Exploring Health Professionals’ Perceptions of Chemotherapy and Radiation Therapy-Related Oral Mucositis

Purpose Determine health professionals’ (HPs’) perceptions of oral mucositis (OM), including clinical presentation of chemotherapy (CT)-induced vs radiation therapy (RT)-induced OM, its assessment and management. Methods HPs involved in the care of head and neck cancer (HNC) patients receiving RT to the oral cavity/oropharynx and haematopoietic stem cell transplantation (HSCT) patients receiving mucositis-inducing CT regimens were invited to participate in a customised 20-question survey. Themes included OM presentation, assessment and management. Results Survey response rate was 81.4%. Most were nurses (33%) and specialist doctors/dentists (25%). Majority (45%) identified as part of the haematology service, followed by radiation oncology (32%). Most haematology and radiation oncology HPs (89% and 70%, respectively) agreed/strongly agreed that OM impacted patients’ ability to complete treatment. There was a significant association (p<0.01) between HPs’ specialty and their perceptions of OM manifestations. Most radiation oncology (85%) and all oral medicine HPs agreed/strongly agreed that clinical manifestations of CT-induced OM and RT-induced OM were different, whereas haematology HPs varied in their perceptions (11% disagreed, 41% were neutral and 48% agreed/strongly agreed). There was uncertainty regarding differences in management of CT vs RT-induced OM: 30% of haematology HPs and 45% of radiation oncology HPs agreed/strongly agreed but most (52% and 45%, respectively in each group) responded “neutral.” Conclusion OM was recognised to adversely impact HSCT and HNC RT patients’ ability to complete treatment. There were differences in HPs’ perceived understanding of OM manifestations and management. Interventions to address these may reduce unwanted variations in patient care and outcomes.

Perception and Attitude of Dental Students and Interns Regarding the Diagnosis and Management of Oral Mucosal Lesions and Salivary Glands Hypofunction

Background: The perception and attitude of dental students/graduates regarding diagnosing/managing oral medicine cases are scarcely investigated. Objective: The aim of this investigation was to evaluate the level of confidence in diagnosing/managing cases of oral mucosal lesions and salivary glands hypofunction. Methods: A 29-items questionnaire descriptive survey was distributed among dental interns and sixth-year students in the city of Jeddah during March-April of 2020. Results: A total of 136 (81 interns and 55 sixth-year students) completed the questionnaire, of which 69.9% were from a government school, and 30.1% were from private schools. For oral mucosal lesions [i.e., aphthous/herpes simplex virus ulceration], the majority of government and private schools’ participants reported being confident in their ability to diagnose (88.4% and 87.8%, respectively) and provide treatment (63.2% and 56.1%, respectively). For oral candidiasis, the majority were confident in their ability to diagnose (government: 95.8%; private: 59.1%) and treat (government: 77.9%; private: 65.9%). The confidence in diagnosing lesions suspicious for dysplasia/premalignancy was high in 77.9% of government and 80.5% of private schools. Similar reporting was found regarding salivary hypofunctions (government: 93.7%; private: 90.2%). For the likeness to refer, the majority of participants were likely to refer to oral medicine, as the 1st choice, followed by oral surgery. Conclusion: Dental interns/sixth-year students seemed to have high levels of confidence in diagnosing/managing oral mucosal lesions and salivary hypofunctions. However, the partial participation and the subjectivity of reporting may have hindered capturing the full/precise picture.

Anthropometric Evaluation of Volume of Maxillary Sinus and Nasal Septum Patterns as an AID in Personal Identification Using CBCT-A Retrospective Study

