A case-control study was conducted to determine the significance of tobacco, alcohol and khat (Catha edulis) chewing habits in the development of oral leukoplakia among Kenyans aged 15 yr and over. In a house-to-house survey, 85 cases and 141 controls matched for sex, age and cluster origin was identified and compared for these risk factors. Smoking unprocessed tobacco (Kiraiku) with a relative risk (RR) of 10.0 (95% confidence interval (CI) = 2.9-38.4) and smoking cigarettes (RR = 8.4; 95% CI = 4.1-17.4) were the most significant factors. While the RR associated with smoking cigarettes alone was 4.5 (95% CI = 1.9-10.8), smoking of both products (RR = 15.2) suggested probable synergy or additive effects. Oral leukoplakia in 18 cases could not be attributed to smoking tobacco. Commercial beer, wines and spirits were relatively weak, but statistically significant, risk factors. Traditional beer, khat and chilies were not significantly associated with oral leukoplakia.

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Background: Despite the diverse conservative and surgical modalities for the management of temporomandibular joint (TMJ) dislocation and the controversy that surrounds them, very little has been done within the East-African setup in terms of highlighting and provoking greater interest in the epidemiology and management of TMJ dislocation. Objective: To audit the pattern of occurrence, demographics, aetiology and enumerate the treatment modalities of TMJ dislocation at the oral and maxillofacial surgery division (OMFS) of the University of Nairobi Dental Hospital. Design: Descriptive cross-sectional study. Setting: University of Nairobi Dental Hospital (UNDH) from January 1995 to July 2005. Results: Twenty nine patients had been diagnosed and managed for TMJ dislocation. Twenty (69%) were females and nine (31%) were males. Their ages ranged from 10-95 years with a mean of 42 years. The cases managed were primarily chronic in nature. The most common form being anterior TMJ dislocation, accounting for twenty-five (86.2%) cases. Trauma was implicated as an aetiology in only five (17%) of the cases while the remaining majority of twenty four (83%) cases were spontaneous. Amongst the causes of spontaneous TMJ dislocation, yawning was the most common accounting for fourteen cases (48.3%). Dislocations caused by trauma were found to be 12.6 times more likely to be associated with other injuries than spontaneous dislocations. Anterior TMJ dislocations were found to be 1.3 times more likely to be associated with absence of molars than posterior TMJ dislocations. Anatomical aberrations, as predisposing factors, were not a significant finding in this research. Eight (28%) of the cases were managed conservatively. Twenty one (72%) of the cases were managed surgically. The eminectomy was the most common technique with a 75% success rate. The highest incidence of TMJ dislocation occurs in the 3rd-5th decade with a female preponderance with bilateral anterior TMJ dislocation being the most common. Most of the cases were managed surgically with eminectomy being the preferred technique with the highest success rate. A study needs to be undertaken to determine reasons' why conservative modalities are least employed in the management of TMJ dislocation in our setup and what can be done about it.

Salivary gland tumours (SGT) are rare, comprising about 5% of head and neck tumours with a higher incidence reported in the western compared with the African centres. There are few studies on SGTs that have been conducted in Africa. A descriptive retrospective study was done to describe the demographic characteristics, site distribution and histological patterns of SGT at a University teaching hospital in Kenya over a 12-year-duration. There were 132 SGTs out of 2426 biopsies of head and neck tumours, the age range was between 8 to 80 years (mean = 43.6 yrs) and the modal age was 50 yrs. The percentage of tumours arising from minor salivary glands (MiSG) (67%) were twice than that from the major salivary glands (MaSG) (33%). The sites most affected for the Misg was the palate and for the MaSG was the submandibular gland. Pleomorphic salivary adenoma (PSA) (40.2%) was the most common benign SGT while adenoid cystic carcinoma) (ACC) (20.5%) was the most frequent amongst the malignant type. The overall male:female ratio was almost 1:1. However, there were more females than males with benign SGTs, whereas an equal gender distribution was noted in malignant SGT. Benign and malignant SGT occur at a younger age. MiSGs of the palate were most frequent site of tumour and the least frequent is the sublingual gland. More than 50% of SGT were malignnant and hence any SGT should raise a high index of suspicion.