Oral health status of institutionalized elderly Cape Coloreds from the Cape Peninsula of South Africa

Clinical Science A Longitudinal Study of Root Caries: Baseline and Incidence Data

A 34-month clinical investigation of root caries was conducted using a hospitalized, chronically-ill population. Forty-five subjects with 150 caries-free surfaces were observed for at least 12 consecutive months. Clinical measurements included diagnosis of new root and coronal caries, gingival inflammation, pocket depth, recession, and distance of new lesions from the gingival margin. The overall root caries attack rate was 1.90 lesions per 100 person-months at risk, with the greatest rate occurring during the first year of study. Mesial and facial surfaces accounted for 84% of all new lesions. Sixteen subjects accounted for 26 new lesions; nine subjects had two or more new lesions. Subjects with new root lesions were found to have lower enamel caries experience but higher root caries experience at baseline and higher scores for gingival inflammation, pocket depth, and recession compared with those who did not develop root caries.

The range of diagnoses for oral soft-tissue biopsies of geriatric patients in a Saudi Arabian teaching hospital

INTRODUCTION

The increased life expectancy being observed worldwide necessitates careful planning for future geriatric oral health care needs, which should be based on epidemiologic surveys to identify these needs. We aimed to survey the range of lesions diagnosed in soft-tissue biopsies of patients over age 60 over a 30-year period in a Saudi Arabian teaching hospital.

METHODS

The histopathology records of geriatric patients with complete demographic data who were diagnosed between 1984 and 2013 at the College of Dentistry, King Saud University, were reviewed. The lesions were then classified into eight broad categories. Associations between variables were evaluated using Pearson's Chi square test.

RESULTS

There were 231 soft-tissue biopsies obtained from geriatric patients whose complete records were available. The male to female ratio was 1.1:1, and the mean age was 66.7 years. Most lesions (69%) occurred in patents aged 60-69 years. Although reactive lesions were generally the most common, the most common lesions were squamous cell carcinoma and fibroma. Lesions were most commonly located on the buccal mucosa and the alveolar ridge/gingivae.

CONCLUSIONS

The range of lesions seen in Saudi geriatric patients were similar to those reported for other parts of the world, although the lesions were more similar to those reported from developing countries. The very high rate of oral cancer, however, is expected to take the majority of the resources allocated to geriatric oral health care, except if a strong, population-based prevention program is initiated immediately.

Prevalence of oral mucosal lesions in institutionalized elderly people in Mashhad, Northeast Iran

OBJECTIVE

The aim of this study was to determine the prevalence of oral mucosal lesions in institutionalized elderly people in Mashhad, northeast of Iran.

BACKGROUND

This study was conducted to assess the prevalence of oral lesions in the institutionalized elderly.

METHODS

In this survey, we studied all of the nursing homes in Mashhad; a total of five encompassing 237 residents. The subjects were examined and lesions recorded in a designed checklist. T-test, chi-square and Fisher's exact tests were used for the analysis.

RESULTS

The mean age of the patients was 79.59 ± 8.88. Ninety-eight per cent of cases had at least one oral mucosal lesion. The most common lesions were fissured tongue (66.5%), atrophic glossitis (48.8%), sublingual varicosity (42%) and xerostomia (38%). There was no significant difference in the prevalence of denture-related lesions (DRLs) between men and women (p > 0.05). Xerostomia was more prevalent in 70-79-year-old than in 60-69-year-old subjects. No case of oral malignant lesion was detected.

DISCUSSION

These findings revealed a higher prevalence of oral mucosal lesions in Mashhad city compared with other studies conducted in other major cities in Iran and abroad. The results emphasise the necessity of national programmes towards oral health promotion.

Prevalence of oral lesions among Saudi dental patients

BACKGROUND AND OBJECTIVES

Few studies have been conducted in the Saudi population on oral mucosal lesions. The purpose of this study was to evaluate the type and extent of oral lesions in a study among dental patients at a college of dentistry in Saudi Arabia.

PATIENTS AND METHODS

Over a 3-year period, 2552 dental outpatients were interviewed and investigated clinically for the presence of oral mucosal conditions. A thorough oral clinical examination was performed, including a radiographic examination. The diagnosis was confirmed histopathologically when necessary.

RESULTS

Of 383 (15.0%) patients found to have oral mucosal lesions, females constituted 57.7% (n=221) and males 42.3% (n=162). The age range of the patients was between 15 to 73 years with a mean age of 38.2 years. The most commonly affected age group was 31 to 40 years, which comprised 21.4% (n=82) of all affected individuals. The least affected age group were individuals older than 61 years. The most common lesion was Fordyce granules (3.8%; n=98), followed by leukoedema (3.4%; n=86) and traumatic lesions (ulcer, erosion) in 1.9% (n=48). Tongue abnormalities were present in 4.0% (n=101) of all oral conditions observed, ranging from 1.4% (n=36) for fissured tongue to 0.1% (n=2) for bifid tongue. Other findings detected were torous platinus (1.3%; n=34), mandibular tori (0.1%; n=2) aphthous ulcer (0.4%; n=10), herpes simplex (0.3%; n=7), frictional hyperkeratosis (0.9%; n=23), melanosis (0.6%; n=14), lichen planus (0.3%; n=9) and nicotinic stomatitis (0.5%; n=13).

CONCLUSION

The findings of this study provide information on the types and prevalence of oral lesions among Saudi dental patients. This provides baseline data for future studies about the prevalence of oral lesions in the general population.

