Therapeutic Approaches to Common Oral Diseases

Therapeutic Approaches to Common Oral Diseases Continuing Dental Education

Sodium lauryl sulfate (SLS)–free dentifrice reduces symptoms of recurrent aphthous stomatitis (RAS).SLS is a surfactant ...
12/11/2025

Sodium lauryl sulfate (SLS)–free dentifrice reduces symptoms of recurrent aphthous stomatitis (RAS).

SLS is a surfactant that can irritate mucosa and strip protective mucous layers, which may predispose susceptible patients to mucosal breakdown and aphthae; removal of this irritant is biologically plausible as a preventive measure.

Systematic review concluded that replacing an SLS-containing toothpaste with an SLS-free alternative is associated with improvements in ulcer pain, healing time, and — in some studies — reduced ulcer frequency.

DOI: 10.1111/jop.12845

Salt water mouthwash, at certain concentrations, is an effective and well-tolerated alternative to 0.1% Chlorhexidine. *...
28/10/2025

Salt water mouthwash, at certain concentrations, is an effective and well-tolerated alternative to 0.1% Chlorhexidine.

* Most Effective & Comparable Option: The 5.8% saline solution has an antibacterial efficacy similar to the commonly prescribed 0.1% Chlorhexidine.

Both of these solutions reduced the oral flora significantly for 5 hours.

* Good Short-Term Option: Homemade 2% saline (the most common and best-tolerated) can be prescribed for short-term indications as its antibacterial action lasts for 3 hours.

Green Tea and Oral Lichen Planus_________________________________Oral lichen planus (OLP) is a common T-cell-mediated in...
09/06/2023

Green Tea and Oral Lichen Planus
_________________________________

Oral lichen planus (OLP) is a common T-cell-mediated inflammatory autoimmune disease with the features of disease chronicity, adult onset, female predilection and depressed immune suppressor activity.

Study results demonstrate that green tea can inhibit antigen presentation, T-cell activation, proliferation and migration, keratinocyte apoptosis, nuclear factor-kappaB activation and MMP-9 activation in the pathogenesis of oral lichen planus.

Epigallocatechin-3-gallate (EGCG) of green tea possesses anti-inflammatory and chemopreventive properties.

Hence green tea, especially EGCG, is likely to be a suitable therapeutic candidate for OLP. Green tea might be also a possible agent for preventing malignancies in OLP.

Zhang, J., & Zhou, G. (2012). Green tea consumption: an alternative approach to managing oral lichen planus. Inflammation Research, 61(6), 535–539. https://doi.org/10.1007/s00011-012-0440-z

Candida superinfection occurs in approximately one-third of patients with oral lichen planus (OLP) or oral lichenoid rea...
09/05/2023

Candida superinfection occurs in approximately one-third of patients with oral lichen planus (OLP) or oral lichenoid reactions (OLR) undergoing corticosteroid therapy. Patients with OLP/OLR should be closely monitored in the first 2 months (60 days) after steroid prescription.

Toothpaste containing extra virgin olive oil, xylitol, and betaine may improve gingival health; however, more studies ar...
04/05/2023

Toothpaste containing extra virgin olive oil, xylitol, and betaine may improve gingival health; however, more studies are needed.

Oleocanthal is a phenolic compound obtained in just-pressed extra virgin olive oil (EVOO), and its structure was found in an in vitro study to be similar to that of ibuprofen (non-steroidal anti-inflammatory drug). Oleocanthal has a greater capacity to inhibit both cyclooxygenases (COX-1 and COX-2) in comparison to ibuprofen at the same concentrations.

The test toothpaste also contains xylitol, which has been found to inhibit the synthesis of TNF-α and IL-1β induced by lipopolysaccharides from Porphyromonas gingivalis through NF-κB pathway activation.

The EVOO phenols and xylitol in the test toothpaste may therefore have combined effects on gingival bleeding.

PMID: 37072503

Few facts of herpes labialis___________________________** Herpes labialis is caused by the herpes simplex virus type 1 (...
26/04/2023

Few facts of herpes labialis
___________________________

** Herpes labialis is caused by the herpes simplex virus type 1 (HSV-1) and is a very common infection. It is estimated that up to 80% of people will have been exposed to the virus at some point in their lives.

** The virus is highly contagious and is transmitted through direct contact with an active lesion or through contact with saliva or ge***al secretions of an infected person.

** Symptoms of herpes labialis typically include tingling, burning, or itching sensations on or around the lips, followed by the appearance of small, fluid-filled blisters that can be painful and may take several days to heal.

** There is no cure for herpes labialis, but antiviral medications such as acyclovir, valacyclovir, and famciclovir can help to reduce the duration and severity of symptoms.

** Recurrent outbreaks of herpes labialis are common, with some people experiencing multiple episodes per year. Outbreaks can be triggered by factors such as stress, illness, sun exposure, and hormonal changes.

** It is possible to transmit the virus to others even when there are no visible symptoms present, a condition known as asymptomatic shedding. Therefore, people with herpes labialis should take precautions to avoid spreading the virus, such as avoiding close contact with others during outbreaks, using condoms during sexual activity, and refraining from sharing personal items such as towels and utensils.

** While herpes labialis is generally considered to be a mild infection, it can cause serious complications in people with weakened immune systems, such as those with HIV/AIDS or undergoing chemotherapy. In rare cases, the virus can also cause encephalitis, a serious inflammation of the brain.

