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1.
J Indian Soc Pedod Prev Dent ; 42(3): 184-189, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-39250201

RESUMEN

BACKGROUND: Chemotherapy, a cornerstone treatment for childhood cancers, can negatively impact oral health. This study aimed to evaluate the prevalence and evolution of oral complications in these patients. MATERIALS AND METHODS: A prospective observational study enrolled 44 children diagnosed with malignancy undergoing chemotherapy at a tertiary care institute in central India. Oral examinations were performed at baseline, with follow-ups at 3-6 and 9-12 months. Data collected included demographics, medical history, oral hygiene practices, and oral lesions. Blood counts and World Health Organization grading for mucositis were used. Descriptive statistics and appropriate statistical tests analyzed the data (P ≤ 0.05). RESULTS: Acute lymphoblastic leukemia (ALL) was the most prevalent malignancy. Children reported various oral complaints such as ulcers, bleeding gums, and difficulty eating. Mucositis prevalence significantly decreased over follow-up visits (baseline: 56.8% and second follow-up: 13.3%). Gingival inflammation was present, though mean scores decreased over time. Oral hygiene scores varied without significant changes. Caries experience scores increased from baseline to follow-up. CONCLUSION: This study identified a high prevalence of ALL and diverse oral complications in children undergoing chemotherapy. While mucositis severity lessened over time, other issues such as caries persisted. These findings highlight the critical need for preventive oral care strategies to safeguard this vulnerable population's oral health.


Asunto(s)
Antineoplásicos , Humanos , Niño , Estudios Prospectivos , Masculino , Femenino , Preescolar , India/epidemiología , Antineoplásicos/efectos adversos , Enfermedades de la Boca/epidemiología , Enfermedades de la Boca/inducido químicamente , Prevalencia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Higiene Bucal , Estomatitis/epidemiología , Estomatitis/inducido químicamente , Adolescente , Caries Dental/epidemiología , Neoplasias/tratamiento farmacológico , Neoplasias/complicaciones
2.
BMC Oral Health ; 24(1): 889, 2024 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-39097712

RESUMEN

BACKGROUND: Increase in nicotine pouch (NP) users, particularly among the young, is a matter of concern requiring a comprehensive understanding of its short- and long-term oral health implications. The objective of this research was to systematically review potential oral side-effects associated with NP usage. METHODS: This systematic review was conducted following the PRISMA guidelines. Databases (Medline via PubMed, Scopus, Cochrane Trial, and Google Scholar) were searched for relevant studies up to February 2024. Modified Newcastle-Ottawa Scale (NOS) and the Risk Of Bias In Non-randomized Studies - of Exposure (ROBINS-E) tool were used to assess the quality and bias of the included studies. RESULTS: Three studies were included for this review, two from Europe and one from USA, and considered of a total of 190 participants. All studies were deemed to have a high risk of bias. Participants used NP for periods ranging from 1 month to 10 years. Among these studies, only one study provided information on the usage pattern between 1 and 5 units for an average of 11 ± 7 min per session. Oral mucosal changes at the site of placement were common among NP users. Oral lesions varied from slight wrinkling to various white lesions, seemingly related to the NP units consumed per day and their duration of usage. Other oral side effects included dry mouth, soreness, gingival blisters, and a strange jaw sensation. CONCLUSIONS: Research on the use of NP and its effect on oral health are currently limited. The use of NP should take into consideration the short-and-long-term effects, especially on oral health. Further studies are crucial to understand oral health implications associated with NP usage. SYSTEMATIC REVIEW REGISTRATION: PROSPERO Registration number CRD 42,024,500,711.


