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Naara S, Andrews C, Sikora A, Williams M, Chambers M, Myers J, Amit M. Oral Pre-malignancy: An Update on Novel Therapeutic Approaches. Curr Oncol Rep 2024:10.1007/s11912-024-01562-1. [PMID: 38865005 DOI: 10.1007/s11912-024-01562-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE OF REVIEW This review aims to provide a comprehensive overview of the current advances in managing and preventing progression of oral potentially malignant disorders (OPMDs), focusing on their histological and clinicopathological features, and management. RECENT FINDINGS Recent studies, including a multicenter cross-sectional study, have identified oral leukoplakia as the most prevalent form of OPMD, comprising over half of the cases examined. Advances in histological grading, specifically the World Health Organization's three-tier system (mild, moderate, and severe dysplasia), have significantly enhanced the accuracy of risk assessment for malignant transformation. Additionally, treatments such as surgical interventions, photodynamic therapy, and chemopreventive and molecularly targeted agents are being evaluated for their safety and efficacy as well as, immune checkpoint inhibitors being evaluated as potential preventive strategies to halt the progression of OPMDs. The management of OPMDs remains challenging due to the lack of standardized screening protocols and varied clinical management approaches. Despite this, recent advancements in diagnostic grading and therapeutic interventions provide a framework for improved treatment outcomes. Continued research into the molecular and cellular mechanisms driving development and progression of OPMDs and innovative treatment trials are essential to optimize strategies that prevent malignant progression and thereby reduce the global health burden of oral cancer.
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Affiliation(s)
- Shorook Naara
- The Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Clara Andrews
- The Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew Sikora
- The Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Michelle Williams
- Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Mark Chambers
- The Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey Myers
- The Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Moran Amit
- The Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
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Alqarni H, Aldghim A, Alkahtani R, Alshahrani N, Altoman MS, Alfaifi MA, Helmi M, Alzaid AA. Crystal methamphetamine and its effects on mental and oral health: A narrative review. Saudi Dent J 2024; 36:665-673. [PMID: 38766295 PMCID: PMC11096620 DOI: 10.1016/j.sdentj.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 05/22/2024] Open
Abstract
The purpose of this comprehensive literature review is to present the available evidence on the effects of methamphetamine on mental and oral health, as well as provide an overview of the most widely used medical and dental care strategies in the management of meth mouth. For this purpose, PubMed and Google Scholar electronic databases were searched for relevant articles, yielding 115 search results, which were further scrutinized for their relevance, leaving 55 for a detailed review. The analysis of the gathered data indicates that a comprehensive patient-centered approach that takes into consideration the physical, mental, and social aspects is crucial for mitigating the detrimental effects of increasing methamphetamine use.
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Affiliation(s)
- Hatem Alqarni
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Adhwaa Aldghim
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Rose Alkahtani
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Nasser Alshahrani
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Majed S. Altoman
- Department of Prosthetic Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammed A. Alfaifi
- Department of Prosthetic Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammad Helmi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz A. Alzaid
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
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Alexander-Savino CV, Mirowski GW, Culton DA. Mucocutaneous Manifestations of Recreational Drug Use. Am J Clin Dermatol 2024; 25:281-297. [PMID: 38217568 DOI: 10.1007/s40257-023-00835-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/15/2024]
Abstract
Recreational drug use is increasingly common in the dermatology patient population and is often associated with both general and specific mucocutaneous manifestations. Signs of substance use disorder may include changes to general appearance, skin, and mucosal findings associated with particular routes of drug administration (injection, insufflation, or inhalation) or findings specific to a particular drug. In this review article, we provide an overview of the mucocutaneous manifestations of illicit drug use including cocaine, methamphetamine, heroin, hallucinogens, marijuana, and common adulterants to facilitate the identification and improved care of these patients with the goal being to connect this patient population with appropriate resources for treatment.
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Affiliation(s)
- Carolina V Alexander-Savino
- State University of New York Upstate Medical University, Syracuse, NY, USA
- Department of Dermatology, University of North Carolina at Chapel Hill, 410 Market Street, Suite 400, Chapel Hill, NC, 27516, USA
| | - Ginat W Mirowski
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Oral Pathology, Medicine, Radiology, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Donna A Culton
- Department of Dermatology, University of North Carolina at Chapel Hill, 410 Market Street, Suite 400, Chapel Hill, NC, 27516, USA.
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Bradley N. Top tips for managing people who experience homelessness and social exclusion in primary care. Br Dent J 2023; 235:14-17. [PMID: 37443213 DOI: 10.1038/s41415-023-6090-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Affiliation(s)
- Natalie Bradley
- Clinical Director at Dentaid the Dental Charity, Totton, United Kingdom.
