Alison M. Rich

Gender differences in dentists' working practices and job satisfaction

OBJECTIVES To describe the working practices and level of job satisfaction of male and female dentists. METHODS A nationwide postal survey of all dentists holding an annual practising certificate in New Zealand (response rate 78.1%). RESULTS The mean number of hours worked per week was 29.1 for female and 36.0 for male dentists. The main reason for part-time practice given by women was caring for children (cited by 67.2%) and for men was personal choice (cited by 63.6%). A greater proportion of females than males were employed on a salary or as an associate in practice rather than owning their own practice. Male dentists were more active in continuing education than females. The mean career satisfaction score for male respondents was 7.6 and for females 7.1 (P<0.001). Relatively more women than men had taken a career break, usually for child rearing. Two-thirds of women and one-third of men planned to retire from dentistry before 60 years of age. CONCLUSIONS Male and female dentists differ in their working patterns and career satisfaction. There is a need for ongoing monitoring of the workforce, particularly as the gender distribution (and societal trends and expectations) continues to change.

Revisiting the association between candidal infection and carcinoma, particularly oral squamous cell carcinoma

Abstract Background: Tobacco and alcohol are risk factors associated with cancer of the upper aerodigestive tract, but increasingly the role of infection and chronic inflammation is recognized as being significant in cancer development. Bacteria, particularly Helicobacter pylori, and viruses such as members of the human papilloma virus family and hepatitis B and C are strongly implicated as etiological factors in certain cancers. There is less evidence for an association between fungi and cancer, although it has been recognized for many years that white patches on the oral mucosa, which are infected with Candida, have a greater likelihood of undergoing malignant transformation than those that are not infected. Objective: This article reviews the association between the development of oral squamous cell carcinoma in potentially malignant oral lesions with chronic candidal infection and describes mechanisms that may be involved in Candida-associated malignant transformation.

A quantitative assessment of Langerhans cells in oral mucosal lichen planus and leukoplakia.

Quantitative analysis of Langerhans cells stained with OKT6 in the epithelium of 42 patients with oral mucosal lichen planus and 14 patients with oral mucosal leukoplakia showed significantly greater numbers of Langerhans cells in lichen planus. This may reflect the role of Langerhans cells in the pathogenesis of this condition and their identification could help in distinguishing lichen planus from leukoplakia.

Monosodium glutamate-related orofacial granulomatosis: Review and case report

A case is reported in a 15-year-old white girl who had a swollen lower face and lips; a diagnosis of orofacial granulomatosis was made. It was suspected that her condition had an allergic basis because an increase in clinical signs and symptoms was shown to be related to the food additive monosodium glutamate. Treatment with a restricted diet resulted in resolution of the facial swelling.

Verruciform xanthoma and concomitant lichen planus of the oral mucosa. A report of three cases.

Verruciform xanthomas are benign muco-cutaneous lesions of unknown aetiology. They have a papillated surface and histologically they are characterised by the presence of foam cells in connective tissue papillae between elongated parakeratinised epithelial rete ridges. Three cases are reported in which oral mucosal verruciform xanthoma and oral mucosal lichen planus occurred concomitantly.

Toll-Like Receptors and Cancer, Particularly Oral Squamous Cell Carcinoma

It is becoming increasingly apparent that the tumor microenvironment plays an important role in the progression of cancer. The microenvironment may promote tumor cell survival and proliferation or, alternatively may induce tumor cell apoptosis. Toll-like receptors (TLRs) are transmembrane proteins, expressed on immune cells and epithelial cells, that recognize exogenous and endogenous macromolecules. Once activated, they initiate signaling pathways leading to the release of cytokines and chemokines, which recruit immune cells inducing further cytokine production, the production of angiogenic mediators and growth factors, all of which may influence tumor progression. This paper examines the actions of TLRs in carcinogenesis with particular emphasis on their role in oral squamous cell carcinoma.

Toll-like receptor 2 is present in the microenvironment of oral squamous cell carcinoma

Background:The aim of this study was to investigate the expression of toll-like receptor 2 (TLR2) on cells associated with oral squamous cell carcinoma, epithelial dysplasia and irritative hyperplasia, using immunohistochemistry.Results:More immune cells expressed TLR2 in carcinoma and dysplasia than in hyperplasia (P<0.001). No hyperplastic samples showed positive TLR2 staining on keratinocytes, whereas keratinocytes in 64% of cases of carcinoma and 74% of cases of dysplasia were TLR2 positive.Conclusion:Positive TLR2 expression in the microenvironment suggests activation of immune surveillance against the altered epithelium, whereas TLR2 expression by malignant keratinocytes may be indicative of resistance to apoptosis as a pro-survival mechanism.

Does performance in selection processes predict performance as a dental student

OBJECTIVE This study investigated associations between the performance of dental students in each of the three components of the selection procedure [academic average, Undergraduate Medicine and Health Sciences Admission Test (UMAT) and structured interview], socio-demographic characteristics and their academic success in an undergraduate dental surgery programme. MATERIALS AND METHODS Longitudinal review of admissions data relating to students entering dental education at the University of Otago, New Zealand, between 2004 and 2009 was compared with academic performance throughout the dental programme. RESULTS AND DISCUSSION After controlling for variables, pre-admission academic average, UMAT scores and interview performance did not predict performance as a dental student. Class place in second year, however, was a strong predictor of class place in final year. Multivariate analysis demonstrated that the best predictors of higher class placement in the final year were New Zealand European ethnicity and domestic (rather than international) student status. Other socio-demographic characteristics were not associated with performance. These interim findings provide a sound base for the ongoing study. CONCLUSION The study found important socio-demographic differences in pre-admission test scores, but those scores did not predict performance in the dental programme, whether measured in second year or in final year.

Prognostic indicators for oral squamous cell carcinoma: A comparison between the tnm and STNMP systems

One hundred and eighteen patients with oral squamous cell carcinoma were staged according to the TNM and STNMP systems. Although both staging systems separated patients into those with a good prognosis and those with a poorer prognosis the more sophisticated system (STNMP) did not provide any additional information. A possible explanation for this anomaly lies in the weighting used in the STNMP system.

The expression of c-erbB-2 protein in the keratinocytes of oral mucosal lichen planus

The expression of the c‐crbB‐2 protein was studied in the keratinocytes from patients with: (i) oral mucosal lichen planus (OLP) (n=2(S): (ii) oral mucosal squamous cell carcinoma (OMSCC) which had arisen in mucosa affected by OLP (n=5); and (iii) normal oral mucosa (n=5). C‐erbB‐2 protein was expressed on the cell membranes of the keratinocytes of nucleated epithelium in the stratum spinosum. The antigenic determinant recognized represents the cytoplasmic domain of a cell surface receptor which binds an as yet uncharacterized heparin binding ligand of unknown function.1.2 The specimens from the live normal subjects showed positive immunohistochemical staining with the monoclonal c‐erbB‐2 protein antibody, the OMSCC specimens were negative, and 23 of 26 of the OLP specimens were positive. The lack of c‐cerbB‐2 expression in the three OLP and in the five OMSCC specimens may indicate a genetic alteration, or masking of the expression of c‐cerbB‐2. The absence of expression in OLP specimens might be an indicator of the possibility of future neoplastic transformation.