Asunto(s)
Salud Bucal , Humanos , Dispositivos para Dejar de Fumar Tabaco/efectos adversos , Nicotina/efectos adversos , Enfermedades de la Boca/inducido químicamente
3.
Support Care Cancer ; 32(8): 549, 2024 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-39048808

RESUMEN

PURPOSE: A MASCC/ISOO Clinical Practice Statement (CPS) is aimed at generating a concise tool for clinicians that concentrates practical information needed for the management of oral complications of cancer patients. This CPS is focused on the management of oral complications of targeted therapy. METHODS: This CPS was developed based on critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. Targeted agents were identified using the National Cancer Institute's list of Food and Drug Administration approved targeted therapy drugs. The information is presented in the form of succinct bullets and tables to generate a short manual about the best standard of care. RESULTS: Oral toxicities secondary to targeted therapy include various mucosal conditions, gingival conditions, jawbone disease, dysesthesia, taste change, and dry mouth. For the purpose of this CPS, we focused on oral mucosal conditions, gingival conditions, taste change, and dysesthesia. The treatment of oral toxicities depends on the symptom severity. Topical steroids and immunomodulators are often used as first-line therapy for oral mucosal toxicities. Treatment approaches for oral dysesthesia and taste change primarily revolve around symptoms management. Typically, therapy protocols align with the therapeutic algorithms employed for other neuropathic pain conditions, incorporating topical pharmacological interventions to achieve relief. Other oral toxicity requires a more specific approach. CONCLUSION: Management of oral toxicities from targeted molecular therapies is designed to alleviate patient discomfort and optimize treatment outcomes. Collaboration between medical and oral health professionals is necessary for best management practices.


Asunto(s)
Antineoplásicos , Terapia Molecular Dirigida , Enfermedades de la Boca , Humanos , Enfermedades de la Boca/inducido químicamente , Enfermedades de la Boca/terapia , Enfermedades de la Boca/etiología , Terapia Molecular Dirigida/efectos adversos , Antineoplásicos/efectos adversos , Antineoplásicos/administración & dosificación , Neoplasias/tratamiento farmacológico , Índice de Severidad de la Enfermedad
4.
Int J Oral Maxillofac Surg ; 53(10): 873-880, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38777710

RESUMEN

This study aimed to report the collective clinical characteristics of oral side effects associated with imatinib therapy according to age, sex, and clinical condition. A bibliographic review was performed using the PubMed, Web of Science, Scopus, Cochrane Library, and Embase databases. Forty-five cases of oral side effects due to imatinib therapy were identified in the literature. With the addition of five new cases seen at the authors' institution, a total of 50 cases were analysed. Of the five new cases, four with gastrointestinal stromal tumours developed oral lichenoid lesions (OLLs), and one with chronic myeloid leukaemia (CML) developed oral hyperpigmentation (OHP). Of the total 50 patients, 26 were male and 24 were female, and age ranged from 29 to 86 years. Most patients were ≥50 years old (80%); only three patients were jaw was the least common, with just five cases (10%). Among the patients with OHP, the predominant clinical condition was CML (22 cases, 91.7%). In conclusion, the possibility of oral side effects needs to be considered during the examination of patients receiving imatinib therapy.


Asunto(s)
Antineoplásicos , Tumores del Estroma Gastrointestinal , Mesilato de Imatinib , Leucemia Mielógena Crónica BCR-ABL Positiva , Enfermedades de la Boca , Humanos , Mesilato de Imatinib/efectos adversos , Mesilato de Imatinib/uso terapéutico , Femenino , Masculino , Antineoplásicos/efectos adversos , Persona de Mediana Edad , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Adulto , Anciano , Tumores del Estroma Gastrointestinal/tratamiento farmacológico , Tumores del Estroma Gastrointestinal/patología , Enfermedades de la Boca/inducido químicamente , Anciano de 80 o más Años
5.
Artículo en Inglés | MEDLINE | ID: mdl-38388332

