Facts and controversies regarding oral health in Parkinson's disease: A case-control study in Spanish patients.

BACKGROUND: Parkinson's disease (PD) is one of the leading neurological disorders, affecting more than 6 million people worldwide. These patients present motor and non-motor symptoms, including oral pathology. The objective of this research is to determine the oral health of patients diagnosed with PD, in order to stablish a specific preventive oral health programme. MATERIAL AND METHODS: Case-control study on 104 PD and 106 control patients. The pre-designed clinical protocol included a complete oral examination on general aspects, standardised epidemiological index for caries, periodontal disease and edentulism, analysis of oral hygiene, presence of mucous/ salivary/ functional disorder, and dental treatments. RESULTS: A higher number of PD patients consumed daily sweets (p<0.004) and antidepressant drugs (p<0.004). Patients with PD practised less interdental hygiene (p<0.023). The mean plaque index was higher in PD (p<0.003). Drooling (p<0.001), xerostomia (p<0.001), hyposialia (p<0.001), dysphagia (p<0.001), hypogeusia/dysgeusia (p<0.025) and chewing difficulty (p<0.006) were more common in PD. CONCLUSIONS: Oral disorders are frequent in PD. A good knowledge of these alterations will allow us design a specific preventive protocol. Some oral alterations may be a sign of diagnostic alert or progression of PD.

Histopathological characterization of the oral lichenoid disease subtypes and the relation with the clinical data.

BACKGROUND: The aim of the study was to analyze the histopathological characteristics of samples with a diagnosis of oral lichenoid disease (OLD) and their link with the location and the type of clinical lesion, and the clinicopathological subtypes. MATERIAL AND METHODS: Retrospective study on 85 consecutive patients diagnosed with OLD (58 women and 27 men, mean age of 57.7 years). Clinical and histopathological characterization of each case (modified WHO criteria). Collection of the clinical and histopathological data of the lesions. Descriptive and comparative statistical analysis of the results. RESULTS: The 78.8% of the cases were considered clinically typical while the 21.2% were considered compatible. Histologically, 52.9% were classified as typical and 47.1% as compatible. Biopsies from "plaque-like" lesions presented hyperkeratosis (p>0.001) and epithelial dysplasia (p=0.06) more frequently. Furthermore, acute inflammation was more evident in erosive-ulcerative lesions (p=0.001). Differences regarding the location of the biopsy were statistically non-significant. However, 42.9% of the tongue biopsies showed epithelial dysplasia. CONCLUSIONS: The histopathological aspect of this disorder is not specific and does not allow us to differentiate between the main subtypes. Therefore, the main reasons to perform a biopsy in this disorder are to define the differential diagnosis and to rule out epithelial dysplasia or a carcinoma. The final histopathological result may be subject to the type of lesion that is biopsied.

Síndrome de Boca Ardiente en el País Vasco: estudio preliminar de 30 casos / Burning Mouth Syndrome in the Basque Country: a preliminary study of 30 cases

Objetivo: Conocer las principales características clinicopatológicas de los pacientes diagnosticados de Síndrome de Boca Ardiente (SBA) en nuestro medio. Material y Métodos: Estudio prospectivo sobre 30 pacientes con SBA, 29 mujeres y 1 hombre, con una edad media de 60,2 años (rango 37-89). Se cumplimentó un protocolo clínico previamente diseñado, se realizó una analítica sanguínea, una toma para cultivo de levaduras, medición del pH bucal y del flujo salival en reposo. Con los datos recogidos se realizó un análisis estadístico descriptivo y comparativo mediante chi cuadrado (p< 0,05). Resultados: Junto a la sensación de ardor o quemazón, un 60 por ciento de pacientes referían sequedad y un 60 por ciento disgeusia. La localización más habitual fue la lengua (66,7 por ciento). El tipo II de SBA fue el más común con el 53,3 por ciento. Un 82,9 por ciento de las mujeres eran postmenopáusicas. El 13,3 por ciento presentaban diabetes tipo II y un 6,7 por ciento déficits vitamínicos. Un 56,6 por ciento tomaba fármacos xerostomizantes. El 56,6 por ciento presentaba trastornos de ansiedad y /o depresión. Un 46,7 por ciento mostraba una deficiente higiene oral y el 44,4 por ciento de los portadores de prótesis utilizaban prótesis desajustadas. El flujo salival estaba reducido en el 50 por ciento de los pacientes. En ningun caso se produjo un crecimiento significativo de levaduras. Conclusiones: Los pacientes de SBA en nuestro medio corresponden principalmente a mujeres postmenopáusicas que muestran ardor lingual, xerostomía, disgeusia y ansiedad y/o depresión (AU)