Osteomyelitis of the jaw is an inflammatory process of the bone marrow that is caused by odontogenic local infection and trauma such as tooth extraction and fractures in the oral and maxillofacial region. The clinical signs include pain, swelling, pus formation, and limited mouth opening. Chronic osteomyelitis presents a diagnostic challenge because of the variability of symptoms across different disease stages and varying health conditions of the patients. This report presents a case of osteomyelitis that was misdiagnosed as a temporomandibular joint disorder (TMD) after tooth extraction. The patient was treated for inflammation after tooth extraction in the early stage; however, as the osteomyelitis progressed chronically, symptoms mimicked those of a TMD. The patient was finally diagnosed with osteomyelitis 6 months after tooth extraction. A review of this case and relevant literature revealed the necessity for a differential diagnosis of chronic osteomyelitis that mimics TMD symptoms.

Hyperparathyroidism (HPT) is a significant condition marked by the overproduction of parathyroid hormones, affecting both systemic health and orofacial regions. Predominantly, secondary HPT associated with chronic kidney disease (CKD) is critical because of its link to widespread conditions such as diabetes and hypertension. This short article highlights the vital role of dental professionals in identifying HPT through panoramic radiography, which can reveal critical orofacial signs such as brown tumors, altered dental development, and specific bone changes. With the CKD prevalence expected to increase alongside an aging population, the importance of early detection of HPT and its manifestations in dental settings cannot be overstated. Dental practitioners play a crucial role in the early detection of HPT, emphasizing the importance of being knowledgeable about its orofacial manifestations.

Acute malocclusion can occur in conditions related to temporomandibular joint (TMJ) disorders. This report presents two cases of acute malocclusion related to posterior disc displacement according to complete disc tearing. A 65-year-old male and an 88-yearold female presented with TMJ pain and occlusal discrepancies. Clinical examination, computed tomography, and magnetic resonance imaging revealed complete disc tearing and posterior displacement of a partial disc fragment. Dental cast analysis revealed a slight anterior and lateral deviation of the mandible toward the non-affected side; however, clinically, significant occlusal changes were not observed. This was attributed to the displacement of a small disc fragment rather than the entire disc. Including the cases presented, most instances of complete disc tearing responded well to conservative treatment such as pharmacotherapy and physical therapy, resulting in pain alleviation, and residual occlusal changes were tolerable for the patients in their daily activities. However, persistent occlusal changes or severe chewing difficulty may require surgical intervention.

Orofacial pain has various causes, making it challenging to differentiate from dentalrelated diseases based solely on symptoms. Toothache, usually attributed to pathological changes in the pulp and periodontal tissue, is the most common cause of orofacial pain and relatively easy to diagnose. However, distinguishing orofacial pain and nonodontogenic toothache due to myofascial, neuropathic, neurovascular, paranasal sinus and cardiac originating, and psychogenic pain presents diagnostic challenges that may result in incorrect treatment. Therefore, dentists must recognize that orofacial pain can arise from not only dental issues but also other causes. This case report explores the necessary considerations in diagnosing orofacial pain and nonodontogenic toothache by examining the diagnoses of patients presenting at the dental hospital with orofacial pain and nonodontogenic toothache of cardiac origin.

Dry mouth is common among older adults and significantly affects the oral health-related quality of life. It is a significant risk factor for dental caries, particularly root caries, in older adults due to concurrent periodontal disease and age-related comorbidities. Clinicians managing patients with dry mouth must be aware of preventive measures against dental caries. This clinical review aims to update our knowledge on the use of fluoride for caries prevention in order to establish better strategies for the management of dry mouth in older adults.

Halitosis is defined as a nasty odor emanating through the mouth and is primarily related to the enhanced concentration of volatile sulfur compounds (VSCs). VSC measurements have been commonly used for experimental comparison and clinical diagnosis. As quantitative methods for comparative analyses of oral malodor, gas chromatography devices have been most commonly used to quickly and easily determine the concentration of several gas components of VSCs, which are agents primarily responsible for halitosis. The concentrations of VSCs fluctuate dynamically depending on contributing factors, including various oral/systemic conditions, intake of medicine and food/drink, oral hygiene, and even routine daily activities. Therefore, the exact analysis of VSCs requires the appropriate standardization of not only exact measurement techniques but also participant conditioning with scientific considerations. Thus, this paper describes the experimental standardizations commonly recommended in previous literature and their scientific background.

A 74-year-old female presented with a complaint of dry mouth, continuous spontaneous burning sensation in the tongue, and asymptomatic submucosal soft tissue mass on both sides of the lower labial mucosa. She refused to undergo total excision of the mass due to concern about the possibility of complications such as nerve damage because of the large size of the mass. As her clinical features and magnetic resonance imaging indicated the possibility of Sjögren’s syndrome, a biopsy of the minor salivary gland of the right lower lip was performed. Consequently, she was diagnosed with mucosa-associated lymphoid tissue (MALT) lymphoma. Although the patient had typical signs and symptoms of Sjögren’s syndrome, the histopathological result of MALT lymphoma made it impossible to determine whether the patient had a history of Sjögren’s syndrome. For patients with risk factors for MALT lymphoma, such as Sjögren’s syndrome, a biopsy of the labial minor salivary gland with immunohistochemical staining can be helpful in the diagnosis of not only Sjögren’s syndrome but also MALT lymphoma.

Purpose: The aim of this study is to analyze the final diagnosis and the pain characteristics of patients with suspected nonodontogenic toothache and to contribute to the knowledge on differential diagnosis. Methods: A retrospective analysis was conducted based on medical records from 185 patients. The following data were collected: age, sex, pain characteristics, radiographic results, initial diagnosis and treatment, and final diagnosis and treatment. The final diagnosis and the pain characteristics of the 3 most common final diagnoses were analyzed. Results: Myofascial pain (MFP) was the most prevalent diagnosed condition accounting for 37.8% of cases, followed by pulpal pain (P) at 31.4%, and trigeminal neuralgia (TN) at 18.9%. There were significant differences in age, onset of the pain, and pain intensity across the 3 groups (all p<0.01). TN group exhibited a lower frequency of spontaneous and continuous pain than the MFP and P groups (all p<0.001). The proportion of patients reporting pain alleviating and aggravating factors related to dental pain was significantly higher in the P group than in the MFP and TN groups (all p<0.001). A concordance rate of 57.0% was observed between the initial and the final diagnosis. Twenty-six patients underwent tooth extractions and 24 patients had root canal treatments. Conclusions It is important to differentiate between dental pain and nonodontogenic toothache to avoid unnecessary dental treatments. Comprehending the pain characteristics of each condition, taking a thorough history taking, and performing diagnostic tests can help differential diagnosis.

This narrative review discusses the changes in the masticatory system due to the physiologic aging process in humans and how these changes should be considered when diagnosing and managing temporomandibular disorders (TMDs) in older adults. Age-related changes in the masticatory system, specifically the temporomandibular joint (TMJ) and masticatory muscles, are associated with an increased prevalence of degenerative TMJ osteoarthritis in older adults, changes in muscle function and often affect masticatory function. Considering older adults’ physiologic changes and comorbidities and their quality of life, diagnosing and managing TMDs in older adults needs a more comprehensive approach than in younger adults. Managing TMDs in older adults can improve orofacial function, such as mastication, leading to improved physical function and quality of life by reducing the risk of frailty.