RESUMEN

BACKGROUND: Thalidomide has anti-inflammatory properties and has been used off-label for multiple mucocutaneous disorders, but its application in managing refractory oral mucosal diseases is unclear. This study aimed to review the efficacy and safety of thalidomide in treating various oral mucosal disorders refractory to conventional therapies. METHODS: The medical records of patients who were prescribed thalidomide from 2002 through 2021 for oral mucosal disorders were reviewed. Data collected included demographic characteristics, oral mucosal disease diagnosis, treatment courses, and thalidomide dose, duration, response, and side effects. RESULTS: Thalidomide was prescribed for 28 patients with diagnoses of recurrent aphthous stomatitis (n = 14), inflammatory oral lichenoid lesions (n = 6), traumatic ulcerative granuloma with stroma eosinophilia (n = 5), chronic radiation-induced mucositis (n = 2), and orofacial granulomatosis (n = 1). Patients were treated for a median duration of 84 days (range 2-1,582). Clinical improvement was observed in 19 of 22 patients who completed at least 1 cycle of thalidomide (86.4%), with complete resolution in 12 patients (54.5%). Adverse events occurred in 75% of patients (n = 21), with 8 requiring thalidomide discontinuation. The most common adverse events included peripheral neuropathy (42.9%), drowsiness (28.6%), and constipation (21.4%). CONCLUSIONS: Thalidomide may be considered for the management of refractory oral mucosal disorders. Drug side effects are common and need monitoring closely during use.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Enfermedades de la Boca , Estomatitis Aftosa , Humanos , Talidomida/efectos adversos , Estomatitis Aftosa/tratamiento farmacológico , Estomatitis Aftosa/inducido químicamente , Enfermedades de la Boca/inducido químicamente , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/tratamiento farmacológico , Granuloma
6.
Head Neck ; 46(8): 1865-1872, 2024 08.
Artículo en Inglés | MEDLINE | ID: mdl-38258988

RESUMEN

BACKGROUND: Immune checkpoint inhibitors (ICIs) are FDA-approved for various cancers, yet their orofacial immune-related adverse events (irAEs) remain poorly understood. Our two-center retrospective study aims to better understand the prevalence and nature of these orofacial irAEs. METHODS: We retrospectively collected demographics, ICI details, and onset of orofacial irAEs in ICI-treated patients at University of California San Francisco and City of Hope (2013-2021). Orofacial irAEs were identified by ICD-10 codes and data categorized as dry mouth/xerostomia, oral mucosal lesions, and orofacial neuropathies. Patients with pre-existing orofacial conditions resembling the reported irAEs were excluded. RESULTS: Among 3768 ICI-treated patients, 408 (10.8%) developed 467 orofacial irAEs: oral mucosal diseases (41.4%), dry mouth/xerostomia (41.0%), and orofacial neuropathies (17.6%). Notably, head and neck cancers had the highest incidence of orofacial irAEs. CONCLUSIONS: Orofacial irAEs are relatively common in patients receiving ICIs, necessitating careful monitoring and management of these complications during and after the treatment.


Asunto(s)
Centros Médicos Académicos , Inhibidores de Puntos de Control Inmunológico , Humanos , Estudios Retrospectivos , Inhibidores de Puntos de Control Inmunológico/efectos adversos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Enfermedades de la Boca/inducido químicamente , Enfermedades de la Boca/epidemiología , Adulto , Neoplasias/tratamiento farmacológico
7.
J Oral Pathol Med ; 52(1): 1-8, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36455995

