Oral mucosal lesions found in smokeless tobacco users

Article Abstract:

Smokeless tobacco (ST, namely chewing tobacco and snuff) is known to be associated with lesions of the oral mucosa, some of which may become malignant. To better evaluate the effect of ST on the mouth, 1,109 major and minor league baseball players were studied during spring training. Subjects completed a questionnaire regarding education, cigarette smoking, alcohol consumption, dental hygiene, and demographic data. Detailed information about ST use, including brands, amount, and overall usage patterns, was also obtained. The men underwent a dental examination in a mobile unit by examiners who were uninformed about patients' ST habits. Red or white lesions of the mouth were classified as erythroplakia or leukoplakia, respectively, and measured. Based on self-reports, subjects were classified as nonusers, former users, or users. Users were further classified into two groups: those who had used ST during the past week (within-week), and those who had not (within-month). Results showed that 493 (45 percent) men were nonusers; 138 (13 percent) were former users; and 463 (42 percent) were users. Of these, 423 were within-week users. Among users, ST had been used on average for almost six and one-half years and was kept in the mouth about 1.6 hours each day. ST users had a higher risk of leukoplakia; of the 423 current users, 196 men had 214 lesions. This was dramatically different from rates for nonusers, among whom seven men had eight leukoplakic areas. Most areas of leukoplakia were found in the areas of the mouth where the tobacco was most often held. Biopsy specimens from 92 subjects were evaluated, and all were benign. The risk for leukoplakia increased with increasing amounts of ST used, both as a function of more tobacco per day, and longer times in the mouth. Snuff users had a much higher rate of leukoplakia than chewers of tobacco. Brands varied in their association with leukoplakia: Copenhagen and Skoal were associated with leukoplakia more than Hawken. Of the ST user group, 46.3 percent had leukoplakia. The relationship of leukoplakia to oral cancer in this population of healthy young men is not clear, but it is possible that, with continued use, an association could develop. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Risk factors, Physiological aspects, Smokeless tobacco, Leukoplakia

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Mucosal burn resulting from chewable aspirin: report of case

Article Abstract:

Juvenile rheumatoid arthritis (JRA), a chronic inflammatory disease, may cause joint or connective tissue damage and lesions of certain internal organs. The disease affects more than 250,000 children in the United States. Aspirin is the safest and most commonly used drug to treat JRA, but it may cause drowsiness, rapid breathing, and stomach upset. Chewable aspirin is used in young children, who have difficulty swallowing tablets. However, chewable aspirin makes more extensive contact with the mucosal tissue lining the mouth than tablets do, and thus it may cause chemical burns on the mucosa. A case is described of a four-year-old girl with JRA who developed a mucosal burn from chewable aspirin therapy. She took five chewable aspirin tablets before bedtime, but fell asleep before swallowing them. Studies have shown that mucosal burns from aspirin may result from sucking on the tablets, taking aspirin in the form of chewing gum, lotion, ointment, or mouth rinse, and exposing a sore tooth to the drug. Dentists should be aware of the potential adverse effects of chewable aspirin therapy on mucosal tissue. Mucosal burns can be prevented by not taking aspirin before bedtime and by cleaning the mouth with a cotton swab to remove all traces of aspirin. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Rheumatoid arthritis in children, Juvenile rheumatoid arthritis, Oral mucosa

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Does low-dose aspirin therapy complicate oral surgical procedures?

Article Abstract:

Patients who must take aspirin every day do not need to stop just because they are having a dental procedure. Aspirin is an anticoagulant, so it is often used therapeutically in patients with a high risk of abnormal blood clot formation. However, this may cause abnormal bleeding. For this reason, they are often told to stop taking aspirin before any kind of surgical procedure. But in a study of 39 patients taking aspirin who were having a tooth extracted, bleeding times among those who stopped taking aspirin were within normal limits. Bleeding during the extraction was easily controlled.

Surgery, Postoperative complications

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