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Zhang J, Liu W, Shi L, Liu X, Wang M, Li W, Yu D, Wang Y, Zhang J, Yun K, Yan J. The Effects of Drug Addiction and Detoxification on the Human Oral Microbiota. Microbiol Spectr 2023; 11:e0396122. [PMID: 36722952 PMCID: PMC10100366 DOI: 10.1128/spectrum.03961-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/08/2022] [Indexed: 02/02/2023] Open
Abstract
Drug addiction can powerfully and chronically damage human health. Detoxification contributes to health recovery of the body. It is well established that drug abuse is associated with poor oral health in terms of dental caries and periodontal diseases. We supposed that drug addiction and detoxification might have significant effects on the oral microbiota. To test the hypothesis, we assessed the effects of drug (heroin and methylamphetamine) addiction/detoxification on the oral microbiota based on 16S rRNA gene sequencing by an observational investigation, including 495 saliva samples from participants. The oral microbial compositions differed between non-users, current and former drug users. Lower alpha diversities were observed in current drug users, with no significant differences between non-users and former drug users. Heroin and METH addiction can cause consistent variations in several specific phyla, such as the enrichment of Acidobacteria and depletion of Proteobacteria and Tenericutes. Current drug users had significantly lower relative abundances of Neisseria subflava and Haemophilus parainfluenzae compared to non-users and former drug users. The result of random forest prediction model suggested that the oral microbiota has a powerful classification potential for distinguishing current drug users from non-users and former drug users. A cooccurrence network analysis showed that current drug users had more complex oral microbial networks and lower functional modularity. Overall, our study suggested that drug addiction may damage the balance of the oral microbiota. These results may have benefits for further understanding the effects of addiction-related oral microbiota on the health of drug users and promoting the microbiota to serve as a potential tool for accurate forensic identification. IMPORTANCE Drug addiction has serious negative consequences for human health and public security. The evidence indicates that drug abuse can cause poor oral health. In the current study, we observed that drug addiction caused oral microbial dysbiosis. Detoxication have positive effects on the recovery of oral microbial community structures to some extent. Understanding the effects of drug addiction and detoxification on oral microbial communities will promote a more rational approach for recovering the oral function and health of drug users. Furthermore, specific microbial species might be considered biomarkers that could provide information regarding drug abuse status for saliva left at crime scenes. To the best of our knowledge, this is the first report on the role of the oral microbiota in drug addiction and detoxification. Our findings give new clues to understand the association between drug addiction and oral health.
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Affiliation(s)
- Jun Zhang
- Shanxi Medical University, Taiyuan, People's Republic of China
| | - Wenli Liu
- Beijing Center for Physical and Chemical Analysis, Beijing, People's Republic of China
| | - Linyu Shi
- Shanxi Medical University, Taiyuan, People's Republic of China
| | - Xu Liu
- Beijing Center for Physical and Chemical Analysis, Beijing, People's Republic of China
| | - Mengchun Wang
- Shanxi Medical University, Taiyuan, People's Republic of China
| | - Wanting Li
- Shanxi Medical University, Taiyuan, People's Republic of China
| | - Daijing Yu
- Shanxi Medical University, Taiyuan, People's Republic of China
| | - Yaya Wang
- Shanxi Medical University, Taiyuan, People's Republic of China
| | - Jingjing Zhang
- Beijing Center for Physical and Chemical Analysis, Beijing, People's Republic of China
| | - Keming Yun
- Shanxi Medical University, Taiyuan, People's Republic of China
| | - Jiangwei Yan
- Shanxi Medical University, Taiyuan, People's Republic of China
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Roberts WE, Mangum JE, Schneider PM. Pathophysiology of Demineralization, Part I: Attrition, Erosion, Abfraction, and Noncarious Cervical Lesions. Curr Osteoporos Rep 2022; 20:90-105. [PMID: 35129809 PMCID: PMC8930910 DOI: 10.1007/s11914-022-00722-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE OF THE REVIEW Compare pathophysiology for infectious and noninfectious demineralization disease relative to mineral maintenance, physiologic fluoride levels, and mechanical degradation. RECENT FINDINGS Environmental acidity, biomechanics, and intercrystalline percolation of endemic fluoride regulate resistance to demineralization relative to osteopenia, noncarious cervical lesions, and dental caries. Demineralization is the most prevalent chronic disease in the world: osteoporosis (OP) >10%, dental caries ~100%. OP is severely debilitating while caries is potentially fatal. Mineralized tissues have a common physiology: cell-mediated apposition, protein matrix, fluid logistics (blood, saliva), intercrystalline ion percolation, cyclic demineralization/remineralization, and acid-based degradation (microbes, clastic cells). Etiology of demineralization involves fluid percolation, metabolism, homeostasis, biomechanics, mechanical wear (attrition or abrasion), and biofilm-related infections. Bone mineral density measurement assesses skeletal mass. Attrition, abrasion, erosion, and abfraction are diagnosed visually, but invisible subsurface caries <400μm cannot be detected. Controlling demineralization at all levels is an important horizon for cost-effective wellness worldwide.
