Callan Meskimen

Log of Literature

General and Oral Pathology

Assignment Criteria

Log of Oral Pathology Literature Review Assignment Guidelines

50 Points Possible (10 points/article)
5 ARTICLES related to oral pathology, in folder
Due Date: March 21, 2017

Point Breakdown:
Content 40
Format 10
Total 50

Content: 1. Summary/review of article content (20 points-4 points per article)

First paragraph…In own words! No quotes, stats…read more than
the
abstract and if a study, describe the results.

2. Critique of Article Contents (20 points-4 points per article)

A. How does the article affect you?
B. Do you agree or disagree with the information presented?
C. Include content on what you learned from the article
D. Include content on how information relates to something you
have already learned in a dental hygiene course

Format: 1. Reference for article (see provided example) (2 points)

Errors:1. Spelling/grammar: -1 point per error…

2. Minimum 1 page (no more than 1” margins), typed, double spaced
(12 font), -1 point per article
3. Attach rubric to assignment-5points!

Sample Reference: Placed at top of page/article

Sadovsky, R. (2005). Varicella zoster vaccination: An update. American Family Physician,

71(11), 2190-2192.

**note the 2 double spaces**

Varicella is a highly contagious condition manifested by fever and a three- to

five-day rash.… ***minimum of three (3) sentences makes a paragraph.***

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Leu-wai-see, P. (2014). The dangers of betel quid chewing. Dimensions of Dental Hygiene,

12(2), 65-69

The article The Dangers of Betel Quid Chewing discusses the stimulant drug

betel quid. The article goes over what it is, how its made and how it creates an

euphoric emotion when chewed. Betel quid is popular in third world countries and

is intertwined closely with the culture and it is slowly showing up in the United

States from immigrants. The article discusses the addictive component of betel quid

and also incorporates how to discuss quitting and steps to take to quit, which go

hand in hand with quitting smoking. Betel quid causes dark stains and calculus and

the article talks about documenting the stain placement, areas of attrition and

abfraction and calculus. The main purpose of this article is to explain the dangers

betel quid have on the oral cavity. Chewing causes attrition and abfraction to the

occulsal and incisal surfaces, with high amounts of extrinsic stain and discoloration

of the buccal mucosa. Betel quid is also associated with higher risk of periodontal

disease, calculus, oral submucous fibrosis and oral cancer. These risks are believed

to be associated with the reaction to the active ingredients in the betel quid and the

increased use of the drug.

I was born and raised in a small town and before starting dental hygiene school

the only stimulant I knew about that you put in your mouth was chewing tobacco, so

naturally betel quid came as a surprise to me. The fact that so many people out in

the world are chewing betel quid especially in third world countries where oral

health care is less of a priority is scary to me. Mothers are giving their infants this
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drug and people start chewing regularly at the young age as 7 makes me strongly

believe that they are so wildly unaware how bad it is for them.

I believe the author did a good job explaining the risks of receiving OSF, oral

cancer and talking about how to get patients to stop. Because chewing betel quid is

associated with their culture and to some immigrants it helps them feel connected I

believe that trying to encourage them to quit would be like asking them to give up a

part of themselves. I like that the author added a table in the reading where if the

patients aren’t ready to quit there is a guide to help them understand the risks and

discussion starters.

I learned a lot from this reading. I’ve never heard of betel quid so I learned that

it is a nut that can be mixed with other substances like spices and tobacco and then

chewed on. Learning that betel nut is the fourth most addictive substance helped

me wrap my mind around just how addictive and difficult it is to quit. The most

useful information I learned is how it affects the oral cavity. Betel quid stains the

teeth reddish black and will also stain the mucosa, which can be scraped off.

