Realizing the clinical utility of saliva for monitoring oral diseases.

In the era of personalized/precision health care, additional effort is being expended to understand the biology and molecular mechanisms of disease processes. How these mechanisms are affected by individual genetics, environmental exposures, and behavioral choices will encompass an expanding role in the future of optimally preventing and treating diseases. Considering saliva as an important biological fluid for analysis to inform oral disease detection/description continues to expand.

Oral Potentially Malignant Disorders and Oral Cavity Cancer.

The Surveillance, Epidemiology, and End Results program from the National Cancer Institute reports that the aggregate number of oral cavity and pharyngeal cancer cases has been increasing over the past decade and, despite an overall decline in oral cavity cancers, this increase is largely related to a dramatic increase in cancers involving oropharyngeal subsites. Early detection of oral cavity cancers is commensurate with improved survival, and opportunistic screening by trained clinicians to detect oral cavity cancer and oral potentially malignant disorders is recommended by the American Dental Association and the American Academy of Oral Medicine.

Adjunctive Diagnostic Techniques for Oral and Oropharyngeal Cancer Discovery.

The most important prognostic factor in predicting the outcome of oral and oropharyngeal cancer (OPC) is the stage at which it is diagnosed. Only 30% of patients are diagnosed with early-stage disease. The oral health care provider performs an important role in early diagnosis of oral cancer.

Oral and oropharyngeal cancer.

Oral and oropharyngeal cancer (OPC) is a complex and often relentless malignancy prone to local invasion and dissemination. Despite advances in understanding of the disease and improved therapeutic interventions, it continues to be diagnosed at an advanced stage and the survival rate remains poor. The financial cost of treating OPC may be the highest of all cancers in the United States and survivors often experience major detriments to quality of life.

It's not just an "oral cancer" exam.

The early identification and treatment of cancer of the head and neck, including oropharyngeal cancer (OPC), is associated with an improved survival rate. Specific efforts to promote screening to improve the early detection of OPC have come under scrutiny, largely due to the low prevalence of the disease. However, screening the patient for OPC does not occur as an isolated event in contemporary practice, but as an integral component of the hard and soft tissue examination to determine the totality of the patient's oral health.

Adjunctive diagnostic aids in oral cancer screening: an update.

During the past decade, several adjunctive aids have been introduced to the marketplace with the promoted goal of improving the dental practitioner's ability to screen for and identify oral premalignant and malignant lesions (OPMLs). These products include the OralCDx Brush Test, ViziLite Plus with TBlue, Microlux, VELscope Vx, Sapphire Plus, Identafi, and the DOE Oral Exam System. They are all marketed as aids for the clinician to use in addition to, not in lieu of, the accomplishment of a conventional oral examination (COE).

White oral lesions, actinic cheilitis, and leukoplakia: confusions in terminology and definition: facts and controversies.

Many diseases affecting the cutaneous tissues may incur observable changes to the mucosal tissues of the oral cavity. As a consequence, the dermatologist should always assess the oral mucosal tissues of their patients as a matter of routine. Equivocal lesions should be referred to a dentist for further assessment.

Antimicrobial efficacy of soap and water hand washing versus an alcohol-based hand cleanser.

The emergence of alcohol-based hand cleansers may represent an alternative to soap and water in the clinical dental setting. In this study, the antimicrobial efficacy of traditional hand washing vs. a unique alcohol-based hand cleanser with persistence was evaluated.

Assessment of the VELscope as an adjunctive examination tool.

The VELscope is a visualization-enhancement adjunct currently marketed to assist the clinician in assessing potentially dysplastic or malignant mucosal lesions in the oral cavity. The author examined 130 subjects, who smoked at least one package of cigarettes per day. The clinical findings derived from a conventional examination protocol were compared to the findings observed with the VELscope.

Gastrointestinal illnesses and their effects on the oral cavity.

Many disease processes affecting the gastrointestinal (GI) tract may cause observable changes to the oral cavity. In fact, oral cavity changes may represent the first clinical manifestation of an underlying GI condition. Recognition and appropriate referral of a possible GI condition contribute to overall health and wellness in patients.

Risk stratification and dental management of the patient with thyroid dysfunction.

The thyroid gland produces hormones critical to the maintenance of the cellular metabolic rate. The actions of these hormones are far-reaching, affecting thermoregulation and calorigenesis; the metabolism of carbohydrates, fats, and proteins; and oxygen utilization. Thyroid hormones also appear to act synergistically with epinephrine and enhance tissue sensitivity to catecholamines.

Unusual presentation of idiopathic osteosclerosis: a case report.

Idiopathic osteosclerosis (IO) typically manifests as an incidentally discovered, well-defined homogenous radiopacity that blends in with the surrounding bone. Once the condition is diagnosed, treatment is neither indicated nor necessary; however, atypical variants of osteosclerosis have been described and may pose a diagnostic and management dilemma for the clinician who encounters them. This case report discusses the differential conditions that should be considered when an atypical variant of IO is encountered.

Risk stratification and dental management of patients with adrenal dysfunction.

Intrinsic and extrinsic physiological stressors (physical, metabolic, or psychological) are constantly challenging the body's homeostatic mechanisms. Regardless of their nature, the body will initiate a series of autonomic responses in an effort to maintain homeostasis. For example, to cope with a perceived threat, cardiac output and respiration are increased, the availability of glucose is increased, and blood flow to the heart, brain, and muscles is increased.

HIV: infection control issues for oral healthcare personnel.

Aim: To present the essential elements of an infection control/exposure control plan in the oral healthcare setting with emphasis on HIV infection.

Methods And Materials: A comprehensive review of the literature was conducted with special emphasis on HIV-related infection control issues in the oral healthcare setting.

Results: Currently available knowledge related to HIV-related infection control issues is supported by data derived from well-conducted trials or extensive, controlled observations, or, in the absence of such data, by best-informed, most authoritative opinion available.

Osteogenesis imperfecta.

Osteogenesis imperfecta is a relatively common hereditary connective tissue disorder characterized by bone fragility and fractures. Other frequently affected tissues include tendons, ligaments, skin, sclera, teeth, and middle and inner ear. Molecular studies have demonstrated that most cases result from mutations affecting the genes responsible for the formation of type 1 collagen.

The patient with actinic cheilosis.

Recent research has greatly enhanced the understanding of the etiopathogenic pathways underlying squamous cell carcinoma (SCC) of the skin. The predominant etiologic agent is ultraviolet radiation. Excessive exposure to sunlight may lead to the development of sunburn, premature aging of the skin, cataracts, immune suppression, and skin cancer.

Cost analysis of hand hygiene using antimicrobial soap and water versus an alcohol-based hand rub.

Proper hand hygiene is acknowledged as the most critical element of an adequate infection control program in the oral healthcare setting. However, adherence to proper hand hygiene protocols is often lacking. Poor compliance with hand hygiene protocols has been attributed to such factors as lack of time, hand irritation, hand dryness, forgetfulness, skepticism over importance, understaffing, perceived low risk of cross-infection, inconvenience, and the belief gloves alone offer protection.