global, national, and state perspectives. Current information on the manifestations of HIV infection and AIDS which are important to dentistry, ramifications for dental health care workers, and initiatives for HIV/AIDS education for dental health care workers in Texas are presented.


Subject(s)
Acquired Immunodeficiency Syndrome , Dental Care for Disabled , HIV Infections , Mouth Diseases/etiology , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/transmission , Dental Care for Disabled/legislation & jurisprudence , Education, Dental, Continuing , Female , HIV Infections/complications , HIV Infections/epidemiology , HIV Infections/transmission , HIV Seropositivity , Humans , Male , Minority Groups , Mouth Mucosa/pathology , Mouth Neoplasms/etiology , Risk Factors , Sex Ratio , Texas/epidemiology , United States/epidemiology
15.
J Am Dent Assoc ; 121(1): 145-9, 1990 Jul.
Article in English | MEDLINE | ID: mdl-2196297

ABSTRACT

The indications for advantages and disadvantages of the punch biopsy technique in the diagnosis of oral mucosal disease are discussed. The punch biopsy is recommended for use by the general practitioner as a simple, fast, inexpensive, and safe procedure for the diagnosis of oral mucosal lesions.


Subject(s)
Biopsy/methods , Mouth Mucosa/pathology , Biopsy/instrumentation , Equipment Design , Histological Techniques , Humans , Mouth Diseases/pathology , Plastics , Specimen Handling , Stainless Steel
20.
Oral Surg Oral Med Oral Pathol ; 66(1): 48-58, 1988 Jul.
Article in English | MEDLINE | ID: mdl-2457197

ABSTRACT

Oral mucosal lesions of Kaposi's sarcoma are a common finding in patients with acquired immunodeficiency syndrome (AIDS). The histologic features of Kaposi's sarcoma vary, depending on the clinical stage of the lesion. Endothelium-lined vessels are the principal feature of early, macular lesions, while spindle cells dominate late-stage, nodular lesions. The histogenesis of both components remains controversial. In this study, biopsy specimens of intraoral Kaposi's sarcoma from 10 patients with AIDS were studied by light and electron microscopic examination and by immunoperoxidase staining with the endothelial markers, factor VIII-related antigen and Ulex europeaus agglutinin I. The results of this study support a vascular origin for both the endothelium-lined vessels and the spindle cells. The latter appear to represent vascular endothelial cells in various stages of differentiation. The histologic features that are useful in the diagnosis of intraoral Kaposi's sarcoma are reviewed.


Subject(s)
Acquired Immunodeficiency Syndrome , Mouth Neoplasms/pathology , Plant Lectins , Sarcoma, Kaposi/pathology , Adult , Antigens , Blood Vessels/ultrastructure , Endothelium, Vascular/pathology , Endothelium, Vascular/ultrastructure , Factor VIII/immunology , Humans , Immunoenzyme Techniques , Immunohistochemistry , Lectins , Male , Middle Aged , Mouth Neoplasms/ultrastructure , Sarcoma, Kaposi/ultrastructure , Staining and Labeling , von Willebrand Factor
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