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Surgical management of chemosensory disorders.

As additional understanding of the histopathologic basis of chemosensory dysfunction has been achieved, several actual and potential surgical approaches for correction have been devised. These currently include correction of steroid-dependent anosmia and hyposmia due to septal deviation. Posttraumatic anosmia might be correctable in the future. Surgical approaches to dysgeusia are sparse, probably due to a paucity of information on the causes of this disorder.

Humans↗

Biological mercury measurements before and after administration of a chelator (DMPS) and subjective symptoms allegedly due to amalgam.

The aim of the study was to explore multivariately the relationship between subjective symptoms allegedly due to amalgam and mercury measurements before and after administration of a chelator. Of 120 participants, the mercury concentrations in urine (U-Hg) and plasma (P-Hg) before and after a chelating agent or placebo were determined as were the numbers of fillings and symptoms allegedly due to subjective symptoms. The dental status was charted. Blood was analysed on 13 parameters. The analysis revealed neither the parameters in blood nor the subjective symptoms to be associated with a dimension dominated by 'mercury indicators'. The final analysis was therefore performed with 'number of subjective symptoms' and enabled to distinguish two subsamples. One subsample was characterised by > 2 subjective "symptoms", highest scores for U-Hg, P-Hg and filled surfaces, and chewing gum for > 1 h a day. The other subsample comprised the subjects with few filled surfaces and low U-Hg and P-Hg, but was not characterised by "no subjective symptoms". The chelator was considered neither to invalidate nor to improve these findings and was concluded not to be helpful in diagnosing "symptoms". The chelator caused side effects in 42% of the subjects and the placebo in 27%. A relationship between amalgam fillings and subjective symptoms could not be shown. Therefore, the mere fact of knowing to have amalgam fillings was assumed to be the reason why subjective symptoms were attributed to amalgam and side effects were ascribed to the treatment.

Adult↗

Eating disorders and oral health: a review of the literature.

This article is a review of the recent literature pertaining to the oral sequelae of eating disorders (EDs). Dentists are recognized as being some of the first health care professionals to whom a previously undiagnosed eating disorder patient (EDP) may present. However, despite the prevalence (up to 4 per cent) of such conditions in teenage girls and young adult females, there is relatively little published in the recent literature regarding the oral sequelae of EDs. This compares unfavourably with the attention given recently in the dental literature to conditions such as diabetes mellitus, which have a similar prevalence in the adult population. The incidence of EDs is increasing and it would be expected that dentists who treat patients in the affected age groups would encounter more individuals exhibiting EDs. Most of the reports in the literature concentrate on the obvious clinical features of dental destruction (perimolysis), parotid swelling and biochemical abnormalities particularly related to salivary and pancreatic amylase. However, there is no consistency in explanation of the oral phenomena and epiphenomena seen in EDs. Many EDPs are nutritionally challenged; there is a relative lack of information pertaining to non-dental, oral lesions associated with nutritional deficiencies.

Adolescent↗

Managing side effects of radiotherapy in head and neck cancer.

Curative radiotherapy for head and neck cancer causes very significant side effects. In addition to their considerable impact on the patient's quality of life, these effects can prejudice treatment outcome. This review looks at the management of the adverse effects of radiotherapy for head and neck cancer.

Dose-Response Relationship, Radiation↗

Burning mouth syndrome.

Burning mouth syndrome (BMS) has been considered an enigmatic condition because the intensity of pain rarely corresponds to the clinical signs of the disease. As a result, BMS patients have variously been labelled as depressed, anxious or hypochondriacal and have often been underserviced by the medical and dental communities. Recently, there has been a resurgence of interest in this disorder with the discovery that the pain of BMS may be neuropathic in origin and originate both centrally and peripherally. This chapter discusses some of our recent understandings of the etiology and pathogenesis of BMS as well as the role of pharmacotherapeutic management in this disorder.

Burning Mouth Syndrome↗

Gustatory sequelae of alimentary disorders.

Disorders in different regions of the alimentary tract have been associated with alterations in gustatory function. Current understanding of mechanisms underlying the taste disturbances and their impact on the physical and emotional well-being of patients is incomplete. Indeed, in most instances, present knowledge remains at a descriptive level. Accumulating evidence that profound interactions occur between the sense of taste and alimentary function poses a challenge to apply this knowledge in the clinic setting.

Animals↗