Dislocation of the condyle of the mandible is a common condition that may occur in an acute or chronic form. It is characterised by inability to close the mouth with or without pain. Dislocation has to be differentiated from subluxation which is a self reducible condition. Dislocation can occur in any direction with anterior dislocation being the commonest one. Various predisposing factors have been associated with dislocation like muscle fatigue and spasm, the defect in the bony surface like shallow articular eminence, and laxity of the capsular ligament. People with defect in collagen synthesis like Ehler Danlos syndrome, Marfan syndrome are said to be genetically predisposed to this condition. Various treatment modalities have been used ranging from conservative techniques to surgical methods. Acute dislocations can be reduced manually or with conservative approach and recurrent and chronic cases can be reduced by surgical intervention. Though the dislocation in our case was 4 months a simple manual reduction proved to be successful. We believe that manual reduction can be attempted as fi rst line of treatment prior to surgical intervention.

Even after treatment, chronic oral mucosal diseases negatively affect patients’ QOL. Use of the Chronic Oral Mucosal Diseases Questionnaire may allow physicians to more effectively care for their patients with these diseases.

Introduction:The shape of the coronoid process and sigmoid notch is useful in anthropological studies and forensic dentistry. Literature review shows that the morphological variation in the shape of coronoid process and sigmoid notch may be due to hereditary or functional changes and have a correlation with the mode and degree of the attachment of temporalis muscle.

Oral malodor one of the most common complaints with which patients approaches us thinking it can be detrimental to his self-image and confidence. Even though majority of oral malodor is of oral origin, there are multiple other systemic causes that have to be addressed while we diagnose and treat this condition. Most of these patients look up to oral care physicians for expert advice, it is critical for us to have the knowledge base and communication techniques to provide quality clinical assessment and implement effective intervention programs. This article reviews the various causes and the diagnostic modalities which will help us treat this multifaceted condition. Key words: Halitosis; Oral malodor; Systemic diseases; Diagnosis DOI: 10.3126/kumj.v8i2.3574 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 269-275

Introduction Temporomandibular disorders (TMDs) are a heterogeneous group of pathologies affecting the temporomandibular joint (TMJ), the jaw muscles, or both. Epidemiological studies of TMD reveal a prevalence of 82% in the general population with 48% of them presenting with clinical features of muscle tenderness and difficulty in mouth opening. TMD are considered to be the most common orofacial pain conditions of nondental origin. Methods The patients with TMD were randomly divided into two groups, A and B, based on their VAS scale. Group A consists of two subgroups 1 and 2 each consisting of 15 patients. Group B consists of two subgroups 3 and 4 consisting of 15 patients. Patients in Group A were given TENS for twenty minutes, and the frequency is adjusted as follows: (i) subgroup 1: TENS frequency at a range of 0–5 (VAS measuring 1–5) and (ii) subgroup 2: TENS frequency at a range of 5 and above (VAS measuring 6–10). Patients in Group B were given MENS for twenty minutes, and the frequency adjusted as follows: (i) subgroup 3: MENS frequency at range of 0–5 (VAS measuring 1–5) and (ii) subgroup 4: MENS frequency at a range of 5 and above (VAS measuring 6–10). Each patient was recalled for five consecutive days for the treatment, and the same intensity and frequency were maintained throughout the treatment period. Results The improvement in VAS is seen to be highly significant statistically in MENS subgroup 4 (moderate-to-severe pain). Subgroups 1 and 3 had improvement in VAS which was comparable in both TENS and MENS groups. Conclusion In the present study, it was found that TENS and MENS are equally effective in improving the functional mouth opening. MENS showed better and immediate effect in relief of pain. Microcurrent also has the advantage of being subthreshold, and hence the side effects such as tingling sensation and paresthesia seen to occur in some patients following TENS are absent. TENS and MENS can be considered as the first line of treatment in patients with acute and chronic masticatory muscle pain and also as an effective treatment option in cases of functional mouth opening.

Context:Oral health awareness and oral care are crucial aspects of oncology nursing practice. However very few studies concentrate on the oral care of cancer patients undergoing cancer treatment and nursing practice in the Indian subcontinent. Most of the published studies have been conducted in the Western and European countries.Aim:This study aimed to determine the nurses’ knowledge and education about oral care in cancer patient undergoing chemotherapy and radiation therapy.Setting and design:A cross sectional descriptive survey was conducted among 158 staff nurses working in oncology related areas from 4 different hospitals of Dakshina Kannada district and Udupi district of Karnataka state, India.Statistical Analysis:descriptive and inferential statistics was used by using SPSS 16 version.Results:Majority 81 (51.3%) of the staff nurses had poor knowledge of oral care in cancer patients whereas 87 (55.1%) reported that knowledge acquired through basic education in oral care is not sufficient. Most of the staff nurses 115 (72.8%) did not receive basic education in oral care of cancer patients. There was significant association between knowledge and variables such as designation (.005), years of work experience (.040) and years of experience in cancer wards (.000) at 0.05 levels.Conclusion:Lack of knowledge suggest the need to develop and implement continuing nursing education programs on oral care specifically for patients receiving cancer treatments, for improving knowledge of staff nurses’ in order to render comprehensive care to the patients. This study also recommends the importance of inclusion of cancer patient specific oral care in the curriculum which can enhance competency of the qualified nurses in cancer wards.

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Background. Oral and oropharyngeal cancer is a debilitating disease with high morbidity and mortality. Depending on the site and extent of the involvement of the cancer and the type of treatment modality, these patients can develop pain, trismus, xerostomia, dysphagia, and taste disturbances, compromising them socially and nutritionally. The aim of the study was to evaluate malnutrition and quality of life in patients treated for oral and oropharyngeal cancer. Methodology. A cross-sectional study was conducted which included 97 patients treated for oral and oropharyngeal cancer. The quality of life of the selected patients was assessed by using a validated European Organization for the Research and Treatment of Cancer’s Quality of Life Questionnaire, Head and Neck and Mandibular Function Impairment Questionnaire. Pre- and posttreatment weight of the patients were assessed, and weight loss of ≥10% of pretreatment weight was considered as malnutrition. The chi-square test was used to correlate the symptoms with the quality of life. A paired t test was used to assess the differences in weight before and after treatment, and a p value of <0.005 was considered as significant. Results. The most commonly reported symptoms were xerostomia (93.81%), pain (81.44%), and dysphagia (76.3%). A total of 40.2% of the individuals in the study had malnutrition. Malnutrition was comparatively lower in the group who had nutritional supplements. Conclusion. The quality of life in patients treated for oral and oropharyngeal cancer deteriorates immediately after the treatment; however, it significantly improves over time.