Mouth cancer (143-145 ICD-9) is a major health problem in many parts of the world. While its incidence is relatively low in most western countries there are some important exceptions to this trend: on the Indian subcontinent and in other parts of Asia it remains one of the most common forms of cancer. This review article summarises the global incidence of mouth cancer using cancer maps. Data have been compiled from the latest edition of Cancer Incidence in Five Continents and recent studies from various locations around the world. Significant geographic variation is noted in the incidence of mouth cancer, with high rates reported for the Indian subcontinent and parts of Asia (male incidence rates in excess of 10 per 100 000 per annum). It is also noted that as with other forms of oral cancer, the majority of population-based data for mouth cancer comes from the Western world with a paucity of reliable data from the so-called developing countries. Mouth cancer remains a serious health problem in many parts of the world with many regions reporting increasing incidence rates particularly in males. Ongoing research into the aetiologic risk factors associated with this disease must remain a very high priority if the causes of mouth cancer are to be established and disease control protocols introduced widely. Oral Diseases (2000) 6, 65-74

Lip cancer (140 ICD‐9) is a form of oral cancer that has a distinctive global epidemiology. This review summarises global incidence rates for male and female lip cancer with the aid of cancer atlases. High male lip cancer rates are reported for regions of North America (12.7 per 100 000 per annum), Europe (12.0 per 100 000 per annum) and Oceania (13.5 per 100 000 per annum), while it is virtually unknown in parts of Asia. Factors commonly cited as important in the aetiology of lip cancer include solar radiation, tobacco smoking and viruses. An attempt is made to summarise the evidence for factors that may be important in lip carcinogenesis. While incidence rates are generally stable or falling among males worldwide, they are rising in many female populations. The aetiology of the disease is far from established and much information regarding its pathogenesis is based on anecdotal rather than case‐controlled epidemiological evidence. The epidemiology of lip cancer supports the proposal that the lip should be considered as a distinct cancer site, rather than being included with other forms of intraoral cancer.

The tongue (141 ICD-9) is the most common intraoral site for cancer in most countries, however its global epidemiology shows significant geographic variation. This review paper summarises the global incidence of cancer of the tongue using cancer maps and references to recent studies from various locations. Tongue cancer remains a serious health problem in many countries including India (male incidence rates up to 6.5 per 100 000 per annum) and parts of Europe (male incidence rates in France up to 8.0 per 100 000 per annum). It is noted that as with other forms of oral cancer the majority of populationbased data for tongue cancer comes from the Western world with a paucity of reliable data from the so-called developing countries. The tongue remains the most common intraoral site for oral cancer worldwide and in a number of countries it is a serious public health problem with significant morbidity and mortality. While the incidence of tongue cancer appears to be stable or falling in some regions of the world, in other areas it is rising, particularly among younger people. Oral Diseases (2000) 6, 75-84

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In 2002/2003 a number of patients presented to the South Australian Oral and Maxillofacial Surgery Unit with unusual non‐healing extraction wounds of the jaws. All were middle‐aged to elderly, medically compromised and on bisphosphonates for bone pathology. Review of the literature showed similar cases being reported in the North American oral and maxillofacial surgery literature. This paper reviews the role of bisphosphonates in the management of bone disease. There were 2.3 million prescriptions for bisphosphonates in Australia in 2003. This group of drugs is very useful in controlling bone pain and preventing pathologic fractures. However, in a small number of patients on bisphosphonates, intractable, painful, non‐healing exposed bone occurs following dental extractions or denture irritation. Affected patients are usually, but not always, over 55 years, medically compromised and on the potent nitrogen containing bisphosphonates, pamidronate (Aredia/Pamisol), alendronate (Fosamax) and zolendronate (Zometa) for non‐osteoporotic bone disease. Currently, there is no simple, effective treatment and the painful exposed bone may persist for years. The main complications are marked weight loss from difficulty in eating and severe jaw and neck infections. Possible preventive and therapeutic strategies are presented although at this time there is no evidence of their effectiveness. Dentists must ask about bisphosphonate usage for bone disease when recording medical histories and take appropriate actions to avoid the development of this debilitating condition in their patients.