Oral candidosis is the most common fungal infection encountered in general dental practice. It manifests in a variety of clinical presentations which may mimic more sinister diseases, and can occasionally be refractory to treatment requiring the attention of an oral medicine specialist. Management of oral candidosis should always include a thorough investigation of underlying predisposing conditions, as the disease often presents when the patient is systemically compromised. This update highlights the pathogenesis, clinical presentation, and management strategies of oral Candidal lesions commonly encountered in dental practice.

An oral examination for the assessment for malignant and potentially malignant oral mucosal lesions is routine in general dental practice. It may be uncommon for general dental practitioners to encounter oral cancer, with anecdotal reports suggesting that this occurs about once every 10 years in a busy general dental practice. However, potentially malignant oral mucosal lesions are relatively common, occurring in about 2.5% of the population. This update highlights the epidemiology, risk factors, diagnosis and management of these oral mucosal lesions.

Worldwide, oral cancer represents approximately 5 per cent of all malignant lesions, with over 800 new intra-oral squamous cell carcinomas registered in Australia each year. Despite recent advances in therapy, the five-year survival rate remains around 50 per cent and the sequelae of treatment can be seriously debilitating. It has been long established that smoking and alcohol consumption are risk factors linked to the development of oral cancer. This review assesses the epidemiological evidence, supportive in vitro studies and mechanism by which alcohol is involved in the development of oral cancer. Further, we review the literature that associates alcohol-containing mouthwashes and oral cancer. On the basis of this review, we believe that there is now sufficient evidence to accept the proposition that alcohol-containing mouthwashes contribute to the increased risk of development of oral cancer and further feel that it is inadvisable for oral healthcare professionals to recommend the long-term use of alcohol-containing mouthwashes.

degree of swelling and lack of precision with depth and area of freezing. It also is highly dependent on operator skill and experience.In this paper we outline the principles, mechanisms of action, and current applications of cryotherapy in the treatment of oral lesions, and present some clinical cases for illustrative purposes. Principles of cryotherapyThe basic technique of cryotherapy stresses rapid cooling, slow thawing and repetition of the freezing process to maximize tissue destruction. 5 The two methods recognized are a closed system with use of probes and nitrous oxide, or an open system with use of a liquid nitrogen spray or a cotton tip.2,5 Spray techniques are useful in widespread dermatological lesions, small skin cancers and intra-bony cavities after curettage to prevent recurrence. The nitrous oxide technique is useful for treatment of various benign and malignant lesions of the oral cavity where more predictable necrosis is necessary and depth of necrosis is also a factor. This system is used by the authors in the treatment of various oral soft tissue lesions, and will be emphasized here. These probes follow the principles of Joule-Thompson expansion which enable substances to undergo a drop in temperature when moved from a high pressure area to a lower pressure area.6 For instance, when nitrous oxide is released from the high pressure inside the cryoprobe to the lower pressure cryo tip, the drop in temperature allows freezing of the tissues to occur (Fig 1a).Modern cryoprobes may also be fitted with tip temperature monitors allowing for time selection and increased control. This allows clinicians to observe the effects at a certain probe temperature and use this as a basis for future treatment. Liquid nitrogen sprays and cotton swabs are more accessible to clinicians but are not suitable for use in the oral cavity. Their disadvantage is a lack of control over the temperature achieved within cells and the area of freezing, which makes them hazardous to use intraorally. Also, rapid evaporation of liquid nitrogen from cotton swabs requires numerous applications on the lesion. Due to direct contact between the cryogen and tissue, a more controlled and profound depth of Cryotherapy for treatment of oral lesionsCS Farah,* NW Savage † AbstractCryotherapy is the deliberate destruction of tissue by application of extreme cold. It is well received by patients due to a relative lack of discomfort, the absence of bleeding and minimal to no scarring after healing. It has many applications in oral medicine and clinical oral pathology, and is extremely useful in patients for whom surgery is contra-indicated due to either age or medical history. In this paper we outline the principles, mechanisms of action, and current applications of cryotherapy in the treatment of oral lesions, and present some clinical cases.

Background: The prevalence of oral and maxillofacial pathology has not previously been reported in the Australian paediatric population. This study aimed to audit a large pathology service to provide insight into the prevalence of oral and maxillofacial pathology. Methods: Written records of a major Australian oral pathology service were imported into an electronic database. Age, gender and histological diagnosis were assessed. Prevalence of histological diagnoses as a percentage of the major diagnostic categories and of the whole sample were calculated, as well as gender predilections and mean age of presentation of disease. Results: A total of 1305 oral pathology specimens, collected from paediatric patients aged 16 and under were included in the analysis. The most common pathology was dental pathology (24.4%), followed by odontogenic cysts (18.5%) and mucosal pathology (17.0%). The most frequently encountered lesion was the dentigerous cyst (9.4%), followed by fibrous hyperplasia (8.3%), radicular cyst (5.2%) and chronic periapical granuloma (5.2%). Conclusions: In the paediatric population, dental pathology and specifically, the dentigerous cyst is the most common pathology type sent for histopathology, suggesting a high prevalence of pathology of dental origin occurring in Australian children.