Aims: To determine the reliability and accuracy of maxillary sinus volume and nasal septum patterns in personal identification in forensics using CBCT (cone beam computed tomography). Study Design: Retrospective Study Place and Duration of Study: Department of Oral Medicine and Radiology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital Nagpur, from September 2019-December 2019. Methodology: 110 CBCT scans of bilateral maxillary sinuses and nasal septum images were retrospectively obtained from the Oral Medicine and Radiology database (68 men and 42 females). The study was divided into two groups based on age. Group -I consists of 58 CBCT scans taken between the ages of 20 and 40, while Group -II consists of 52 CBCT scans taken between the ages of 41 and 80. The height, breadth, and depth of the maxillary sinus were measured linearly. The nasal septum was classed as simple deviation to the right or left, sigmoid type, reverse sigmoid type, and straight based on the septa's deviations. Each person's combined maxillary sinus and nasal septum pattern was documented. Results: The difference in maxillary sinus volume between two age groups was significant (P<0.5). In age group I, there was a substantial change in the left deviation pattern, and there was a significant change in the reverse sigmoid pattern in males and the straight nasal septum pattern in females. With whatever nasal septum configuration, there were no volumetric alterations(P>0.5). Conclusion: In future, further research will be needed with a larger number of images to compare in order to arrive at a definitive identification.

Evaluation of the Relation of Smoking, Gallstones, and Renal Stones With Sialolithiasis in Patients Referred to Oral Medicine and ENT Department of Tabriz University of Medical Sciences

Background: The exact mechanism of the formation of salivary gland stones is unknown. Elucidating pathophysiology of the formation of salivary stones might prevent both their formation and the need for implementing invasive surgical procedures. Therefore, this study aimed to evaluate the effects exerted by some etiological factors on the formation of salivary gland stones. Methods: In this case–control study, the records of 80 patients with sialolithiasis were studied as a census from April 2011 to June 2019. These patients were referred to the Oral Medicine and the ENT departments of Tabriz University of Medical Sciences. The control group consisted of the same number of the patients with no sialolithiasis. Two groups were compared in terms of stone size, smoking, gallstones, and renal stones. Chi-squared, independent t-test, and Mann-Whitney U test were adopted to examine the quantitative variables. The data were analyzed using SPSS 17. Statistical significance was set at P<0.05. Results: Overall, 96.2% of sialoliths were found in the submandibular gland, of which 78.8% were single. Moreover, 32.5% of the patients with a history of sialolithiasis were smokers, whereas this frequency was 23.8% in the control group. In the case and control groups, 2.5% and 5% of the patients had a history of renal stones, respectively. Only one patient who had undergone a surgical procedure to remove salivary gland stones had a history of gallstones, while none of the patients in the control group had a history of gallstones. Conclusions: The results showed that the formation of salivary gland stones was not associated with smoking, history of renal stones, and gallstones. Furthermore, it was found that the numbers and sizes of salivary stones were not affected by smoking.

What’s in a Name?

Guest Comment by Dr. Manisha Lakhanpal Sharma, Professor & Head, Department of Oral Medicine and Radiology, ITS Dental College, Hospital and Research Centre, Greater Noida

Demographic and Clinical Profile of Oral Submucous Fibrosis: A Retrospective Study

Aims: Assessment of risk factors and the role of habit variables such as duration and frequency in the severity of OSMF and to ascertain the association of gender predilection for different habits and severity of OSMF. Study Design: Descriptive retrospective study. Place and Duration of Study: Department of Oral Medicine and Radiology, Rural Dental College, Pravara Institute of Medical Sciences (Deemed University), Loni Bk. between January 2012 and December 2019. Methodology: This descriptive retrospective study of 1790 OSMF patients was carried out at the tertiary level dental hospital in the rural population of Western Maharashtra. The clinicodemographic data including details of habits was collected for a period of 8 years. Results: The average age of the patient in the study was 32.8 years, with 16.5:1 M:F ratio. Significantly higher proportions of females (69.6%) were illiterate and belonged to low socioeconomic status.There was a statistically significant increase for areca nut chewing (OR=0.135(0.054-0.342), P < 0.0001), gutkha chewing (OR=22.32(10.421-47.817), P < 0.0001), tobacco chewing (OR= 0.111(0.04-0.308), p<0.0001), smoking habits (OR=30.791(7.472-126.89), P < 0.0001) and alcohol (OR=12.692(3.077-52.347, p < 0.0001) in males when compared with females.The maximum patients were seen in stage II (37%) and stage III (34%), followed by stage I (18.73%) and stage IV (10.3%) and the severity of OSMF was more in subjects who had the habits for longer duration. Conclusion: There was a definite gender predilection for various habits and their variables (frequency, duration), educational and socioeconomic status, clinical features and disease severity. Significant correlation was also found between habit variables (duration, frequency) and severity of the disease.