ImportanceDry mouth, oral candidiasis, and recurrent aphthous ulcers are 3 of the most common oral conditions that may be associated with patient discomfort, decreased quality of life, and morbidity.ObservationsIn a meta-analysis of 26 population-based cohort and cross-sectional studies, the global prevalence of dry mouth symptoms was 23% (95% CI, 18% to 28%), placing individuals at risk of oral candidiasis, dental caries, dysgeusia, masticatory/speech impairment, and oropharyngeal dysphagia. Dry mouth is associated with using more than 3 oral medications per day (odds ratio [OR], 2.9 [95% CI, 1.4 to 6.2]), head and neck radiation, and Sjögren disease. Symptoms may include difficulty swallowing and speaking, thirst, and halitosis. Dry mouth is associated with an 11.5% (95% CI, 3.6% to 27%) higher risk of oral candidiasis, based on a meta-analysis of 6 observational cohorts. Management of dry mouth includes mechanical salivary stimulants, oral moisturizers, and/or systemic sialagogues. Oral candidiasis is an opportunistic fungal infection caused by overgrowth of the Candida genus with C albicans, which accounts for 76.8% of infections. The prevalence of oral candidiasis is higher in patients who are immunosuppressed, for example, those with HIV (35% [95% CI, 28% to 42%]) and those with salivary gland hypofunction (OR, 3.02 [95% CI, 1.73 to 5.28]). Common risk factors associated with oral candidiasis include use of antibiotics (P = .04) and oral mucosal disorders such as lichen planus. Oral burning and dysgeusia are common symptoms of oral candidiasis. Treatment includes addressing risk factors and use of topical and/or systemic antifungal medications. Recurrent aphthous stomatitis is characterized by symptomatic round or oval oral ulcers, which are covered by a gray-white fibrin layer and encircled by an erythematous ring. A meta-analysis of 10 case-controlled studies revealed an increased risk of recurrent aphthous stomatitis associated with polymorphism of IL-1β (+3954C/T) (OR, 1.52 [95% CI, 1.07 to 2.17]) and IL-1β (−511C/T) (OR, 1.35 [95% CI, 1.09 to 1.67]). Another meta-analysis of 9 case-control studies reported that patients with recurrent aphthous stomatitis had a higher frequency of nutritional deficiencies, including vitamin B12 (OR, 3.75 [95% CI, 2.38 to 5.94]), folic acid (OR, 7.55 [95% CI, 3.91 to 14.60]), and ferritin (OR, 2.62 [95% CI, 1.69 to 4.06]). Recurrent aphthous stomatitis can be associated with systemic diseases. A meta-analysis of 21 case-control studies revealed that celiac disease is associated with a higher incidence of recurrent aphthous stomatitis (25% vs 11%; OR, 3.79 [95% CI, 2.67 to 5.39]; P <.001). Topical corticosteroids are first-line agents to manage recurrent aphthous stomatitis; however, systemic medications may be necessary in more severe cases.Conclusions and RelevanceDry mouth, oral candidiasis, and recurrent aphthous ulcers are common oral conditions that may be associated with patient discomfort, decreased quality of life, and morbidity. First-line treatment includes over-the-counter sialagogues for dry mouth, topical antifungals for oral candidiasis, and topical corticosteroids for aphthous ulcers. Oral conditions that do not improve with first-line treatment may require treatment with systemic medications.

中文翻译：

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常见口腔疾病

重要性口干、口腔念珠菌病和复发性阿弗他溃疡是 3 种最常见的口腔疾病，可能与患者不适、生活质量下降和发病率相关。观察对 26 项基于人群的队列和横断面研究进行荟萃分析，口干症状的全球患病率为 23%（95% CI，18% 至 28%），使个体面临口腔念珠菌病、龋齿、味觉障碍、咀嚼/言语障碍和口咽吞咽困难的风险。口干与每天使用超过 3 种口服药物（比值比 [OR]，2.9 [95% CI，1.4 至 6.2]）、头颈放射和干燥病有关。症状可能包括吞咽和说话困难、口渴和口臭。根据对 6 个观察队列的荟萃分析，口干与口腔念珠菌病风险增加 11.5%（95% CI，3.6% 至 27%）相关。口干的治疗包括机械性唾液刺激剂、口腔保湿剂和/或全身性促涎剂。口腔念珠菌病是一种机会性真菌感染，是由于口腔念珠菌过度生长而引起的。念珠菌属属与白色念珠菌，占感染人数的 76.8%。免疫抑制患者的口腔念珠菌病患病率较高，例如 HIV 感染者（35% [95% CI，28% 至 42%]）和唾液腺功能低下患者（OR，3.02 [95% CI，1.73]）至 5.28]）。与口腔念珠菌病相关的常见危险因素包括使用抗生素（磷= .04) 和口腔粘膜疾病，例如扁平苔藓。口腔灼烧感和味觉障碍是口腔念珠菌病的常见症状。治疗包括解决危险因素以及使用局部和/或全身抗真菌药物。复发性口疮性口炎的特征是有症状的圆形或椭圆形口腔溃疡，其上覆盖有灰白色纤维蛋白层，周围有红斑环。对 10 项病例对照研究的荟萃分析显示，复发性口疮性口炎的风险增加与 IL-1β (+3954C/T)（OR，1.52 [95% CI，1.07 至 2.17]）和 IL-1β（+3954C/T）多态性相关。 −511C/T)（OR，1.35 [95% CI，1.09 至 1.67]）。另一项对 9 项病例对照研究的荟萃分析报告称，复发性口疮性口炎患者营养缺乏的频率较高，包括维生素 B12（OR，3.75 [95% CI，2.38 至 5.94]）、叶酸（OR，7.55 [95% CI，3.91 至 14.60]）和铁蛋白（OR，2.62 [95% CI，1.69 至 4.06]）。复发性阿弗他口炎可能与全身性疾病有关。对 21 项病例对照研究的荟萃分析显示，乳糜泻与复发性口疮性口炎的较高发病率相关（25% vs 11%；OR，3.79 [95% CI，2.67 至 5.39]；磷<.001)。外用皮质类固醇是治疗复发性口疮性口炎的一线药物；然而，在更严重的情况下，可能需要全身药物治疗。结论和相关性口干、口腔念珠菌病和复发性口疮溃疡是常见的口腔疾病，可能与患者不适、生活质量下降和发病率相关。一线治疗包括治疗口干的非处方止涎剂、治疗口腔念珠菌病的外用抗真菌药以及治疗口疮性溃疡的外用皮质类固醇。一线治疗无法改善的口腔状况可能需要全身药物治疗。