RESUMEN

BACKGROUND: Biologic agents are rapidly emerging as an effective therapy to treat autoimmune and other chronic diseases. The use of these agents is poorly characterized, resulting in a lack of guidance for dental practitioners. Case reports of oral adverse events have begun to emerge. However, their scope and frequency have not been summarized and analysed to date. The objective of this review was to characterize the literature on oral adverse effects associated with biological therapy when used for autoimmune and inflammatory disorders. METHODS: This review was developed in accordance with scoping review recommendations. Search strategies were developed and employed for six databases. Studies were selected using a systematic search process but with broad inclusion of study types given the paucity of information available. Reports of oral adverse events were analysed descriptively according to agent, mechanism of action, underlying disease, and oral adverse effect observed. RESULTS: Our search returned 2080 articles and 51 met our inclusion criteria, of which most were case reports. The most frequent adverse effects included angioedema, oral lichenoid lesions, osteonecrosis of the jaw, and oral infections. There were also cases of oral malignancies associated with use of biologic agents. Less common effects such as pigmentation were also described. CONCLUSIONS: Oral adverse events have been reported in patients on biologic therapy, albeit in small numbers to date. This limits the generalizability of these results, which should not be used to generate a clinical guideline as they are based primarily on case reports. However, this study presents the first review characterizing the adverse effects observed. Large multi-center studies will be necessary to further define the oral and dental complications caused by biologic agents.


Asunto(s)
Enfermedades de la Boca , Osteonecrosis , Humanos , Factores Biológicos , Odontólogos , Rol Profesional , Enfermedades de la Boca/inducido químicamente
9.
Indian J Pharmacol ; 53(4): 298-300, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34414908

RESUMEN

Moxifloxacin is a fluoroquinolone with excellent activity in community-acquired respiratory tract infections. Common adverse effects are gastrointestinal symptoms, headache, dizziness, etc., Some serious adverse effects include tendon rupture, rhabdomyolysis, peripheral neuropathy, and interstitial nephritis. Cutaneous adverse effects include allergic reactions, angioedema, Steven-Johnson syndrome, and toxic epidermal necrosis. Erythema multiforme (EM), an acute self-limiting disease, most commonly occurs due to infection and rarely due to drugs or systemic disease. EM is classified into EM major and minor, both having skin lesions. A third category of EM has also been described with only oral involvement and without any skin lesions. Oral EM itself is an uncommon entity which has been reported due to nonsteroidal anti-inflammatory drugs. Here, we are reporting a case of moxifloxacin-induced oral EM. After extensive search in PubMed-Medline database, we could not find any such co-occurrence of moxifloxacin-induced oral EM. To the best of our knowledge, this is the first reported case.


Asunto(s)
Eritema Multiforme/inducido químicamente , Enfermedades de la Boca/inducido químicamente , Moxifloxacino/efectos adversos , Eritema Multiforme/patología , Femenino , Humanos , Persona de Mediana Edad , Enfermedades de la Boca/patología
10.
Pan Afr Med J ; 38: 370, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34367449

RESUMEN

INTRODUCTION: highly active antiretroviral therapy (HAART) has contributed to a reduction in HIV- related oral lesions and improved quality of life among HIV seropositive patients. However, the therapy is not without its side effects. This study was aimed at assessing the self- reported orofacial manifestations due to long term use of HAART, as well as the pattern of oral lesions on examination. METHODS: this was a cross-sectional study conducted among HIV seropositive adult patients in Ibadan, who had been on HAART for at least two years. Data were collected using an interviewer-administered questionnaire. Clinical diagnosis of HIV-related oral lesions was made according to the EC-Clearinghouse criteria. Data analysis was done using SPSS version 25. RESULTS: the study participants comprised of 227 HIV seropositive patients who were HAART experienced, with 54 (24%) males and 173 (76%) females. Their mean age (±SD) was 44.7 (±9.4) years. The participants CD4 count ranged from 13-1338cells/mm3, with a median count of 341 cells/mm3. About half (45%) of the participants noted one or more orofacial changes since they commenced HAART. These oral changes included dryness of mouth, burning sensation, abnormal taste, melanotic hyperpigmentation, oral thrush, ulcers, and parotid swelling. Most of those who reported oral changes had been on HAART over 10 years (p=0.03), and the changes were more reported among those on the first-line regimen. CONCLUSION: melanotic hyperpigmentation was the most common oral lesion found and burning mouth syndrome was the most commonly reported complain among HIV-seropositive adults who are on long-term HAART.


