Oral health care of Saudi leukemic patients

There is a growing demand in Saudi Arabia for better oral health care; however, the need varies from one group to another. Patients with leukemia require more dental care than do healthy subjects because of associated serious oral complications and physical disabilities in maintaining plaque-free teeth. Because of a dental manpower shortage, leukemic patients in Saudi Arabia are likely to be receiving less specialist dental care than they require. A pilot study of 30 leukemic patients from four major hospitals in Riyadh showed high indices of plaque, calculus, and gingival bleeding. While hopitalized, 54% of the patients had a plaque index of greater than 80%, whereas 31% of the patients had a bleeding index of greater than 80%. All leukemic patients examined had either oral ulcerations, fungal infection, gingival enlargement, or gingival bleeding that necessitated further medical attention. This study indicated that Saudi leukemic patients desperately require better oral health care. Additional specialist dental centers staffed by appropriately trained dental personnel are urgently needed to provide oral health care for these patients.

Meswak chewing stick versus conventional toothbrush as an oral hygiene aid

This study consisted of two trials. Trial 1 compared the meswak with the toothbrush when used twice and five times a day. Trial 2 compared habitual meswak users with toothbrush users. Under experimental conditions, a significant reduction in gingivitis was found both buccally (p less than 0.01) and lingually (p less than 0.05) after using a meswak five times a day compared with a conventional toothbrush. Twice a day brushing with a meswak produced a significant reduction in gingivitis buccally (p less than 0.005) compared with toothbrushing, but lingually the difference was insignificant. There were no significant differences in plaque scores between a meswak and a conventional toothbrush when brushing was continued five times a day. Plaque scores became significantly higher when a meswak was used only twice a day compared with toothbrushing, specifically on the lingual surfaces of the teeth (p less than 0.01). Habitual meswak users showed a significant reduction in gingival bleeding (p less than 0.05) and interproximal bone height (p less than 0.02) compared with toothbrush users. The differences in plaque scores and pocket depth measurements between the two groups were insignificant. The results imply that a meswak, used five times a day, may offer a suitable alternative to a toothbrush for reducing plaque and gingivitis. However, meswak may not be sufficient for maintaining interproximal dental health when used without the support of other oral hygiene aids.

More unusual pigmentations of the gingiva

Three unusual types of oral pigmentation are presented. The first is a brown orange pigmentation caused by the habit of using the bark of Juglans regia for teeth cleaning. The second is a bright yellow pigmentation associated with the habit of chewing the seeds of Cola nitida. The third is a generalized mousy brown pigmentation related to the habit of chewing the leaves of Catha edulis. The purpose of this article is to describe the nature of these pigmentations and to present their clinical and histologic features.