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Affiliation(s)
- W. Eugene Roberts
- grid.257413.60000 0001 2287 3919Indiana University & Purdue University at Indianapolis, 8260 Skipjack Drive, Indianapolis, IN 46236 USA
| | - Jonathan E. Mangum
- grid.1008.90000 0001 2179 088XDepartment of Biochemistry and Pharmacology, Dentistry and Health Sciences, University of Melbourne, Corner Grattan Street and Royal Parade, Parkville, Victoria 3010 Australia
| | - Paul M. Schneider
- grid.1008.90000 0001 2179 088XMelbourne Dental School, University of Melbourne, 720 Swanston St, Melbourne, Victoria 3010 Australia
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Roberts WE, Mangum JE, Schneider PM. Pathophysiology of Demineralization, Part II: Enamel White Spots, Cavitated Caries, and Bone Infection. Curr Osteoporos Rep 2022; 20:106-119. [PMID: 35156182 PMCID: PMC8930953 DOI: 10.1007/s11914-022-00723-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW Compare noninfectious (part I) to infectious (part II) demineralization of bones and teeth. Evaluate similarities and differences in the expression of hard tissue degradation for the two most common chronic demineralization diseases: osteoporosis and dental caries. RECENT FINDINGS The physiology of demineralization is similar for the sterile skeleton compared to the septic dentition. Superimposing the pathologic variable of infection reveals a unique pathophysiology for dental caries. Mineralized tissues are compromised by microdamage, demineralization, and infection. Osseous tissues remodel (turnover) to maintain structural integrity, but the heavily loaded dentition does not turnover so it is ultimately at risk of collapse. A carious tooth is a potential vector for periapical infection that may be life-threatening. Insipient caries is initiated as a subsurface decalcification in enamel that is not detectable until a depth of ~400μm when it becomes visible as a white spot. Reliable detection and remineralization of invisible caries would advance cost-effective wellness worldwide.
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Affiliation(s)
- W. Eugene Roberts
- American Board of Orthodontics, Indiana University & Purdue University at Indianapolis, 8260 Skipjack Drive, Indianapolis, IN 46236 USA
| | - Jonathan E. Mangum
- Translational Proteomics Laboratory, Department of Biochemistry and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Corner Grattan Street and Royal Parade, Melbourne, Victoria 3010 Australia
| | - Paul M. Schneider
- American Board of Orthodontics, Melbourne Dental School, University of Melbourne, 720 Swanston St, Melbourne, Victoria 3010 Australia
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Gaio DC, Bastos FI, Moysés SJ, Moysés ST, Corrêa da Mota J, Nicolau B, Ignacio S, Cubas MR, Tozetto Vettorazzi ML, Gonçalves Dos Santos ZFD, Werneck RI. Assessing oral health of crack users in Brazil: Perceptions and associated factors, findings from a mixed methods study. Glob Public Health 2020; 16:502-516. [PMID: 32912074 DOI: 10.1080/17441692.2020.1809693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study explores associated factors and perceptions of oral health among crack users recruited in open drug scenes in Brazil. A mixed methods approach was used. The quantitative component analysed findings from a large (N = 7381), population-based survey. The outcomes under analysis were 'self-perception of oral health' and 'self-reporting of problems affecting the mouth, teeth and gingiva (gums)'. The qualitative component comprised a focus group, with 12 individuals recruited from a drug treatment clinic. Lower self-perception of oral health problems vis-à-vis a higher prevalence of problems affecting the mouth, teeth, and gingiva were found in users who had a lower level of education, used substances daily, had worse self-perception of physical health, did not receive health care and regularly used alcohol and/or tobacco. The results show an association between substance use and decline in oral health, as well as the lack of health services focusing on such issues. Oral health services should be emphasised as a gateway to the health system. So far, the putative cross-referral between services and professionals working in oral health and other health professionals working in the field of drug dependence has not been observed.
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