Chewing betel quid reduces the caries risk but also cause attrition abfraction to the

hard tissues. The betel nut has an active ingredient called arecoline that is

associated with stopping the growth of periodontal fibers and increasing the growth

of collagen. Arecoline thus is associated with loss of periodontal attachment and oral

submucous fibrosis (OSF). OSF when the oral cavity stiffens up from the excess

collagen from the arecoline making it very difficult for the patient to swallow, talk,

eat and speak. I also learned that betel quid can cause oral squamous cell carcinoma

and has characteristics very similar to what we learned with chewing tobacco
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especially since Betel Quid is laced with tobacco. The article and what we have gone

over in our classes how to approach a patient and explain the dangers and

complications of their habit are very similar. If the patient doesn’t want to quit we

learned in class to educate them and try to motivate them to think about their

health. We haven’t learned the exact stages for quitting, but everything we have

learned goes hand in hand with the stages. Overall, I thought this was an informative

and interesting article and I would recommend it to my classmates and co-workers.

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Kushins, H. (2010). The ranula: recognizing and treating this rare oral lesion. The

Dimensions of Dental Hygiene, 8(4): 32-34

The article, The Ranula: Recognizing and Treating this Rare Oral Lesion,

focuses on the benign soft tissue mass’s characteristics and how to treat it. The

ranula is a blue swelling cyst filled with mucous on the floor of the mouth that

resembles a belly of a frog. The sublingual/submandibular salivary glands leak fluid

and fill the soft tissue making a mucous filled, asymptomatic and movable mass. The

etiology derives from a sialoth, trauma to the ducts, a tumor or stenosis. The article

explains that there are three different types of ranulas: oral/simple,

cervical/plunging, and mixed ranula. Simple ranulas can be multiple different sizes

and can change the placement of the tongue causing interference of the oral

functions. Plunging ranula has swelling around the neck from the mucous escaping

and traveling down to the neck. Lastly, a mixed ranula has a mixture of simple and

plunging and has swelling in the mouth as well as on the neck. High amylase is

counted to diagnosis and the recommended treatment to surgically remove the

ranula.

I chose this article because we had just learned about ranulas and I wanted to

relate what I knew to that this article had to say about them. Since reading this I feel

like I have a better understanding of how they appear and the multiple different

types of ranulas. The article states that ranulas are typically very rare and I hope

that I will be able to see one throughout my career.

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The information was very clear and concise and easy to read. The only

subject I questioned was the different types of procedures introduced by Table 1. If I

had a ranula and wanted it removed why would I agree to a procedure such as

incision and drainage if it has a recurrence rate of 71%-100%? If I were going to get

the surgery done I would only want it done once so why wouldn’t the Dr. choose the

procedure that has the absolute lowest recurrence rate?

Content that I learned from this article is there are different types of ranulas.

I had assumed that a ranula was a blue mass filled with mucous on the floor of the

mouth and I had no idea that it can also be shown on the neck. With this

information if I do ever palpate a patient’s neck and feel swelling I will have to think

about the possibility of it being a plunging ranula. From the information we learned

about in class, to the textbook and the article I now feel like I have a better

understanding for what it is and how it looks to be able to use differential diagnosis

to determine this lesion.

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Ditmyer, M. Demopoulos, C. Mobley, C. (2013). Under the influence. Dimensions of

Dental Hygiene, 11(7): 40-44

The article, Under the Influence, discusses dental caries and their association

with the use of tobacco and marijuana. According to the article tobacco and

marijuana use has continued to rise in high school students throughout the years.

Also, with marijuana being a trendy topic and becoming legal in some states

younger adolescents are not associating marijuana with being a dangerous drug.

Both drugs are known for causing stains and xerostomia, which increases the risk of

dental caries. The article also factors in the known stereotype that marijuana users

snack and eat cariogenic foods, have poor oral hygiene and visits the dentist less

than non-users, which thus would increase dental caries. A study was done over 8

years with adolescents using the drugs simultaneously, and the results found an

increase in dental caries. The study also found that the untreated decay had a

greater effect on the severity of the decay. Dental hygienists are urged to

communicate the severity and dangers of these drugs on the oral cavity and body.

