Community Dentistry Third Year

1. Oral cancer and other
conditions
PDS 372

2. • Life and death implications
• Age-adjusted mortality rates
• International classification of diseases ninth revision
(ICD-9) 140-149
• Malignant neoplasms of lip, oral cavity and pharynx
(C00-C14)
• ‘Oral Cancer’ includes malignant neoplasms of the lip;
(ICD-10 C00),
intra-oral sites (ICD C01–C06) and the oro-pharynx (ICD
C09 & C10).

3. • Sites include:
– Tongue
– Lip
– Buccal mucosa
– Floor of the mouth
– Salivary glands
– Pharynx
– Does not include throat

4. • Squamous cell carcinoma
• Risk factors
– Tobacco
– Alchohol
– Sunray
– Ill fitting dentures
– Chronic inflammation, Lichen planus
– Viral infection

7. • Pre-cancerou lesions:
– Morphologically altered tissue in which cancer is more
likely to occur than its apparently normal counterpart
• Leukoplakia
– White patch that cannot be characterized clinically or
by pathological examination as anything else
• Erythroplakia
– Bright red or velvety plaque that cannot be
characterized clinically or pathologically as being due
any thing else

8. PROFILE OF CANCER IN RIYADH ARMED FORCES HOSPITAL
Osama M. Koriech, MBBCh, DMRT, FRCR; Rashid Al-Kuhaymi, FRCS (1994)
.
Overall distribution and ranking.
Number
Percentage (%)
Malignancy
Gastrointestinal
909
18
Lymphoma
660
13
Head and neck
497
10
Breast
465
9
Nervous system
410
8
Genitourinary
371
7
Leukemia
294
6
Sarcoma
281
6
Endocrine
250
5
Respiratory
239
5
Gynecologic
192
4
Unknown primary
153
3
Skin
85
2
Others
194
4
Total
5000

9. Primary sites of head and neck cancers.
Number
Primary Sites
Percentage
(%)
Nasopharynx
206
41
Oral cavity
121
24
Larynx
74
15
Salivary
30
6
Oro- and laryngopharynx
25
5
Sinuses
19
4
Ear
11
2
Conjunctiva
6
1
Nasal cavity
5
1
Total
497

10. CANCER IN THE GIZAN PROVINCE OF SAUDI ARABIA: AN ELEVEN
YEAR STUDY
Pradeep Tandon, MD; Ved P. Pathak, MD; Akhtar Zaheer, MD; Anup Chatterjee, MD;
.
Regional comparison of relative frequencies (% of total) of 10 common malignancies in females.
Present
Series
Oral cavity
22.33
KFSH4
referrals
(Mahboubi1987)
Dhahran5
(Rabadi1987)
Al-Baha6
(Willen1989)
Asir7
(Khan1991)
KKU,
Riyadh8
(Ajarim1992)
5.91
NA
2.0
41.0
NA

11. Most common malignancies in males and females: world comparisons (skin cancers excluded).
Western Africa
North America
China
Indian subcontinent
Eastern Europe
Present series
1
Liver
Lung
Stomach
Mouth/Pharynx
Lung
Liver
2
Lymphoid
Prostate
Esophagu
s
Lung
Stomach
Lymphoma/Leukemia
3
Prostate
Colorectal
Liver
Esophagus
Colorectal
Mouth
4
Stomach
Bladder
Lung
Stomach
Prostate
Bladder
5
Mouth/Pharynx
Lymphoid
Colorectal
Lymphoid
Mouth/Pharynx
Prostate
1
Cervix
Breast
Cervix
Cervix
Breast
Mouth
2
Breast
Colorectal
Stomach
Breast
Stomach
Lymphoma/Leukemia
3
Lymphoid
Lung
Esophagu
s
Mouth/Pharynx
Cervix
Breast
4
Liver
Lymphoid
Breast
Esophagus
Colorectal
Liver
Male
Female

12. ORAL AND UPPER AERO-DIGESTIVE TRACT MALIGNANCY:
A REVIEW OF A FIVE-YEAR EXPERIENCE
Aziza Al-Mobeerik, MD, BDS, MSc

13. Cleft lip and palate

14. • Of genetic origin
• Related to environment
• Correlation between late birth order and
presence of clefts
• Occurrence associated with:
• first trimester: spontaneous abortion, flu
and fever, maternal drugs.
• Second trimester: spontaneous abortion.

15. •
•
•
•
More facial cleft in boys
More isolated cleft palate in girls
More clefts in plural births
Clefts are associated with: low birth
weight, higher mortality rate, prematurity
and malformations.

16. Malocclusion
• Prevalence
• Case definition: difficult due to
– Different cultural perceptions
– Different perceptions of malocclusion among
orthodontists
– Examiner inconsistency
• Treatment needs

17. THE PATTERN OF MALOCCLUSIONS IN SAUDI ARABIAN PATIENTS
ATTENDING FOR ORTHODONTIC TREATMENT AT THE COLLEGE OF
DENTISTRY, KING SAUD UNIVERSITY, RIYADH
Khalid M. Al-Balkhi, BDS, MS*, Ahmed A. Zahrani, BDS, MSc, DFM**
• The prevalence of many orthodontic-related variables
was investigated and analyzed in the largest orthodontic
clinic in Saudi Arabia. The results of the study indicate
that the majority of the orthodontic cases were young
patients with females showing a marginally higher
percentage than males.
• ClassI molar relationship, permanent dentition, ovoid
arch form, crowding, asymmetrical tooth extraction and
asymmetrical arch were found most frequently. A very
strong correlation was found between asymmetrical
tooth extraction and the existence of dental arch
asymmetry. Crossbite, crowding and class III molar
relationship may be the principal reasons for patients to
seek orthodontic treatment.

21. TMJ disorders
• Case definition:
– no suitable case definition
– Group of extremely painful and distressing
conditions
– Diagnosis is difficult because it often accompanied
by generalized pain in the H&N
• Statistics:
– Women with TMD are three times the men.
– Common in children and adolescence as in adults

22. • Epidemiological studies:
Commonly measured signs and symptoms are:
– Pain with joint movement
– Limited mandible movement
– Deviation of mandible on movement
– Joint clicking or crepitus
• Treatment of TMJ disorders:
– no agreement on a standard treatment and outcomes

23. • Ortho treatment, attrition, premature
contact has no influence on TMD
• TMD is related to: depression, emotional
distress, lower SES, poorer health.
• Current and future approaches to treat
and manage cases:
– Multidisciplinary effort is required for its better
comprehension