OBJECTIVE:This systematic review evaluated oral health, including oral health-related quality of life (OHRQoL), in older adults with head and neck cancer (HANC) or oral potentially malignant disorders (OPMDs). The PICO/PECO focus question for this study was: 'What is the incidence/prevalence of adverse oral health (O) among people aged 60 years or older (P) who have been diagnosed with HANC or an OPMD (E), relative to people aged 60 years or older who have not been diagnosed with HANC or an OPMD, or younger people aged less than 60 years who have been diagnosed with HANC or an OPMD (C)?' METHODS:A comprehensive literature search was performed across PubMed, OVID Medline, CENTRAL and Embase, guided by the PICO/PECO framework. Publications from 1960 up to April 2025 were considered, yielding 1070 records for initial screening. RESULTS:A total of eight studies were included for analysis. A narrative review only was presented. Findings from the included studies demonstrated conflicting results. Two cross-sectional studies demonstrated better post-treatment OHRQoL across some domains for older patients with HANC than younger patients; however, this was contradicted by data from two prospective cohort studies which showed no differences in post-treatment OHRQoL between older and younger patients with a history of HANC. Findings from a different prospective cohort study demonstrated a linear relationship between HANC patients' age and the incidence of post-radiotherapy moderate-severe xerostomia. There were no data on oral health consequences among older adults with OPMDs. CONCLUSIONS:This systematic review revealed inconclusive findings on the impact of HANC and OPMD on oral health in older adults. PROSPERO REGISTRATION:CRD420251003419.

A patient in his 60s presented to the local emergency department with symptoms of acute decompensating heart failure. Following initial investigations under cardiology he was transferred to haematology, where a provisional diagnosis of cardiac amyloidosis was established. Unfortunately, it was not possible to obtain an appropriate tissue sample for confirmation of diagnosis, and the patient was referred to oral medicine for consideration of a buccal fat pad biopsy. A labial salivary gland (LSG) biopsy was undertaken and demonstrated amyloid deposits staining salmon pink with Congo red under light microscopy and an apple-green birefringence with polarised light. The blocks were transferred to the National Amyloidosis Centre where a diagnosis of amyloid light-chain amyloidosis was made. LSG biopsy is a minimally invasive and effective method in the diagnosis of systemic amyloidosis.

BACKGROUND:Autoimmune bullous diseases (AIBD), Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS-TEN) and erythema multiforme (EM) often present with clinically similar features in the oral mucosa: classically widespread mucosal erosions or ulceration. Despite this, there are no formalized guidelines for the specific management of the oral manifestations of these conditions. OBJECTIVES:We sought to establish an consensus on the management of oral involvement of AIBD, SJS-TEN and EM using the Delphi method. METHODS:Participants were sent a survey comprising 62 statements organized into 6 categories: general oral and dental recommendations; disease severity scoring; topical therapies for active oral involvement in AIBD; systemic therapies for active oral involvement in AIBD; additional considerations for inpatient care of AIBD, EM, SJS-TEN; specific considerations for EM and SJS-TEN. Participants rated the level of appropriateness of each statement. Results were analysed using the RAND/UCLA Appropriateness Method. RESULTS:34 experts, primarily Oral Medicine clinicians and Dermatologists, completed the survey. Consensus was achieved for 58 (93.5%) statements after a single round. General recommendations included rigorous oral hygiene and regular dental/periodontal care. Disease-specific severity scoring was recommended to guide treatment and monitor response. For active oral AIBD, experts recommended moderate-to-super potent topical corticosteroids, guided by severity and site of oral disease. For inpatients, supported oral hygiene, regular topical anaesthetics and nutritional support for impaired intake were recommended. For acute EM and SJS-TEN, recommendations included regular lip care with gentle debridement of haemorrhagic crusts and application of soft paraffin. CONCLUSIONS:This Delphi sets out a broad framework for the management of oral involvement in AIBD, SJS-TEN and EM, to be adapted by a multidisciplinary team, for both acute and long-term management of these conditions. It may help to standardize the management of oral manifestations of these conditions in future multicentre studies.