The article contains useful tips on how to communicate with your patients and

questions to ask them.

I was really excited to read this article because I wanted information and

facts to tell my patients on why they should stop abusing these drugs, but honestly

this article really disappointed me. The support behind the association of these

drugs and dental caries was weak and several times it was stated that there isn’t

cold facts and research over this topic. I also really disagree with the literature they
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provided used to back their accusations. The literature they attached was strictly

about tobacco use and tobacco and marijuana are very different so I don’t agree

with associating them together. I also was upset that they used a stereotype to claim

that smokers/marijuana users have bad oral hygiene that have a cariogenic lifestyle

that don’t go to the dentist. I don’t believe an author’s stereotype should have any

merit in literature.

Although I don’t completely agree with they way the article was written I do

agree with the role tobacco/marijuana have on dental caries and I will use the

information found in the study and talk to my patients about how it causes

xerostomia and stain. In class we learned that xerostomia causes dental caries so it

makes sense if smoking tobacco/marijuana causes xerostomia then they also cause

dental caries. I also will ask my patients about their eating habits and brushing

habits to determine the best treatment and oral hygiene instruction for them. Other

information that I learned is that tobacco is responsible for one out of five deaths

and the consumption amount in the United States is over 360 billion. I also was

unaware of the fact that tobacco use is on the rise and tobacco use in people 65 and

older is approximately 7.9%. I assumed that the older generation would be much

higher than the younger age group. I also learned that the lifetime use of marijuana

in 2011 for 19-28 year olds was 56%. Dental decay is a huge part of oral pathology

and this article gave more evidence that tobacco/marijuana is a chemical cause to

this disease.
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Palazzolo, M. Palazzolo, D. Poth, M. (2009). A primer on common oral conditions.

Dimensions of Dental Hygiene, 7(4), 38-41.

The article, A Primer on Common Oral Conditions, focuses on discussing

aphthous ulcers and herpes. Apthous ulcers are described as painful round pus filled

ulcers on nonkeratinized skin with a red halo. The most common locations apthous

ulcers are found are on the buccal/labial mucosa, soft palate, and ventrally on the

tongue. Although the cause is idiopathic they may be linked to a low immune

system. There are three variants on apthous ulcers: minor, major and herpetiform.

Minor is the most common and has small lesions that take around 1-2 weeks to heal.

Major is known to be very painful with large ulcerations that can have irregular

boarders and cause scarring. Herptiform is the least common form and the lesions

form in small clusters. These clusters heal within a week, but as the clusters die new

clusters form. There are several over the counter treatments such as topical

anesthetics, which help with symptomatic relief. Rinses such as Tetracycline will

help with the pain, size and duration of the lesion. The article recommends mixing

lidocaine, Maalox and Benadryl before eating to coat the lesion.

Herpetic lesions are viral lesions that can affect the ororfacial region and

other parts of the body. When working in the dental field we will run into HHV-1

and HHV-2. HHV-2 is responsible for outbreaks in the genitalia region and HHV-1 is

responsible for outbreaks in the orofacial area. Although HHV-2 is mostly

responsible for herpes in the genitalia the number of cases of HHV-2 on the orofacial

region have been increasing due to genitalia to oralgenitial contact. Herpes can
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produce two forms of infections: primary and recurrent. Primary infections are very

uncommon and are more likely to arise in children. Vesicles will appear on either

keratinized or non-keratinized tissue with almost immediately from contact with

the virus. The lesion will heal in 7-14 days and patients are advised to keep

hydrated and treat with coating agents of topical anesthetics. Recurrent herpes is a

much more common form of herpes. Recurrent herpes labialis is considered a cold

sore that arises on the commissure of the mouth and patients are advised not to

touch the lesion because it is very contagious. Intra-oral recurrent herpes are

lesions that form on the attached gingiva and palatal mucosa. When a patient has

other systemic diseases such as AIDs or HIV intra-oral recurrent herpes could be

dangerous and spread. Treatment of herpes include antiviral medications such as:

Peniclovir, Docosanol, and Valacyclovir.

