"Mind" in Betel-quid Use and Related Disorders

Impact of COVID-19 Lockdown on Oral Oncology-related Outpatient Volume at Indian Dental Institutions

AIM AND OBJECTIVE

This study aimed to evaluate the impact of the lockdown on oral oncology-related out-patient volume at Indian dental institutions.

MATERIALS AND METHODS

The total number of newly diagnosed cases of oral submucous fibrosis, oral leukoplakia, oral lichen planus, and oral cancers, recorded at two dental institutional settings before lockdown (January-March 2020) and after lockdown (June-August 2020), were included retrospectively and compared.

RESULTS

The study included a total of 797 cases at both institutions. At Institution-I, a total of 312 cases were recorded before the lockdown, and 63 cases were recorded after the lockdown. At Institution-II, a total of 311 cases were reported before lockdown, and 111 cases were recorded after lockdown. Comparisons between the pre-lockdown and post-lockdown data yielded a significant change in the proportions of oral sub-mucous fibrosis, oral leukoplakia, oral lichen planus, and oral cancers at both institutions (Chi-square test; p < 0.001). Following the lockdown, a substantial reduction was observed in the proportion of oral submucous fibrosis (OSMF) cases at both institutions, and the proportion of oral cancers increased at both institutions. There was a significant difference between the proportions of cases reported before lockdown at both institutions (p < 0.001). However, after-lockdown, no such differences were noted (p = 0.69); the absence of significance could most likely be due to the low sample size or low-power during the post-lockdown period.

CONCLUSION

The oral potentially malignant disorders (OPMD) and oral cancer (OC) patient volumes reduced substantially following lockdown. During the post-lockdown period, the proportion of oral cancers increased, whereas the proportion of OSMF cases decreased. Results indicate that OPMD and oral cancer patients were impacted differently by the lockdown.

CLINICAL SIGNIFICANCE

This study provides insight into the impact of lockdown and highlights the importance of reestablishing oral oncology-related patient care. A vital discussion is also provided on useful compensatory strategies that may reduce delays during the ongoing crisis. How to cite this article: Panta P, Reddy P, Misra SR, et al. Impact of COVID-19 Lockdown on Oral Oncology-related Outpatient Volume at Indian Dental Institutions. J Contemp Dent Pract 2021;22(5):501-505.

New Directions for Oral Submucous Fibrosis Research: Whole Evaluation for Holistic Rehabilitation!

Oral submucous fibrosis (OSF) is an oral potentially malignant disorder (OPMD) associated with prolonged betel-quid (BQ) use. It affects both physiological and psychological dimensions, leading to a significant morbidity. Some challenges in OSF research include: Assessment and correction of: (i) Quality of life, (ii) burning sensation, and (iii) nutritional deficiency. There are numerous medical treatments for OSF, but most of them fail to offer complete rehabilitation. This is because some underpinnings of this condition like "mental factors" that contribute to habit continuation at root level, "poor quality of life," and "nutritional deficiencies" are still uncorrected. We believe that OSF must be managed at the "mind and body" level to accomplish holistic rehabilitation. Herein, we briefly describe the general condition of OSF patients, and highlight the possibility of a novel telomere-based assessment of psychosocial stress, and support use of meditation to counter excessive "telomere shortening" which is linked to oral cancer. We also expand the current view on "burning sensation" in OSF from an entire physical concept to a possibility of mental factors, and finally recommend rich, micronutrient supplementation (through diet) to counter free radical production within the hypoxic oral epithelium.