Mucous membrane pemphigoid (MMP) is an autoimmune, sub epithelial, muco-cutaneous disorder characterized by tense blister formation, which breaks down to produce areas of ulceration affecting predominantly the mucous membranes but can also affect the skin. The oral cavity is the site most commonly affected, followed by the conjunctiva. Diagnosis is made using a combination of history examination of potentially involved sites including the oral cavity, skin, eyes, and anogenital mucosal membrane and supplemented with the use of special investigations including histology and direct and indirect immunofluorescence. Depending on the sites affected, this condition can significantly affect the patients' quality of life and successful treatment can be taxing for many clinicians. This case report aims to highlight an alternative approach to the management of MMP in a patient with recalcitrant disease who developed side effects to a number of systemic medications used commonly in the management of MMP. We describe a unique combination of doxycycline 200 mg daily and tacrolimus 0.25 mg/5 mL mouthwash 3 times daily which resulted in resolution of her symptoms and a significant improvement in clinical findings over a 3-month period. Thereafter she was maintained on tacrolimus mouthrinse intermittently when her oral mucosa flared. Two years after the commencement of the tacrolimus mouthrinse, the patient passed away from an unrelated condition. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).

Understanding how students approach learning is of interest in health professional education, though there is limited evidence that identifying learning styles improves educational outcomes. This study investigated learning style preferences of clinical dental students at Queen’s University, Belfast, using the VARK questionnaire, and explored whether preferences were associated with gender or academic achievement. Of 86 respondents (72% response rate), 69% preferred multimodal learning styles, with quad-modal (all four VARK modes) being the most common at 41%. Multimodal refers to a preference for more than one learning style. No relationship was found between learning style, gender, or academic distinction. Notably, a higher proportion of females achieved distinctions, a finding warranting further exploration. These results suggest that while multimodal learning is common, learning style preferences do not explain gender differences in academic performance. Given the lack of evidence for the efficacy of adapting teaching to learning styles, caution is warranted in using this information to inform curriculum design.

Spindle cell carcinoma is a rare biphasic malignancy consisting of epithelial and mesenchymal components. It is a poorly differentiated variant of squamous cell carcinoma accounting for less than 2% of intraoral tumours, with only 69 cases reported in the literature. Clinical presentation may vary from exophytic tumours to infiltrating ulceration in the oral mucosa. Atypical presentation and erractic behaviour of these tumours mean management can be challenging, therefore prompt diagnosis and treatment are required to address the significant morbidity and mortality associated with this disease. A 49-year-old patient presented to the oral medicine clinic reporting pain affecting the left side of their palate and cheek. Prior to their attendance, they were assessed by their general medical practitioner and neurologist; however, a trial of various medications resulted in no improvement in their symptoms. Intra-oral examination revealed an ulcer in the left hard palate with underlying visible maxillary bone. A subsequent biopsy confirmed the diagnosis of spindle cell carcinoma, and the patient received radiotherapy with adjuvant chemotherapy. Further imaging revealed distant metastasis in the right lung and treatment was changed to palliative immunotherapy. Follow-up imaging has shown lung nodules to be stable, and the patient remains under review with the regional head and neck cancer team. We report a rare case of intra-oral spindle cell carcinoma diagnosed from a palatal lesion, which has only been reported in four cases previously at this site. Despite preceding encounters with multiple medical professionals, it is not clear whether an intra-oral examination was carried out which may have established the diagnosis earlier. It emphasizes the importance of full head & neck examination, including intraoral examination in presentations of unexplained and intractable orofacial pain.

Dental education has been delivered in Queen's University for just over 100 years, with the Dental School celebrating its centenary in 2020. During that time, the undergraduate curriculum has evolved greatly, through innovations in the delivery of teaching and assessment driven by changes in educational practice, developing technologies and, most recently, the COVID-19 pandemic. Throughout all of these changes, our focus remains on our students, their wellbeing, and their development as lifelong learners for a career in the dental profession.

In March 2017, a group of teachers of human disease/clinical medical science (HD/CMSD) representing the majority of schools from around the UK and Republic of Ireland met to discuss the current state of teaching of human disease and also to discuss how the delivery of this theme might evolve to inform improved healthcare. This study outlines how the original teaching in medicine and surgery to dental undergraduate students has developed into the theme of HD/CMSD reflecting changing needs as well as guidance from the regulators, and how different dental schools have developed their approaches to reach their current state. Each school was also asked to share a strengths, weakness, opportunities and threats (SWOT) analysis of their programme and to outline how they thought their HD/CMSD programme may develop. The school representatives who coordinate the delivery and assessment of HD/CMSD in the undergraduate curriculum have extensive insight in this area and are well-placed to shape the HD/CMSD development for the future.