When I found this article we had just finished up discussing infectious

diseases and immunologic diseases and I thought it would be a perfect article to

relate to. Little did I know that it would be almost word from word to our

PowerPoint. I was so surprised that I opened up my notes and pretty much followed

along checking to see if there were any differences, which there wasn’t too many.

There aren’t any points in the article that I would disagree with. I really liked

reading this article, it was a good review but I also learned a few things. I learned

that herpes affect bone-bearing tissues and apthous ulcers can only occur on

nonkeratinized tissues. Also, I never truly understood how detrimental intra-oral

recurrent herpes could be on a sick person and can cause someone to die. I

understood that herpes form on patients with AIDS, but I didn’t realize that herpes
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could truly be dangerous enough to cause death. I also learned more about the

treatment of apthous ulcers and herpes. I didn’t know that rinsing with tetracycline

would help with the pain of apthous ulcers and I feel like that is really good

information to take to clinics. When I read this article I enjoyed the fact that I could

relate to every point they were making and pointing out information that was left

out, such as the article not discussing that herpes travel on the sensory nerve.

Nothing is better than reading along with an article and having a good

understanding of the content such as apthous ulcers and herpes and being able to

see things I know and learning something random that I didn’t know.
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Sharauga, C. Price, T. Dotson, D. (2012). Educate your patients about hpv.

Dimensions of Dental Hygiene, 10(1), 52-55.

The article, Educate Your Patients About HPV, discuses what HPV is and how

it can affect your body. The article starts off explaining that HPV is a very common

disease and every year millions more will be infected. HPV can range from warts on

hands and feet to HPV causing cervical cancer. There are over 100 different strands,

most are low risk, but there are a few strands that such as 16,18, 31 and 45 that will

put you as risk for cancer. HPV infects the basal cells of stratified epithelium and

typically the body will fight off this infection. Along with warts HPV can infect oral

lesions such as the oral cavity, the esophagus and the ororespiratory tract.

Hygienists are responsible for noticing lesions during examinations and helping

their patients understand the lesion and referring patients. Lesions hygienists may

find are: warts, condy-loma acuminatum, and papillomas. The lesions may appear

white or the same color of tissue. The lesions may be bumpy or have finger

projections and can be attached on a stalk or flat. Research has found that HPV may

play a big factor in head and neck cancers. It is thought that HPV is involved in

tonsillar cancer, oropharyngeal cancer, tumors and morbidity. HPV is acquired via

oral-genital contact and patients need to be educated on safe sex. To help detect

HPV saliva can be tested to see if there is any HPV present. If a patient is tested

positive but doesn’t have any symptoms the patient should be tested for persistent

HPV infection. To treat lesions such as warts removal by laser or excision may be
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appropriate and patients with cancerous lesions may need to have follow-up

procedures.

I really enjoyed this article, I could easily relate to the topic, thanks to

learning about viral infections in class, but I also learned a lot. From studying

diseases in class, to reading several articles about diseases to actually seeing

verruca vulgaris on a patient in clinic I’ve defiantly formed a newfound respect for

these scary diseases. I never in a million years would have guessed that over 20

million Americans and counting are infected with HPV. Something that I read that

made me slightly question the article is when the article discusses taking a salivary

test on a patient that has no symptoms or evidence of HPV. What causes a Dr. to do

this test when there are no physical symptoms on an individual? Does the patient’s

health history/sexual history play a role in determining whether to do the test or

not? Information that I learned from this article is that HPV may be associated with

several different types of cancers such as head and neck cancers. We learned in class

that HPV 16 and 18 were cancerous and this article just expanded on other strains

such as 6,7,33,35 and 39. I also learned that oropharyngeal cancers kill around

300,000 people a year. I believe I can use that information with my patients that use

tobacco and alcohol or are very sexually active.

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