Oral mucosal disease: a decade of new entities, aetiologies and associations

New patterns of oral mucosal disease and indeed new disorders have been emerging over the past decade. Although infection with human immunodeficiency viruses (HIV) is having the most profound impact, there are also major changes in oral health and the standard of health care required, because of other new disorders and medical care. The increase in tissue transplantation, with the concomitant use of immunosuppression is resulting in a range of oral problems. Other iatrogenic oral diseases likely to increase include ulcers associated with cytotoxic chemotherapy; lichenoid eruptions related to drugs and restorative materials; and a multiplicity of other complications. Dilemmas are presented by some new disorders such as orofacial granulomatosis. No less are the difficulties presented by the now obvious heterogeneous nature of oral subepithelial vesiculobullous disorders. Finally, there are, even in these days of social medicine and antimicrobial availability, new infectious diseases emerging. Continued increases in population mobility; continued sexual promiscuity; and the development of new drugs are all likely to act to increase the spectrum of oral disorders seen.