Asunto(s)
Terapia Antirretroviral Altamente Activa/efectos adversos , Infecciones por VIH/tratamiento farmacológico , Enfermedades de la Boca/inducido químicamente , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Terapia Antirretroviral Altamente Activa/métodos , Recuento de Linfocito CD4 , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/patología , Nigeria , Calidad de Vida , Encuestas y Cuestionarios , Factores de Tiempo , Adulto Joven
11.
Regul Toxicol Pharmacol ; 125: 105007, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34298086

RESUMEN

Acute oral toxicity classifications are based on the estimated chemical dose causing lethality in 50 % of laboratory animals tested (LD50). Given the large number of pesticide registration applications that require acute toxicity data, an alternative to the in vivo test could greatly reduce animal testing. The United Nations Globally Harmonized System of Classification and Labelling of Chemicals (GHS) Mixtures Equation estimates the acute toxicity of mixtures using the toxicities of mixture components. The goal of this study was to evaluate the concordance of LD50s predicted using the GHS Mixtures Equation and LD50s from the in vivo test results. Using the EPA classification system, concordance was 55 % for the full dataset (N = 671), 52 % for agrochemical formulations (N = 620), and 84 % for antimicrobial cleaning products (N = 51). Most discordant results were from substances LD50 > 2000 mg/kg (limit test) or 2000 < LD50 < 5000 mg/kg that were predicted as LD50 > 5000 mg/kg. A supplementary analysis combining all formulations with an LD50 > 500 mg/kg produced a concordance of 82 %. The lack of more toxic formulations in this dataset prevented a thorough evaluation of the GHS equation for such substances. Accordingly, our results suggest the GHS equation is helpful to predict the toxicity of mixtures, particularly those with lower toxicity.


Asunto(s)
Agroquímicos/toxicidad , Detergentes/toxicidad , Enfermedades de la Boca/inducido químicamente , Pruebas de Toxicidad Aguda/normas , Naciones Unidas/normas , Mezclas Complejas/toxicidad , Relación Dosis-Respuesta a Droga , Sustancias Peligrosas , Dosificación Letal Mediana , Plaguicidas/toxicidad
12.
Drug Deliv ; 28(1): 1569-1584, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34291722

RESUMEN

To prepare glutaraldehyde-based cross-linked medium molecular weight chitosan nanoparticles encapsulated with 5-Fluorouracil (5-FU), to overcome dosing frequency as well as reducing acute oral toxicity and poor bioavailability of the drug. Medium molecular weight chitosan nanoparticles (MMWCH-NPs) were prepared by reverse micelles method based on glutaraldehyde (GA) cross-linking and optimized by the process as well as formulation variables like a various drug to polymer ratio, cross-linker volumes, varying stirring speeds (rpm), different time of rotation/stirring, respectively and their effects on the mean particles size distribution and entrapment efficiency %EE and %LC of NPs. Characterization of formulations was done by FTIR studies, TEM, PXRD, TGA, Stability, and dissolution drug release studies were performed by dialysis bag technique at both pH (1.2 & 7.4) and acute oral toxicity studies in albino rabbits. The formulated nanoparticles showed a smooth morphology with smaller particle size distribution (230-550 nm), zeta potential (-15 to -18 mV) required to achieve enhanced permeation and retention effect (EPR), entrapment efficiency (%EE 12-59%). These NPs exhibited a controlled drug release profile with 84.36% of the drug over a period of 24 h. Drug release data were fitted to different kinetic models which predominantly followed Fickian diffusion mechanism (R2 = 0.972-0.976, N = 0.326-0.256). The optimized formulation (5-FU6) was observed under DSC/TGA, TEM. PXRD curves, FTIR, which confirmed thermal stability, structural integrity, amorphous state, compatibility between drug and polymer of optimized (5-FU6) as well as reduced acute oral toxicity in albino rabbits. Cross-linked medium molecular weight chitosan nanoparticles are nontoxic, well-tolerated therefore could be the future candidate for therapeutic effects as novel drug delivery carrier for anticancer drug(s).


