The field of dental treatment has experienced significant shifts over the past decade, beginning in the 2010s. These changes have been driven by several factors, including the emergence of direct oral anticoagulants (DOACs), the establishment of the Action Plan for Drug Resistance Control, and updates to the Medication-related Osteonecrosis of the jaw (MRONJ) position paper. To maintain high standards of care, dental professionals must consistently integrate new research findings into their practices and strive to improve the overall quality of dental treatments.

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In recent years, in our super-aged society, where people are striving for health and longevity, aesthetic awareness and interest in the oral cavity are increasing among men and women of all ages and both sexes. In particular, the number of patients requesting tooth bleaching procedures for discolored teeth has been increasing. Tooth bleaching is a minimally invasive esthetic dentistry that can make patients smile. To meet the needs of these patients, Department of Cariology at the University of Tokushima Hospital has reestablished a system for patients to receive tooth bleaching treatment for discolored teeth. Therefore, we would like to report on the bleaching procedures we are performing at our department.

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Myeloid sarcoma (MS) is a rare extramedullary tumor mass consisting of mature or immature myeloblasts. MS occurrence is mainly associated with the onset of acute myeloid leukemia (AML) and has a poor prognosis. MS also occurs, to a lesser extent, in myelodysplastic syndromes (MDS). The progression of MDS depends on the percentage of myeloblasts in peripheral blood or bone marrow. The transformation to AML is defined as the presence of more than 20% of myeloblasts. Herein, we report an extremely rare case of intraoral MS that arose in the hard palate over the course of the leukemic transformation of MDS. A 72 years-old Japanese man with a medical history of MDS was referred to our department because of continuous bleeding from the teeth extraction sockets. He had a gingival mass resembling a palatal abscess in his hard palate and underwent tooth extraction and puncture of the mass. Blood tests revealed that the proportion of myeloblasts increased up to 9% at that time. An incisional biopsy was carried out. Analysis of the histopathological findings showed aggregation of large, blast-like cells under the gingiva. These cells were positive for myeloperoxidase, naphthol AS-D chloroacetate esterase, CD68, and CD117 and negative for CD3, CD20, CD79a, and CD138. The Ki-67 labeling index was about 80%. The histopathological diagnosis was MS. Because stage progression of MDS was suspected, the hematologist performed bone marrow aspiration. The percentage of myeloblasts in the bone marrow was 26%, and the diagnosis of transformation to AML was confirmed. After one course of remission-induction chemotherapy by low-dose cytarabine, aclarubicin, and granulocyte-colony stimulating factor, the myeloblasts disappeared from the peripheral blood and bone marrow, the intraoral tumor regressed completely, and no further bleeding was observed. Twelve months after the chemotherapy, the patient died from a pneumonia.

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Purpose: Perioperative oral function management is undertaken based on request from physicians. However, the awareness among physicians on perioperative oral management (POM) may be limited. In this study, physicians were educated on POM using an online tool. We then reported the initiative of employing an online tool that is efficient and allows for data dissemination to all participants while maintaining data confidentiality.
Methods: We conducted a questionnaire survey with physicians from each department using an online tool to investigate the level of awareness and utilization of e-learning. The POM overview video included information on the effectiveness of POM, medical fees, and current and future initiatives, and served as an announcement to encourage requests. The original POM video which limited the target audience to the patients undergoing radiotherapy/chemotherapy or palliative care related to cancer (PRCP) was emphasizing POM in PRCP and supportive care for oral mucositis.
Result: According to the questionnaire survey, physicians acknowledged the effectiveness of POM. However, despite the presence of these patients, approximately one-third of the physicians did not initiate the request. The awareness on POM increased through e-learning. Furthermore, the number of requests for POM increased during the period of physician education, compared to a similar period prior to the education.
Conclusion: Active dental intervention during the perioperative period necessitates continuous education for physicians and collaboration between medicine and dentistry departments. Online tools could be used for physician education.

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