INTRODUCTION Oral Medicine focuses on care for patients with chronic, recurrent and medically related disorders of the orofacial region that are distinct from diseases of the periodontal and tooth tissues, with an emphasis on non-surgical management. At present, there are no shared outcomes for Oral Medicine to define the standards to be achieved before new graduates become registered dentists engaged with ongoing professional development. CURRICULUM We present a consensus undergraduate curriculum in Oral Medicine agreed by representatives from 18 Dental Schools in the United Kingdom and Republic of Ireland. The scope of Oral Medicine practice includes conditions involving the oral mucosa, salivary glands, neurological system or musculoskeletal tissues that are not directly attributable to dental (tooth and periodontium) pathology. Account is taken of the priorities for practice and learning opportunities needed to support development of relevance to independent clinical practice. The outcomes triangulate with the requirements set out by the respective regulatory bodies in the UK and Republic of Ireland prior to first registration and are consistent with the framework for European undergraduate dental education and greater harmonisation of dental education. CONCLUSIONS This curriculum will act as a foundation for an increasingly shared approach between centres with respect to the outcomes to be achieved in Oral Medicine. The curriculum may also be of interest to others, such as those responsible for the training of dental hygienists and dental therapists. It provides a platform for future collective developments with the overarching goal of raising the quality of patient care.

Ab initio computational, microwave spectroscopic, and electron diffraction techniques have been used to study the gas-phase structure of cyclopropylbenzene. Theoretical calculations at the HF, B3LYP, and MP2 levels for basis sets 6-31G(d) and 6-311G(d) have been carried out. Both MP2 and B3LYP calculations showed the bisected form to be lower in energy (245/157 and 660/985 cal mol(-1), respectively, for basis sets 6-311G(d)/6-31G(d)). Rotational constants for the bisected form of the parent and eight singly substituted (13)C isotopic species were obtained. The selection rules of the observed rotational transitions and the facts that eight (rather than six) singly substituted (13)C isotopers are observed and assigned and that seven of the compound's nine carbon atoms lie in the molecule's symmetry plane required the molecule to exist in the bisected conformation. No transition from the perpendicular form was observed in the pulsed-jet microwave experiment. Gas-phase electron diffraction data were collected at a nozzle-tip temperature of 265 K. Least squares analyses were carried out using ED data alone and with the inclusion of microwave rotational constants. The principal structural results (r(g) and angle(alpha)) obtained from the combined ED/MW least-squares analysis are r(C-H)(av) = 1.093(6) A, r(C(7)-C(8))(v) = 1.514(20) A, r(C(8)-C(9))(d) = 1.507(26) A, r(C(7)-C(1)) = 1.520(25) A, r(C-C)(Ph) = 1.395(1) A, angleC(1)C(7)C(8) = 119.6(17) degrees, angleC(2)C(1)C(7) = 122.5(25) degrees, angleC(1)C(2)C(3) = 120.9(35) degrees, angleHC(8)C(9) = 116.7(20) degrees, angleHCC(Ph) = 120.0 degrees (assumed).

This study investigated the effects of iron replacement on the incidence of recurrent herpes labialis and serum ferritin levels in patients with sideropenia. Ten patients with diagnosed sideropenia and a history of recrudescent herpes labialis were prescribed ferrous sulphate for a period of 3 months. Patients were questioned on the number of episodes of recrudescent herpes labialis that developed per month before treatment and the number of episodes of recrudescent herpes labialis that developed per month after the commencement of replacement iron therapy and during the follow-up period. All blood samples were collected by venipuncture for assay of ferritin levels. Serum ferritin levels were significantly increased compared to pretreatment levels (P < 0.05). The number of monthly episodes of recrudescent herpes labialis was reduced from 0.78 to 0.2 episodes per month following treatment (P < 0.05). The findings of this study suggest that iron replacement therapy should be further studied as a treatment option in sideropenic individuals with frequent recurrences of recrudescent herpes labialis.