Asunto(s)
Antineoplásicos/administración & dosificación , Quitosano/química , Fluorouracilo/administración & dosificación , Nanopartículas/química , Animales , Antineoplásicos/efectos adversos , Antineoplásicos/farmacocinética , Química Farmacéutica , Preparaciones de Acción Retardada , Portadores de Fármacos , Liberación de Fármacos , Estabilidad de Medicamentos , Fluorouracilo/efectos adversos , Fluorouracilo/farmacocinética , Glutaral/química , Peso Molecular , Enfermedades de la Boca/inducido químicamente , Enfermedades de la Boca/prevención & control , Tamaño de la Partícula , Conejos
13.
Regul Toxicol Pharmacol ; 125: 105015, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34293429

RESUMEN

A decision-scheme outlining the steps for identifying the appropriate chemical category and subsequently appropriate tested source analog(s) for data gap filling of a target chemical by read-across is described. The primary features used in the grouping of the target chemical with source analogues within a database of 10,039 discrete organic substances include reactivity mechanisms associated with protein interactions and specific-acute-oral-toxicity-related mechanisms (e.g., mitochondrial uncoupling). Additionally, the grouping of chemicals making use of the in vivo rat metabolic simulator and neutral hydrolysis. Subsequently, a series of structure-based profilers are used to narrow the group to the most similar analogues. The scheme is implemented in the OECD QSAR Toolbox, so it automatically predicts acute oral toxicity as the rat oral LD50 value in log [1/mol/kg]. It was demonstrated that due to the inherent variability in experimental data, classification distribution should be employed as more adequate in comparison to the exact classification. It was proved that the predictions falling in the adjacent GSH categories to the experimentally-stated ones are acceptable given the variation in experimental data. The model performance estimated by adjacent accuracy was found to be 0.89 and 0.54 while based on R2. The mechanistic and predictive coverages were >0.85.


Asunto(s)
Sustancias Peligrosas/química , Enfermedades de la Boca/inducido químicamente , Relación Estructura-Actividad Cuantitativa , Pruebas de Toxicidad Aguda/métodos , Animales , Relación Dosis-Respuesta a Droga , Dosificación Letal Mediana , Mapas de Interacción de Proteínas , Ratas
14.
Pediatr Transplant ; 25(6): e13947, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33350561

RESUMEN

Systemic medications categorized as diphenylhydantoin, calcineurin inhibitor and calcium channel blocker may have effects on the oral cavity by modifying the inflammatory and immune response and causing undesired tissue proliferative reactions. Calcineurin inhibitors are medications commonly used for long periods in patients undergoing allogeneic hematopoietic stem cell transplant (HSCT) and solid organ transplantation. Medication-related fibrovascular hyperplasia (MRFH) is an extra gingival hyperplastic nodular growth associated with medications use. This study reports five cases of pediatric patients (6 to 12-years-old) diagnosed with Fanconi anemia (FA) after HSCT who presented similar oral mucosal lesions associated with the use of cyclosporine, phenobarbital and amlodipine. After excision of the lesions, histopathological analysis described them as pyogenic granuloma (PG). As the aetiology of the lesions manifested by the patients was associated with the use of medications, the final diagnosis was MRFH. Despite the clinical and histopathological similarity between PG and MRFH, it is fundamental to know the aetiological agent for achieving definitive diagnosis and correct management. Considering the etiologic agent (medication) and histopathological findings, it is suggested that the most appropriate term for this manifestation should be "medication-related fibrovascular hyperplasia". The correct nomenclature related to extra gingival hyperplastic lesions identified in patients on medications with potential to induce hyperplastic reactions should be adopted to facilitate scientific communication and improve the treatment.


