Patients with oral mucosal disease have difficulty in oral self-care and tend to have poor oral hygiene. Furthermore, steroid therapy may increase the risk of secondary infection in the oral cavity. Although the importance of oral hygiene management has been reported so far, there have been few detailed studies on the relationship between disease severity and oral hygiene management.
In this study, the correlation between disease severity and oral hygiene status was evaluated in 10 pemphigus vulgaris （PV） patients and 5 oral lichen planus （OLP） patients. A significant correlation （r＝0.751, P＜0.01） was observed between disease status and oral hygiene in PV patients. In contrast, no significant correlation was observed in OLP patients （r＝0.233, P＜0.05）. Oral hygiene intervention by dental hygienists is important in the acute phase of PV, because it should prevent worsening of the disease severity and the secondary infection associated with steroid therapy. In OLP, exacerbation factors such as narrow oral vestibule and patient background may affect the effectiveness of professional oral hygiene treatment. Therefore, elimination of the exacerbating factors and individualized oral management are needed.

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There are some reports that hepatitis C virus （HCV） infection is involved in the development of oral lichen planus （OLP）. In the present study, we performed a clinical investigation on OLP patients with HCV infection. The subjects were 24 HCV-infected patients （HCV group） who were clinically and histopathologically diagnosed as OLP in our department, and 130 patients without HCV infection （control group）. We compared age, gender, number and site of lesions, clinical types, therapeutic effects, and malignant transformation rate. There were no significant differences in gender, age, number and site of lesions between the two groups, but there were significantly more erosive and ulcer types in the HCV group than in the control group. The HCV group had a better therapeutic effect, but there were significantly more relapse cases than in the control group. The malignant transformation rate in the HCV group was 8.3％, which was higher than that in the control group （3.8％）. These results suggest that long-term follow-up is necessary because the HCV group is more likely to relapse and has a higher malignant transformation rate.

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In Japan, the number of patients with oral candidiasis is expected to increase with an aging society. We investigated clinical statistics of patients with oral candidiasis who visited the Division of Oral Medicine, Tokyo Dental College, Ichikawa General Hospital between April 2019 and March 2020. The mean age of the patients was 71.1 years, women accounted for 69.6％ of the total. Many cases displayed local risk factors, such as dry mouth and denture using. The diagnostic classification was erythema type in 47.7％, followed by pseudomembranous type in 42.3％. Candida albicans was the causative organism in 88.3％ of cases. Regarding the efficacy of treatment, 23.8％ of patients did not respond to antifungal drugs, and 17.8％ of patients showed recurrence. Oral candidiasis generally has a good prognosis; however, some cases were intractable. More multi-institutional surveys are needed to understand detailed characteristics.

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Idiopathic thrombocytopenic purpura is characterized by an increased destruction of the platelets by autoantibodies and is sometimes marked by abnormal bleeding in the oral cavity. Patients are therefore often diagnosed with the disease during a hospital dentistry visit and are prescribed appropriate oral management according to their symptoms during hospitalization. The case patient was a 76-year-old man. He had a platelet count of 4×10³/μl, spotted purpura on the lower limbs, and multiple hematomas in the oral cavity. During hospitalization in the department of internal medicine, dietary modifications were provided to the patient, and oral management was provided with the cooperation of nurses and dental hygienist. Subsequently, the patient’s condition improved, and he was discharged on the 19th day of hospitalization.

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