This study describes the predictive value of oral epithelial dysplasia (OED) grading as an indicator for malignant transformation and progression. The records of an Australian-based pathology laboratory were searched for oral mucosal biopsies with a dysplastic or malignant diagnosis. Examination for an association with progression and malignant transformation without reinterpretation was performed. Analysis was undertaken using hazard ratios and the Fisher exact test. A total of 368 patients with a diagnosis of OED were included. Twenty-six patients (7.1%) underwent progression or malignant transformation; the annual malignant transformation rate was 1%. No other characteristics were associated with a heightened risk of progression or transformation. The severity of OED was not associated with risk of malignant transformation, suggesting that the current OED grading system is not useful for predicting patient outcomes or for determining management strategies. Definitive treatment of all OED is recommended, until a more reliable progression/transformation system is developed.

Oral candidosis is the most common fungal infection encountered in general dental practice. It manifests in a variety of clinical presentations which may mimic more sinister diseases, and can occasionally be refractory to treatment requiring the attention of an oral medicine specialist. Management of oral candidosis should always include a thorough investigation of underlying predisposing conditions, as the disease often presents when the patient is systemically compromised. This update highlights the pathogenesis, clinical presentation, and management strategies of oral Candidal lesions commonly encountered in dental practice.

AimTo discuss the broad evidence base on which strategies to enhance the early detection and diagnosis of oral cancer and potentially malignant disorders (PMD) should be designed.MethodsWe reviewed the evidence for current oral mucosal screening approaches and used a theoretical model to explore behavioural influences on the early detection of oral cancer, and to outline strategies for future interventions and research.ResultsWhile considerable advances are being made in techniques to detect oral cancer, there has been less attention paid to the patient and health care provider factors which may influence delays in detection of oral cancer. This review proposes that unless future theory based studies target these aspects of oral cancer, then efforts to improve its timely detection will have limited effectiveness.ConclusionsA primary tenet of screening programs, whether opportunistic, targeted or population based is that at-risk people present for screening. They must also present early enough in the disease process for detection to lead to a better outcome. This is particularly relevant for oral cancer. Five-year survival rates have not improved over past decades and this has mainly been attributed to delays in detection. Early detection, diagnosis and treatment significantly enhance survival rates and reduce morbidity