Asunto(s)
Bloqueadores de los Canales de Calcio/efectos adversos , Anemia de Fanconi/terapia , Granuloma Piogénico/inducido químicamente , Trasplante de Células Madre Hematopoyéticas , Inmunosupresores/efectos adversos , Enfermedades de la Boca/inducido químicamente , Amlodipino/efectos adversos , Niño , Ciclosporina/efectos adversos , Femenino , Humanos , Hiperplasia/inducido químicamente , Masculino , Fenobarbital/efectos adversos
16.
Am Fam Physician ; 102(10): 613-621, 2020 11 15.
Artículo en Inglés | MEDLINE | ID: mdl-33179891

RESUMEN

Drugs are being prescribed with more frequency and in higher quantities. A serious adverse drug event from prescribed medications constitutes 2.4% to 16.2% of all hospital admissions. Many of the adverse drug events present intraorally or periorally in isolation or as a clinical symptom of a systemic effect. Clinical recognition and treatment of adverse drug events are important to increase patient adherence, manage drug therapy, or detect early signs of potentially serious outcomes. Oral manifestations of commonly prescribed medications include gingival enlargement, oral hyperpigmentation, oral hypersensitivity reaction, medication-related osteonecrosis, xerostomia, and other oral or perioral conditions. To prevent dose-dependent adverse drug reactions, physicians should prescribe medications judiciously using the lowest effective dose with minimal duration. Alternatively, for oral hypersensitivity reactions that are not dose dependent, quick recognition of clinical symptoms associated with time-dependent drug onset can allow for immediate discontinuation of the medication without discontinuation of other medications. Physicians can manage oral adverse drug events in the office through oral hygiene instructions for gingival enlargement, medication discontinuation for oral pigmentation, and prescription of higher fluoride toothpastes for xerostomia.


Asunto(s)
Antihipertensivos/efectos adversos , Hipersensibilidad a las Drogas/etiología , Sobrecrecimiento Gingival/inducido químicamente , Inhibidores de Hidroximetilglutaril-CoA Reductasas/efectos adversos , Hiperpigmentación/inducido químicamente , Hipoglucemiantes/efectos adversos , Xerostomía/inducido químicamente , Albuterol/efectos adversos , Amlodipino/efectos adversos , Anticonvulsivantes/efectos adversos , Atorvastatina/efectos adversos , Osteonecrosis de los Maxilares Asociada a Difosfonatos/etiología , Broncodilatadores/efectos adversos , Deprescripciones , Fluoruros/uso terapéutico , Sobrecrecimiento Gingival/terapia , Humanos , Hiperpigmentación/terapia , Lisinopril/efectos adversos , Losartán/efectos adversos , Metformina/efectos adversos , Metoprolol/efectos adversos , Enfermedades de la Boca/inducido químicamente , Enfermedades de la Boca/terapia , Omeprazol/efectos adversos , Higiene Bucal , Inhibidores de la Bomba de Protones/efectos adversos , Simvastatina/efectos adversos , Tiroxina/efectos adversos , Pastas de Dientes/uso terapéutico , Xerostomía/terapia
18.
Dermatol Clin ; 38(4): 523-533, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32892860

RESUMEN

Adverse reactions to medications are common and may have a variety of clinical presentations in the oral cavity. Targeted therapies and new biologic agents have revolutionized the treatment of cancers, autoimmune diseases, and inflammatory and rheumatologic diseases but have also been associated with adverse events in the oral cavity. This review describes the most common clinical presentations of oral mucosal reactions to medications, namely hyposalivation, lichenoid reactions, ulcers, bullous disorders, pigmentation, fibrovascular hyperplasia, reactive keratosis, dysesthesia, osteonecrosis, infection, angioedema, and malignancy.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/complicaciones , Erupciones Liquenoides/inducido químicamente , Enfermedades de la Boca/inducido químicamente , Boca/patología , Animales , Osteonecrosis de los Maxilares Asociada a Difosfonatos/etiología , Humanos , Hiperpigmentación/inducido químicamente , Hiperplasia/inducido químicamente , Leucoplasia/inducido químicamente , Neoplasias de la Boca/inducido químicamente , Úlceras Bucales/inducido químicamente , Parestesia/inducido químicamente , Enfermedades Cutáneas Vesiculoampollosas/inducido químicamente , Xerostomía/inducido químicamente
19.
J Cancer Res Ther ; 16(3): 463-469, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32719252