Oral lesions in elderly population: a biopsy survey using 2250 histopathological records

OBJECTIVE

To perform an oral biopsy survey focused on the incidence of oral lesions in Brazilian elderly patients.

METHODS

A total of 17 329 oral biopsy records were analysed and divided into two age groups: elderly patients, > or =60 years old; and non-elderly patients, <60 years old. Information about sex, race, age and histopathological diagnosis (categorised in non-neoplastic and neoplastic lesions) was collected. Differences of diagnosis incidence were tested by comparison between two proportions (binomial test).

RESULTS

The incidence of epithelial malignant neoplasms and pre-malignant lesions in the elderly group was higher than non-elderly group, as well as autoimmune diseases and salivary gland tumours. The three most prevalent lesions in the elderly group were inflammatory fibrous hyperplasia, squamous cell carcinoma, and fibroma.

CONCLUSION

The distribution of oral diseases using biopsies allows greater accuracy in data about oral health of elderly patients, especially when considering malignant and pre-malignant lesions.

Descriptive epidemiology of oral neoplasms in Sudan 1970-1985 and the role of toombak

Data from 1,916 cases of oral neoplasms occurring in the Sudan in a 16-year period, from January 1970 to December 1985, were retrieved and analysed. The study revealed a relatively high frequency of oral neoplasms in comparison with neighbouring countries. In this study, squamous-cell carcinoma was the most common oral malignancy (66.5%), followed by tumours of the salivary gland (14.7%), neoplasms of nonodontogenic and non-epithelial origin (9.6%) and odontogenic neoplasms (8.6%). Men had a higher frequency than women. The older age group of both genders showed a relatively high frequency of squamous-cell carcinoma. Among northern Sudanese there was a high rate of squamous-cell carcinoma, while southern Sudanese showed a high rate of odontogenic and salivary-gland neoplasms. The use of toombak has been stated to play a major role in the aetiology of oral squamous-cell carcinoma in the Sudan, and is suspected to be associated with neoplasms of the salivary glands.

Effects of cannabis smoking on oral soft tissues

The oral effects of cigarette smoking have been well documented but the effects of cannabis smoke on the oral environment have been poorly documented. Three-hundred cannabis/tobacco/methaqualone smokers were examined. Two control groups consisting of 152 tobacco- and 189 non-smokers respectively were examined similarly. Health of the oral tissues and oral dryness was recorded. Lesions present included leukoedema, leukoplakia and numerous others. The only significant differences between lesions and conditions noted in cannabis users and controls occurred with respect to leukoedema, dry mouth and traumatic ulcer.

An investigation into the association between leukoedema and smoking

One thousand, nine-hundred and ninety-six Cape Coloured high school pupils (655 females and 1,341 males, 14-18 years old) were examined to determine the prevalence of leukoedema and to investigate its relationship with smoking. Results were contradictory. Only in some subgroups was it found that the proportion of smokers with leukoedema was significantly larger than non-smokers with leukoedema; that those with leukoedema consumed significantly more tobacco than those without leukoedema, and that there was a corresponding increase in smoking and leukoedema with age. An analysis of the relationship between smoking, the sex, and leukoedema showed a relationship between sex and leukoedema, but that leukoedema was independent of smoking. Also the prevalence of the condition in smokers and ex-smokers was not significantly different. No correlation existed with the type of smoking and between the severity of the lesion and the amount of tobacco consumed. It is concluded that smoking does not cause the lesion but may aggravate it and that its etiology must be multifactorial.

The association between perioral injury and mucoceles

Because the origin of perioral mucous extravasation cysts (mucoceles) has been associated with injury to the glandular apparatus in the lips and cheeks it was decided to compare two groups of subjects, the one group having a known history of violent and antisocial behaviour and the other not. 474 institutionalized reform school boys and 532 randomly selected boys from state schools were examined. 48.9% of the reform boys and 2.8% of the state school pupils (p less than 0.0001) had oral scars. Mucoceles were observed in 8.2% of reform boys and 0.8% of state school boys (p less than 0.0001), the former being the highest prevalence of mucoceles reported as yet in man. 60% of the cases with mucoceles could relate the advent of the mucocele to an injury, and a significant relationship exists between the occurrence of mucoceles and the presence of oral scars (p less than 0.001). The study strongly suggests a direct relationship between oral injury and the origin of mucoceles.

Prevalence of root surface caries among institutionalized older persons

Fifty-nine residents of a chronic hospital (average age 67.9 years) were examined visually for root surface caries. Root lesions were found to be present in 44 of the residents and were located most frequently on the proximal surfaces of anterior teeth. The number of coronal DF surfaces, age and number of retained teeth were the factors found to be helpful in discriminating between persons with and without root surface caries.

The application of the International Classification of Diseases to dentistry and stomatology

The Application of the International Classification of Diseases to Dentistry and Stomatology (ICD-DA) takes from the parent volume (the International Classification of Diseases) all those items of specific interest in regard to oral pathology whether they be common or rare conditions, or whether the pathology originates in the oral cavity or is a manifestation of a systemic disease. The initial advantage is convenience in finding the numerical classification of disease without searching through the large parent volume. However, an even greater advantage is the fact that these conditions are not sufficiently subclassified in the parent manual whereas in the ICD-DA they are classified down to the five-digit level to make differential diagnosis meaningful within the practice of dentistry.