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Objectives The aim of this study was to evaluate the need for dental treatment, compliance with post-radiation prophylactic care and incidence of long-term complications following radiotherapy to the head and neck. Methods The study is a retrospective analysis of dental records of patients referred for oral examination before radiation treatment to the head and neck between 2006 and 2016. Data of dental status and need for dental treatment before radiation therapy were used as baseline information. Dental records could be obtained from 126 patients (men n = 74; women n = 52). The mean time from completed radiotherapy to follow-up was 5.8 years (SD 2.9). Results The need for dental treatment was for the majority of patients relatively modest and mainly due to caries and fractures of teeth or fillings, but extensive need for dental treatment was noted in a few patients. One hundred and twenty-five out of 126 patients had complied with individual post-radiation prophylactic care programmes provided by the regular caregiver. Ninety-two out of 126 obtained dental records (73%) described hyposalivation and/or xerostomia. Osteoradionecrosis developed in 11 patients (8.7%), frequently requiring long-term treatment. Conclusions The results indicate that dental status may often be preserved if the patient is given regular information on oral hygiene and complies with prophylactic follow-up. Individual cases develop serious complications, and dental hygienists and dentists must be observant on early signs of rampant caries, trismus and osteoradionecrosis.

The implementation of information technology in healthcare is a significant focus for many nations around the world. However, information technology support for clinical care, research and education in oral medicine is currently poorly developed. This situation hampers our ability to transform oral medicine into a 'learning healthcare discipline' in which the divide between clinical practice and research is diminished and, ultimately, eliminated. This paper reviews the needs of and requirements for information technology support of oral medicine and proposes an agenda designed to meet those needs. For oral medicine, this agenda includes analyzing and reviewing current clinical and documentation practices, working toward progressively standardizing clinical data, and helping define requirements for oral medicine systems. IT professionals can contribute by conducting baseline studies about the use of electronic systems, helping develop controlled vocabularies and ontologies, and designing, implementing, and evaluating novel systems centered on the needs of clinicians, researchers and educators. Successfully advancing IT support for oral medicine will require close coordination and collaboration among oral medicine professionals, information technology professionals, system vendors, and funding agencies. If current barriers and obstacles are overcome, practice and research in oral medicine stand ready to derive significant benefits from the application of information technology.

Background/aims: In the present study, a model for measuring the intensity of skin erythema by computer-assisted digital image analysis (DIA) was elaborated. The DIA technique was compared with laser Doppler perfusion imaging (PIM) to evaluate the relationship between erythema and skin perfusion. Methods: To produce erythema, three different types of nicotine patches (Nicotinell®, Nicorette® and Nicorette® placebo) were randomly applied ventrally on the upper arms for the time period recommended by the manufactures. After removal of the patches, colour photographs for subsequent DIA were taken and laser Doppler scanning for PIM was performed. The relationship between PIM and DIA was estimated intra- and inter-individually. Results/conclusions: A statistically significant linear correlation between PIM and DIA data was found, but the relationship was relatively weak. This may be explained by the fact that DIA and PIM are influenced by different physiological factors such as skin chromophores and velocity of moving cells. The results strengthen the theory that erythema and perfusion measurements reflect separate physiological phenomena and that the methods should be considered complements to each other in the experimental situation.

174 patients referred to the Department of Oral and Maxillofacial Surgery, Central Hospital, Karlstad, Sweden during 1987 to 1989 for lichenoid lesions and evaluation of a possible connection with amalgam restorations were invited to a clinical re-examination. 159 of the patients were re-examined with the purpose of evaluating the long-term effect upon performed substitution therapy. Partial or total removal of amalgam had been recommended according to a set of given criteria. The re-examination showed that 62 patients had performed partial and 69 patients total removal of amalgam fillings. 28 patients had not performed any substitution therapy. There was a difference between recommended and performed therapy. The results demonstrated that 92% of patients with lichenoid lesions only in contact with amalgam fillings healed or improved clinically following removal of amalgam. No statistical difference was found in healing between patients who only removed fillings in contact and those who had removed all amalgam restorations. More than 60% of buccal lichenoid lesions without contact with amalgam at time of referral disappeared following amalgam substitution. Gingival lichenoid lesions did not respond to substitution of amalgam to another material. 3 out of 17 patch-tested patients demonstrated a hyper-sensitivity reaction to mercury. All lichenoid lesions in these patients healed following total substitution. Partial or total removal of amalgam fillings was also performed on 10 patients with completely negative patch-tests. 6 out of these patients demonstrated complete healing of their lichenoid reactions at re-examination. The lichenoid reaction is to be regarded as a reaction pattern within the oral mucosa directed towards a specific agens in patients predisposed to develop such a reaction. Dental amalgam plays an etiological role in the development of lichenoid reactions and should be removed when in clinical contact with the lichenoid lesion. Total removal of amalgam may also be tried in other cases in patients with long-standing atrophic or erosive lesions where other therapy forms have been tried with poor clinical result.