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1. 1. Desquamative gingivitis is more prevalent than suspected. 2. 2. Treatment is often delayed because of obscurity of diagnosis and symptoms. 3. 3. Desquamative gingivitis is a better descriptive name than gingivosis. 4. 4. It is feasible to assume that it is a disease entity which affects primarily women. 5. 5. Treatment with hormones must be well supervised and prolonged. 6. 6. The use of topical steroids has been proved an efficient and effective method of treatment.

OCCASIONALLY HUMAN DISORDERS occur which do not seem to be typical of any reported condition. The pur­ pose of this article is to report an unusual disorder, which has been seen in four patients at Emory Univer­ sity School of Dentistry within the past two years. All efforts to establish its etiology have been unrewarding. This unusual oral condition is represented by symptoms forming a triad of gingivitis, cheilitis and glossitis. The symptoms fluctuate in severity, undergoing periods of slight remission and exacerbation, although they never disappear entirely. The gingivitis is atypical in that it is a diffuse, erythe­ matous process involving the entire attached gingiva and bears no resemblance to common marginal gin­ givitis. The surface is velvety and friable. It is always intact and no erosion, desquamation or bullae forma­ tion has been observed. Biopsies of this gingival tissue are incompatible with desquamative gingivitis, pemphi­ goid, erosive lichen planus or lupus erythematosus. The angular cheilitis and glossitis appear to be com­ patible with conditions caused by avitaminosis B, but they are refractory to long term vitamin therapy. Per­ nicious anemia is ruled out by adequate levels of hemaglobin. None of the patients was found to be diabetic nor could any fungal overgrowth be demonstrated. CASE HISTORIES Case 1 The patient, a 26-year-old Negro woman, was seen at Emory University School of Dentistry for "sore gums." Her medical history revealed hay fever and an allergy to penicillin. She bruised easily and stated that she often felt tired and run down. She worried about her health, particu­ larly her oral condition, and considered herself to be nervous. She was not taking any medication. She was menstruating regularly. She had no skin lesions or mucous membrane involvement other than the oral manifestations.

Significant oral problems commonly occur in the dying patient. The education of the dental practitioner to patient management should include concepts related to the dying, as well as to loss and grief reactions that may necessitate dental or oral treatment, or be precipitated by these treatments.

(1970). Denture Stomatitis I. The Etiology in Relation to Trauma and Infection. Acta Odontologica Scandinavica: Vol. 28, No. 1, pp. 71-92.

Of 142 patients with various oral symptoms, an unusually large number demonstrated a glucose intolerance. A significant number appeared to have diabetes. This points out the importance of a differential diagnosis and dental responsibilities in health care.

Oral manifestations of metabolic diseases include dryness and burning of the mouth in diabetes, changes in dental structures in hyperparathyroidism, enamel hypoplasia in congenital hypoparathyroidi...

Summary Six cases of vitamin B12 deficiency presenting with a sore tongue are described. Only one of these had significant changes in the peripheral blood. The value of an assay of the serum vitamin B12 is discussed.

Although oral mucosal manifestations are not usually observed in dermatitis herpetiformis, the long and difficult course of the disease frequently brings the patients to the dentist, who should be aware of the specific oral manifestations.

The differential diagnosis of patients who have a psychogenic tongue symptom should include the anxiety states, hypochondriacal reactions, conversion reactions, tic, and masochistic reactions. Although tongue-thrusting has been implicated in some orthodontic cases, generally psychogenic tongue dysfunctions do not cause morphologic dental conditions. However, the practitioner must appropriately deal with the condition that stimulated symptom formation.

The 3 year clinical, endocrinological, and histopathological findings in 2 case reports (and 4 patients followed clinically) of cyclic allergic gingivostomatitis characterized by a fiery-red inflammation of the gingiva, angular cheilitis, and loss of the filiform papillae have been presented and discussed. Five of the 6 patients were females, and all 6 suffered from a hormonal imbalance. The histological appearance was characterized by both thinned and hyperplastic epithelium, dilated capillaries near the surface, and an intense, mature plasma cell infiltrate which obliterated the normal architecture of the lamina propria. Multiple myeloma was ruled out by physical, radiographic, hematologic, microscopic, protein electrophoresis, and urinalysis studies. It was verified, clinically and histologically following a 4 month abstention from the habit, that the gingivostomatitis was produced by an allergic response to chewing gum - most likely the essential oils used as flavoring agents. There is also a strong possibility that hormonal imbalance may play a role in the inducement of this unusual clinical phenomenon.