How general dentists could manage a patient with oral lichen planus

Factors influencing engagement in oral cancer prevention activities among dental students and professionals in Saudi Arabia

BACKGROUND

Oral cancer is a pressing health concern in the Saudi Arabia (SA), with rising incidence and mortality rates. Despite the efforts in raising awareness, gaps persist in knowledge, attitudes, and practices (KAP) related to oral cancer prevention (OCP) among dental health professionals. This study aimed to identify the key factors influencing engagement in oral cancer prevention activities among dental students and professionals in Saudi. It examines the impact of socio-demographic characteristics and assesses their KAP related to oral cancer prevention.

METHOD

A cross-sectional study was conducted between November 2023 and February 2024 using a pre-validated online questionnaire distributed among oral health providers across various regions and sectors in SA. The survey included questions about participants' KAP toward OCP. Descriptive statistics and logistic regression analyses were used to analyze the data.

RESULTS

Out of 400 oral health providers invited, 157 completed the survey. The findings showed a discrepancy between knowledge and practice. While awareness of OC was generally high, this did not consistently lead to favourable attitudes or effective practices. The engagement in OCP activities was significantly associated with good knowledge, practice and favourable attitude scores. Profession significantly influenced participation, with clinicians (P = 0.013, OR = 0.131, 95% CI: 0.026-0.653) and those in administrative roles (P = 0.030, OR = 0.101, 95% CI: 0.013-0.804) both less likely to participate compared to dental students. Knowledge was a significant predictor (P = 0.002), with providers demonstrating poor knowledge being far less likely to participate (OR = 0.053, 95% CI: 0.008-0.339).

CONCLUSION

The study identified a critical need for enhancing OCP education and training among oral health providers in SA. The findings indicate that continuous, targeted, and culturally sensitive training could bridge the existing KAP gap, potentially leading to improved early detection and management of OC, thereby reducing its morbidity and mortality rates in the region.

Impact of Rheumatic Diseases on Oral Health-Related Quality of Life

Introduction  Oral-health-related quality of life (OHRQoL) represents a part of the general health-related quality of life (HRQoL). This OHRQoL indicates someone's subjective knowledge of a patient's oral health status, which is mostly associated with physical conditions and general HRQoL issues. A report by the World Health Organization labeled rheumatic and musculoskeletal diseases as the second most reported cause of disability worldwide. Considering their potential influence on the masticatory system, rheumatic diseases (RDs) can significantly affect oral health and the quality of life. Objective This study aimed to evaluate the impact of RDs on OHRQoL, including oral complaints, oral habits, oral functions, and dental care. Materials and methods This cross-sectional, multicenter study was conducted in multi-governmental medical and dental institutions in Riyadh, Saudi Arabia. The research was approved by the ethics committee Institutional Review Board (IRB). The validated surveys were distributed to the subjects manually. Data were analyzed using Statistical Package for the Social Sciences (SPSS) 23.0 software, and all parameters were expressed in frequencies and percentages. Results The study included 108 patients: 10 males (9.3%) and 98 (90.7%) females. Approximately 81% of the study group reported occasional changes in the quality of life caused by oral or temporomandibular joint (TMJ) problems. Dental caries and periodontal diseases were the most commonly reported complaints (73.1%). Regarding oral manifestations of RDs affecting the quality of life, 91.7% of participants never experienced difficulty speaking and taste changes; pain and discomfort in the mouth were always present in 4.6% of the participants. Conclusion Patients with RDs exhibited reduced OHRQoL, with several differences between the entities. Specifically, OHRQoL decreased in diseases with more oral manifestations, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), which showed a high percentage in this study (SLE, about 27.8%; RA, 62%).

Knowledge, attitudes, and practices of oral cancer prevention among students, interns, and faculty members at the college of dentistry of Jazan University

Background

Oral cancer awareness among current and future dental practitioners plays a substantial role in the early detection and prevention of oral cancer. Therefore, this study aimed to assess the knowledge, attitudes, and practices (KAP) of oral cancer prevention (OCP) among oral health practitioners in the College of Dentistry at Jazan University, Saudi Arabia, and to determine factors that facilitate, or limit practices related to oral cancer prevention.