RESUMEN

BACKGROUND: Tobacco practice in relation with oral diseases is a foremost cause for the global oral disease burden and is accountable for up to 50% of all periodontitis cases among adults. The present cross-sectional study was undertaken to evaluate the local effects of various types of smokeless tobacco on periodontal health in tobacco pouch keratosis (TPK) patients in Mangalore city in the state of Karnataka. MATERIALS AND METHODS: A total of 345 TPK patients were evaluated of which all were smokeless tobacco users. All the patients were clinically examined for different clinical periodontal parameters such as stains, gingival recession (GR), periodontal pocket, furcation involvement, and mobility and local effects of various types of smokeless tobacco on periodontal health in TPK sites were recorded. RESULTS: The prevalence of GR was of 87.5%. Haathichaap was the most common smokeless tobacco used (35.9%) closely followed by nonpackaged type (loose tobacco) (19.4%). This was followed by Madhu (14.2%). Likewise, periodontal parameters were observed more in these patients in decreasing order. CONCLUSION: The results of the present study agree strongly with other smokeless tobacco user studies in terms of the strong association between GR and smokeless tobacco placement. The present cross-sectional study indicates that TPK lesions are positively associated with periodontal diseases. It is important to raise awareness of both oral cancer and periodontal risks and inform about its possible health consequences thereby working towards an improvement of oral and general health and related quality of life in these patients.


Asunto(s)
Recesión Gingival/epidemiología , Queratosis/fisiopatología , Enfermedades de la Boca/epidemiología , Enfermedades Periodontales/epidemiología , Tabaco sin Humo/efectos adversos , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Recesión Gingival/inducido químicamente , Recesión Gingival/patología , Humanos , Incidencia , India/epidemiología , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/inducido químicamente , Enfermedades de la Boca/patología , Enfermedades Periodontales/inducido químicamente , Enfermedades Periodontales/patología , Calidad de Vida , Adulto Joven
20.
Int J Pharm Pract ; 28(6): 591-598, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32614498

RESUMEN

OBJECTIVES: Oral adverse drug reactions are common and are associated with some of our most frequently used medicines. It is important to identify and manage oral adverse drug effects promptly as they not only negatively impact dental health, but also adversely affect medication adherence, clinical outcomes and patient quality of life. This study assessed the location of oral drug-induced adverse effects in the registered drug company product information (PI) of the top 100 most commonly used drugs in Australia as dispensed on the Pharmaceutical Benefits Scheme in 2018. METHOD: Publicly available data on dispensed medicines were accessed from the Australian Commonwealth Department of Health, to determine the top 100 medicines. The drug company PI for each of these drugs was manually searched to find their oral adverse effects. The number, type and location of the oral adverse drug reactions (ADRs) were recorded. KEY FINDINGS: Oral ADRs were commonly found varying in nature and severity. However, they were difficult to find as there is no dedicated section for oral/dental adverse effects in the PI and the section they are in is inconsistently applied. CONCLUSIONS: We recommend that regulatory authorities such as the Therapeutic Goods Administration in Australia create an additional section for oral/dental adverse effects so they are easier to find, which may assist health professionals detect recognise and report adverse drug effects manifesting in the oral cavity.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Enfermedades de la Boca/inducido químicamente , Enfermedades Estomatognáticas/inducido químicamente , Sistemas de Registro de Reacción Adversa a Medicamentos , Australia , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/fisiopatología , Humanos , Enfermedades de la Boca/fisiopatología , Índice de Severidad de la Enfermedad , Enfermedades Estomatognáticas/fisiopatología
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