Evaluation of an oral moisture-checking device for screening dry mouth

Objective: This multicenter clinical study was to assess the clinical usability of an oral moisture-checking device in detecting the dry mouth patients and evaluating the optimal measurement site. Materials and Methods: The study group comprised 250 patients with dry mouth and 241 healthy volunteer subjects at 13 medical centers. This device was used to measure the moisture degrees of the lingual mucosa and the buccal mucosa. Subjective oral dryness, objective oral dryness, and saliva flow rates were also compared between the two groups. For statistical analysis, receiver-operating characteristic analysis was performed to calculate the area under the curve (AUC). Results: The moisture degree of the lingual mucosa was significantly lower in the dry mouth group (27.2 ± 4.9) than that in the healthy group (29.5 ± 3.1, AUC = 0.653). When a lingual mucosa moisture degree of 31.0 or higher was defined as normal, less than 27.0 as dry mouth, and 27.0 to less than 31.0 as borderline zone of dry mouth, both the sensitivity and the specificity for the diagnosis of dry mouth were close to 80%. Conclusion: These results suggest that the oral moisture-checking device is a usable screening device for dry mouth.

Patients with dental hemorrhagic complicationsundergoing warfarin therapy exhibit excessiveinternational normalized ratio prolongation: A report of 2 cases

Dental?hemorrhagic?complications,?including?postoperative?bleeding?and?traumatic?hemorrhage?as?emergency?cases,?often?occur?in?patients?undergoing?oral?anticoagulant?therapy?such?as?warfarin?therapy.?Recent?research?recommends?that?warfarin?dosage?should?be?assessed?every?12?weeks.?Therefore,?most?physicians?generally?accept?international?normalized?ratio?(INR)?monitoring?at?longer?intervals.?However,?cases?are?encountered?in?which?the?INR?prolongation?is?observed?despite?of?invariable?dosage?of?warfarin.?In?this?report,?we?present?2?cases?of?patients?with?dental?hemorrhagic?complications?undergoing?oral?anticoagulant?therapy?who?exhibited?excessive?INR?prolongation.?These?patients?exhibited?decreased?appetite?and?hypoalbuminemia. We?speculate?that?long-term?appetite?loss?resulted?in?the?increase?in?the?serum?concentration?of?free?warfarin and?vitamin?K deficiency. Our?study?indicates that we?should?notice malnourishment?when?we?treat patients?who?have?undergone?warfarin?therapy with dental?surgical procedures.?It?is?recommended?that measurement?of?INR just before?a?dental?surgical?treatment.

A Case of Giant Epidermoid Cyst in the Floor of the Mouth That Caused Severe Obstructive Sleep Apnea Syndrome

We describe here, a case with a giant epidermoid cyst in the floor of the mouth that caused severe obstructive sleep apnea syndrome (OSAS). A 37-year-old man was referred to our clinic because of a swelling in the floor of his mouth and sleep apnea syndrome. The occurrence of breathing disorders and daytime drowsiness was monitored to evaluate his OSAS 1 day before and 7 days after surgery. Before surgery, the apnea-hyponea index (AHI) and Epworth Sleepiness Scale (ESS) were 45.7 and 22, respectively. The clinical diagnosis was a dermoid or an epidermoid cyst that caused severe OSAS. Under general anesthesia, the patient underwent intraoral surgical removal of the cyst, along with aspiration to reduce the mass. After surgery, his sleep apnea syndrome was significantly improved. The postoperative AHI and ESS were 5.5 and 7, respectively. As of 2 years after the operation, there was no evidence of recurrence.