Methods

A self-administered questionnaire survey was done among dental students (n = 274), interns (n = 81), and faculty members (n = 117) in the College of Dentistry at Jazan University between May 2019 to February 2020. The questionnaire was developed in English and modified from a previously validated and published questionnaire into Arabic. It covered every KAP of oral cancer prevention that was useful in accomplishing the study's objectives. Logistic regression analysis was utilized to determine the factors associated with the practice of oral cancer prevention in the past year.

Results

Only 29.7% reported having participated in any OCP activities in the past 12 months while about 42% and 53% of participants referred suspected oral cancer patients to the departments of maxillofacial surgery and oral medicine, respectively. Most of the participants had poor knowledge (71.9%), unfavourable attitudes towards OCP (83.6%) and poor levels of practice (62.9%). The study found that the attitude of the participants was significant in influencing their practices of OCP in the previous 12 months, after adjusting for all other factors.

Conclusion

It was concluded that the level of knowledge, attitudes, and practices of OCP among the sample population was poor. The survey findings suggest that oral health practitioners in Jazan are inexperienced in the methods to adopt for prevention and early detection of oral cancer, despite the high prevalence of oral cancer among province residents. Further research should investigate effective educational strategies and training for improving the participation of students, interns, and faculty members in oral cancer prevention activities.

Cutaneous, genital and oral lichen planus: A descriptive study of 274 patients

Background

Lichen planus (LP) is a chronic autoimmune disease that affects the oral mucosa as well as the skin, genital mucosa and other sites. Objective: to evaluate the correlation between oral, genital and cutaneous lichen planus, in a sample of LP patients.

Material and Methods

This descriptive study reviewed 274 clinical histories of patients, who all presented histological confirmation of lichen planus verified by a pathologist, attending research centers in Barcelona.

Results

A total of 40 LP patients (14.59%) presented genital lesions. Of 131 patients with cutaneous LP (47.8%), the most commonly affected zones were the body’s flexor surfaces, representing 60.1% of cases. 24% of patients (n=55) related the start of the lesions with previous stress events. Of the 131 subjects with cutaneous lesions, 19% (n=25) also presented oral lichen planus (OLP). Of the total sample, 53.6% (n=147) of patients presented oral lesions. The systemic diseases most commonly associated with this patient sample were psychological problems such as stress, anxiety and depression (48%), hypertension (27%), gastric problems (12%), and diabetes (9.7%). A family history of lichen planus was found in only 2 cases (0,72%) out of the total of 274.

Conclusions

Any patient with OLP should undergo a thorough history and examination to investigate potential extraoral manifestations. The fact that 37 patients with OLP in this patient series were identified with simultaneous involvement at more than one site highlights the need for thorough evaluation and multidisciplinary approaches to this disease.

Key words:Oral lichen planus, extra-oral manifestations, cutaneous lichen planus, genital lichen planus.

Oral lichen planus and its relationship with systemic diseases. A review of evidence

BACKGROUND

Oral lichen planus (OLP) is one of the most common dermatological diseases which are present in the oral cavity. It is a chronic autoimmune, mucocutaneous disease that affects the oral mucosa as well as the skin, genital mucosa and other sites.

OBJECTIVE

Review the relevant information to OLP and its relationship with systemic diseases.

MATERIAL AND METHODS

Searches were carried out in the Medline/PubMed, Lilacs, Bireme, BVS, and SciELO databases by using key-words. After an initial search that provided us with 243 papers, this number was reduced to 78 from the last seven years. One of the first criteria adopted was a selective reading of the abstracts of articles for the elimination of publications that presented less information regarding the subject proposed for this work. All the selected articles were read in their entirety by all of the authors, who came to a consensus about their level of evidence. The Scottish Intercollegiate Guidelines Network (SIGN) criteria were used as the criteria of methodological validation.

RESULTS

Only 9 articles showed an evidence level of 1+, 2+, 3 or 4, as well as a recommendation level of A, B, C or D. Three of them were non-systematic reviews, one was a cohort study and only one was a controlled clinical trial. Three of the studies were case series, with respective sample sizes of 45, 171 and 633 patients.

CONCLUSIONS

Several factors have been associated with OLP. Patients with OLP are carriers of a disease with systemic implications and may need the care of a multidisciplinary team. The correct diagnosis of any pathology is critical to making effective treatment and minimizes iatrogenic harm. For OLP is no different, taking into account its association with numerous systemic diseases that require special attention from health professionals. Periodic follow-up of all patients with OLP is recommended. Key words:Oral lichen planus, etiopathogenesis, systemic diseases.