Few facts about aphthous stomatitis:____________________________________** Aphthous stomatitis, commonly known as canker...
25/04/2023

Few facts about aphthous stomatitis:
____________________________________

** Aphthous stomatitis, commonly known as canker sores, is a prevalent condition affecting around 20% of the population.

** The exact etiology of aphthous stomatitis is still unknown; however, it's believed to be related to genetic, immune system, and environmental factors.

** The clinical manifestation of aphthous stomatitis includes small, painful, round or oval-shaped ulcers with a white or yellow center and red border, typically located inside the mouth, such as the tongue, lips, and cheeks.

** Aphthous stomatitis is not contagious.

** Certain foods, stress, hormonal changes, and trauma to the mouth may trigger aphthous stomatitis.

** The initial management of aphthous stomatitis involves symptomatic treatment with over-the-counter pain relievers, topical anesthetics, and oral rinses.

** In severe cases, prescription medications such as corticosteroids or immunomodulators may be necessary.

** There is no definitive cure for aphthous stomatitis, but symptoms typically improve on their own within a few days to a couple of weeks.

** Aphthous stomatitis is not associated with an increased risk of oral cancer.

** Good oral hygiene, avoiding trigger foods, and stress management can help reduce the frequency and severity of outbreaks in people with frequent or severe aphthous stomatitis.

**Vitamin B12 deficiency may be linked with aphthous stomatitis, and supplementation may help reduce the frequency and severity of outbreaks.

** Probiotics are being studied as a potential preventive or therapeutic option for aphthous stomatitis.

** In rare cases, aphthous stomatitis may be a manifestation of underlying systemic diseases, such as Crohn's disease or celiac disease.

** If you experience frequent or severe canker sores, it's recommended to consult with a healthcare professional to rule out underlying medical conditions and explore treatment options.

** Proper management of aphthous stomatitis can improve quality of life and reduce the impact of symptoms on daily activities.

Use of tacrolimus in Oral lichen planus_____________________________________Oral lichen planus is a chronic inflammatory...
23/04/2023

Use of tacrolimus in Oral lichen planus
_____________________________________

Oral lichen planus is a chronic inflammatory disease that affects 1-2% of the population. It is a T-cell mediated autoimmune process of unknown etiology.

Tacrolimus (also known as FK506) works by inhibiting the activity of calcineurin, a protein phosphatase that plays a crucial role in the activation of T-cells. When T-cells are activated, they release cytokines and other immune mediators that can cause inflammation and tissue damage. By inhibiting calcineurin, tacrolimus prevents the activation of T-cells and reduces the production of these immune mediators, leading to a decrease in inflammation and tissue damage.

Tacrolimus is more effective if used along with topical corticosteroids. Currently tacrolimus is 50 times more expensive than clobetasol, therefore, cost of treatment should be taken into consideration.

PMID: 24260597

Preemptive analgesic administration seems beneficial in reducing postoperative pain levels and analgesic intake in singl...
19/04/2023

Preemptive analgesic administration seems beneficial in reducing postoperative pain levels and analgesic intake in single visit root canal treatment.
600 mg of ibuprofen tablet was taken 1 hour before the procedure.

PMID: 35786581

Managing adverse effects of systemic steroids_____________________________________________Patients treated with systemic...
12/04/2023

Managing adverse effects of systemic steroids
_____________________________________________

Patients treated with systemic corticosteroids should receive calcium and vitamin D supplementation.

To prevent steroid-induced osteoporosis, bisphosphonates (i.e., alendronate, risendronate) should be considered in at-risk patients.

The prophylactic use of H2-blockers or proton pump inhibitors for steroid-induced peptic ulcers remains controversial, and treatment should be individualized to the patient.

Annual ophthalmologic examinations are recommended to screen for steroid-related ocular complications (i.e., cataracts, glaucoma).

Systemic antibacterial, antifungal and antiviral therapies are recommended when clinically indicated.

Steroid in Pemphigus vulgaris Systemic corticosteroids have had a significant impact on the treatment of pemphigus vulga...
11/04/2023

Steroid in Pemphigus vulgaris

Systemic corticosteroids have had a significant impact on the treatment of pemphigus vulgaris and remain the backbone in the management of PV.

The first-line treatment of mild PV is systemic corticosteroids, which takes several weeks to achieve a response.

Tapering down of the dose can be initiated when symptoms are improved, but if reappearance of more than three lesions occurs, then dosing should be increased again to induce remission.

https://www.ncbi.nlm.nih.gov/books/NBK560860/ #:~:text=Pemphigus%20vulgaris%20is%20a%20life,significant%20pain%20and%20functional%20impairment.

Azathioprine in Pemphigus vulgaris Azathioprine antagonizes purine metabolism and inhibits the synthesis of DNA, RNA, an...
11/04/2023

Azathioprine in Pemphigus vulgaris

Azathioprine antagonizes purine metabolism and inhibits the synthesis of DNA, RNA, and proteins. It may decrease the proliferation of immune cells, which results in lower autoimmune activity.

In conjunction with prednisone, it is more effective than prednisone alone.

Off-label use of azathioprine may be an effective monotherapy in mild cases, although therapeutic effects are delayed 3-5 weeks. Consider withdrawal if no improvement is seen within 3 months.

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