Oral submucous fibrosis (OSF) is a chronic, insidious disease caused by areca nut use, and is associated with both significant morbidity (including pain and reduced oral opening) and an increased risk for malignancy. This systematic review explored and updated the current medical (i.e., non-surgical) interventions available for the management of OSF. Of the 27 published medical interventions, there were four randomized controlled trials. The overall quality of these randomized controlled studies was assessed using the GRADE approach and significant limitations that challenged the conclusions were found. However, this review was valuable in terms of identifying opportunities to provide recommendations for future research, in terms of the populations to research, the types of interventions needed, the types of outcomes to be measured, the study designs needed, and the infrastructure required to conduct studies. The next step is to initiate a pathway for a low-cost research plan leading to the development of a brief protocol for future clinical trials in this field, with an emphasis on conducting studies in regions of the world where OSF is prevalent.

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Purpose: The present study was conducted to find the preferred mode of learning among first-year preclinical students and compare the preferred mode of learning with sex, faculty of students, and academic performance of the students using the VARK questionnaire. Methods: A cross-sectional study was done among 142 first-year Bachelor of Medicine–Bachelor of Surgery and Bachelor of Dental Surgery students from February to May 2018. Demographic data and various academic performance marks were recorded for each individual. VARK (visual, aural, read/write and kinesthetic) questionnaire version 7.8 was administered to calculate the score of each component. Mean VARK scores were calculated and each student classified by their preferred mode of learning. The preferred mode of learning was compared with sex, nationality, faculty of students, and academic performance using χ 2 , unpaired t -tests, and the Mann–Whitney U test. P <0.05 was taken as statistically significant for comparison. Results: A majority of the students (53.52%) were multimodal. The most common multimodal mode of preference was bimodal (26.06%), while the most common unimodal preference was kinesthetic (29.06%). Total V score, K score, and VARK score were higher among males, while A and R scores were higher among females. The K score (7.96±2.35 in males and 6.96±2.43 in females) differed significantly ( P =0.019) between male and female subjects. More subjects with higher scores in the theory exam of anatomy were unimodal learners (53.8%) compared to multimodal learners (46.2%). Conclusion: From this study, it can be concluded that undergraduate students were diverse in their learning styles, but most were multimodal. Though learning styles were found to vary by sex, nationality, and academic performance, differences were not statistically significant.

Oral cancer is most prevalent in low-and middle-income countries where it is associated with late diagnosis. A significant factor for this is the limited access to specialist diagnosis. The use of artificial intelligence for decision making on oral cavity images has the potential to improve cancer management and survival rates. This study forms part of the MeMoSA ® (Mobile Mouth Screening Anywhere) project. In this paper, we extended on our previous deep learning work and focused on the binary image classification of 'referral' vs. 'non-referral'. Transfer learning was applied, with several common pre-trained deep convolutional neural network architectures compared for the task of finetuning to a small oral image dataset. Improvements to our previous work were made, with an accuracy of 80.88% achieved and a corresponding sensitivity of 85.71% and specificity of 76.42%.

Background/purpose: In this in vitro study, we assessed the antifungal effect of mouth rinses containing chlorhexidine and thymol. Materials and methods: The fungistatic activities of chlorhexidine-and thymol-containing mouth rinses were assessed by means of the minimum inhibitory concentration (MIC) and the fungicidal activity was determined by a time-kill assay. Results: The chlorhexidine-containing mouthwash was able to kill all strains of Candida albicans and Candida tropicalis in shorter times compared to the thymol-containing mouthwash. Hexidine showed an MIC of 1:32 for both Candida species, whereas Listerine respectively showed MICs of 1:8 and 1:16 for C. albicans and C. tropicalis. Conclusions: Antimicrobial agents used in the study had good in vitro activity against the two Candida species. Mouth rinses containing chlorhexidine showed superior antifungal and fungicidal activities compared to the thymol-containing mouth rinse. Both antimicrobial agents may be suggested for use as topical antifungal agents.

Background:Oral potentially malignant disorders (OPMDs) and oral cancer (OC) are preventable oral mucosal diseases prevalent in Asian region. This epidemiological study aims to identify oral potentially malignant disorders (OPMDs) and oral cancer (OC), confirm histopathologically, and treat or refer these cases among the population of Eastern Development Region (EDR) of Nepal. It also attempts to assess the risk factors associated in order to compare dose–response measurements of oral habits in these patients.Methods:Cross-sectional epidemiological study was conducted over a period of 2 years in 16 districts of EDR. A total of 3,200 people were screened. A brief history was taken and visual screening examination was conducted in two phases as described by British Columbia Oral Cancer Prevention Program. Suspicious oral lesions were biopsied either by punch or scalpel after toluidine blue staining. Tissue specimen was transported to the institutional lab for histopathological processing. The reports were sent to the patients through the local leaders or organizations. Results:More than 40% of the study population either chewed areca nut and/or tobacco. Eighteen percent were smokers. OPMDs were prevalent among 468 study population with male-female ratio of 3:1. Tobacco pouch keratosis (50.4%) was the most prevalent OPMD, followed by OSF (29.1%). Fifty-two had squamous cell carcinoma and 8 had verrucous carcinoma. Conclusion:Chewing areca nut, tobacco, commercial areca nut/tobacco preparation and smoking being the major risk factors, there is high prevalence of oral cancer and OPMDs in the EDR of Nepal.

Context:Problem-based learning (PBL) is a methodology widely used in medical education and is growing in dental education. Initiation of new ideas and teaching methods requires a change in perception from faculty and institute management. Student-centered education is a need of the day and PBL provides the best outlet to it.Aim:To introduce PBL, assess feasibility and challenges in undergraduate dentistry program and evaluate the impact on their learning.Settings and Design:PBL was used as a teaching methodology on 37 students in 2nd year BDS program. The PBL was duplicated as that of MBBS program. PBL was spread over 5 days. Pre- and post-test questions along with different questionnaires were designed for the students and tutors/faculty to be administered after PBL session.Subjects and Methods:Case with temporomandibular joint and muscles of mastication and occlusion was designed as a module with five triggers given to students who were divided into five groups over two tutorials facilitated by tutor. Resource sessions were held by involved departments (Oral Biology, Oral Pathology, Oral Medicine and Radiology, Orthodontics, and Oral Surgery). Students were allotted time for search, research and discover to search literature.Statistical Analysis Used:Descriptive statistics.Results:Pre and post-test comparison showed that the knowledge increased immensely following PBL sessions. Students’ assessment by tutors following two PBL tutorials showed a mean score of 34.9 ± 4.01 and 35.5 ± 3.86, respectively. Students’ feedback showed that most of them preferred PBL because they found it interactive, collaborative, goal and research oriented. Students were motivated to learn new topic because learning objectives were formulated by themselves and they developed self-directed learning skills. The tutors learned to design cases.Conclusions:PBL encouraged students to use more interactive methods of learning which possibly will make them lifelong learners.

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