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Aids education programs that combine traditional instruction with hands-on patient experience may help dental practitioners diagnose and treat HIV-related oral lesions. Researchers surveyed 133 dentists and dental hygienists and 4 patients who participated in a one-day AIDS education program. The program included instruction, hands-on experience interviewing and examining 7 patients with HIV-related oral manifestations, and videotape-augmented case discussions. All of the dental providers felt that the course was useful or extremely useful and most would recommend it to their colleagues. The hands-on approach was extremely valuable to the majority. The course increased providers' confidence in diagnosing and treating HIV-related oral infections and in handling sensitive HIV-related issues with patients and staff. All of the patients were very pleased or happy with their participation and would participate again.

Diagnosis and treatment of temporomandibular disorders (TMD) is controversial. TMD are different types of joint and muscle disorders that affect the bones in the side of the head and the lower bone of the jaw. Among 386 dentists who were surveyed about the diagnosis and treatment of TMD, 205 were general dentists and 181 were specialists. The specialists were more likely to agree with TMD experts about the pathophysiology of TMD than the general dentists. The two groups of dentists agreed on the use of different types of treatment for TMD. They also agreed on the psychophysiological aspects of TMD, and their opinions did not differ significantly from those of TMD experts. More controversy surrounded the association between TMD and different psychiatric disorders.

Wegener's granulomatosis is a systemic disease of the head and neck area which manifests itself in granulomatous vasculitis (inflammation of blood vessels), glomerulonephritis (inflammation of the kidney), and small vessel hypersensitivity vasculitis. Untreated cases of Wegener's disease can lead to sepsis and death. Although Wegener's disease rarely affects the mouth, in some cases it appears as gingivitis (inflammation of the gums). In these cases, a unique pattern is created. The patient shows an exuberant gingivitis with granular, fragile tissue, and scattered petechial areas (blood spots). No other disease is known to produce this combination of symptoms. As a result, the dentist encountering this condition in a patient should refer the patient for medical evaluation and treatment. Wegener's granulomatosis is treated with cytotoxic agents, most frequently, cyclophosphamide. In some cases, these agents are used in conjunction with glucocorticosteroids. When possible, corticosteroid therapy is tapered off, and both drugs are discontinued after one year of treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)