Sjö gren's syndrome is a chronic autoimmune disease that affects many individuals within the community. Despite this, its exact aetiology and pathogenesis is still unclear. Sjö gren's syndrome affects many organ systems in the body. However, for dental practitioners it is important to recognize the many oral and dental manifestations that are associated with the syndrome. In addition to these oral manifestations, this review will discuss the systemic manifestations of Sjö gren's syndrome as well as the current understanding of factors that have a role in its aetiology and pathogenesis. Furthermore, this review will highlight the difficulties and complexities that are inherent in the diagnosis of Sjö gren's syndrome and the important role that dental practitioners can play in the management of its oral manifestations. The effective management of oral manifestations and minimization of oral disease in patients with Sjö gren's syndrome can result in improved quality of life for these patients.Keywords: Sjö gren's syndrome, aetiology, pathogenesis, diagnosis, dental management.Abbreviations and acronyms: HCV = hepatitis C virus; HIV = human immundodeficiency virus; HLA = human leukocyte antigen; IFN = interferon; MHC = major histocompatibility complex; SS = Sjö gren's syndrome; TNF = tumour necrosis factor.

Background A study undertaken in 1992–1993 identified that HIV‐infected dental patients were substantially disadvantaged with regard to the social impact of their oral disease. The oral pain experienced by HIV‐positive patients prior to the introduction of combination antiretroviral therapy (cART) was attributable to specific features of HIV‐related periodontal disease and other oral manifestations of HIV such as candida infections and xerostomia. A repeat of this study in 2009–2010 provided additional information in the post‐cART era. Methods Data were collected from three sources: the 2009–2010 HIV‐positive sample, the National Survey of Adult Oral Health (NSAOH) and the original 1992–1993 study. Collation of data was by clinical and radiographic oral examination. Information about the social impact of oral conditions was obtained from the Oral Health Impact Profile. Results The caries experience of the 2009–2010 HIV‐positive sample was improved with statistical significance for both mean DMFT and mean DT, while the presence of HIV‐related periodontal disease still occurs. Statistically significant improvements were achieved for prevalence and severity of oral health related quality of life. Conclusions The need for timely access to oral health care with a focus on prevention is essential for HIV‐positive individuals whose health is impacted by chronic disease, smoking and salivary hypofunction.

Background: There is limited information on self-perceived oral health of homeless populations. This study quantified selfreported oral health among a metropolitan homeless adult population and compared against a representative sample of the metropolitan adult population obtained from the National Survey of Adult Oral Health. Methods: A total of 248 homeless participants (age range 17-78 years, 79% male) completed a self-report questionnaire. Data for an age-matched, representative sample of metropolitan-dwelling adults were obtained from Australia's second National Survey of Adult Oral Health. Percentage responses and 95% confidence intervals were calculated, with nonoverlapping 95% confidence intervals used to identify statistically significant differences between the two groups. Results: Homeless adults reported poorer oral health than their age-matched general population counterparts. Twice as many homeless adults reported visiting a dentist more than a year ago and that their usual reason for dental attendance was for a dental problem. The proportion of homeless adults with a perceived need for fillings or extractions was also twice that of their age-matched general population counterparts. Three times as many homeless adults rated their oral health as 'fair' or 'poor'. Conclusions: A significantly greater proportion of homeless adults in an Australian metropolitan location reported poorer oral health compared with the general metropolitan adult population.

Bisphosphonate associated osteonecrosis of the jaws (ONJ) usually commences at the alveolus. Comparison is made between the structure and function of long bones and alveolar bone and the differing susceptibilities of the bisphosphonates at these different sites are explored. Current concepts of the causation of ONJ are discussed. The clinical implications of these findings to dentists managing periodontal conditions are presented.Keywords: Alveolar bone, bone diseases, bisphosphonates, osteonecrosis of the jaws.Abbreviations and acronyms: BMD = bone mineral density; CT = computerized tomography; CTX = serum beta cross laps assay; ONJ = osteonecrosis of the jaws.

(Accepted for publication 13 July 2005.) INTRODUCTIONTongue cancer is the most common intra-oral malignancy in Western countries. It accounts for between 20 to 50 per cent of all malignancies involving the oral cavity.1 More males than females are affected and the highest incidence occurs in the seventh decade of life.1,2 The vast majority of tongue malignancies, more than 95 per cent, are squamous cell carcinomas (SCC).1,2 The lateral border and the base of the tongue are the most commonly involved sub-sites of the tongue. Indeed in some studies, the base of the tongue accounts for up to one-third of all SCC of tongue. 3 The aetiological agents that are considered most important with respect to SCC of the tongue include tobacco (smoking and chewing habits) and alcohol consumption. 1,2The incidence and mortality of the disease varies between different geographic areas. There has been a reported increased incidence of tongue SCC and associated mortality over recent decades in Europe and the United States. 2,4,5 Additionally, an increased incidence of SCC of the tongue in young adults has been reported from studies conducted in several countries.2-6 Approximately 5-10 per cent of cases of tongue cancer occur in younger patients, many of whom do not have the identified risk factors such as smoking and alcohol. 6 Debate continues in the literature regarding the aetiology, tumour biology and prognosis of tongue cancer in young patients.In spite of advances in cancer therapy, the worldwide trend in five-year survival rates of tongue SCC since the early 1970s has remained relatively constant,