Toothache is a common consequence of dental problems such as dental caries, periodontitis and pericoronitis. It is a phenomenon commonly characterized as a major source of impairment in almost all aspects of human quality of life, specifically disturbing sleep, social interactions, performance of daily tasks and influencing careseeking behaviour. 1,2 Previous studies reported that the prevalence of toothache ranged from 1.3% to 87.8% in different countries and populations. 3 With regards to related factors, previous study showed that younger age and lower socioeconomic status, including household income and mother's education 4 were the factors most consistently associated with higher likelihood to get toothache. 5,6 Worse oral status, snacks consumption, 7 dental treatments, 8 with untreated decayed teeth, 9 anxiety, stress, 10 depression 11 and homeless, 12 were also found to be associated to toothache.

Background Immunotherapy is becoming a standard of care for non-small cell lung cancer (NSCLC). Checkpoint inhibitor-associated pneumonia (CIP) is a rare and potentially life-threatening event that can occur at any time during tumor immunotherapy. However, there may be differences in the radiological patterns and prognosis of CIP during different periods. This study aimed to investigate the radiographic features and prognosis of early- and late-onset immune-related pneumonitis. Methods We retrospectively analyzed the clinical data of 677 NSCLC patients receiving immunotherapy to identify 32 patients with CIP, analyzed the clinical and radiographic data, and summarized the radiological features and prognosis of early- and late-onset CIP. Results CIP had an incidence of 4.7%, a median onset time of 10 weeks, and a mortality of 28.1%. Among these, CIP included 14 early-onset cases, where grade ≥ 3 CIP accounted for 92.9%, main radiographic pattern was organizing pneumonia (OP)-like pattern, and mortality was 50.0%. We also identified 18 late-onset CIPs, where grade ≥ 3 CIP accounted for 50.0%, main radiographic pattern was nonspecific interstitial pneumonia (NSIP)-like pattern, and mortality was 11.1%. The overall survival rate of the early-onset group was significantly lower than that of the late-onset group (P < 0.05). Conclusion Early-onset CIP cases were higher in the Common Terminology Criteria for Adverse Events (CTCAE v5.0) grade and mainly presented with an OP-like radiographic pattern; whereas, late-onset CIP cases were lower in CTCAE grade and mainly presented with an NSIP-like radiographic pattern. Finally, the prognosis of the early-onset CIP group was poorer than that of the late-onset CIP group. We believe that this study will be helpful for clinicians for making early diagnosis and deciding treatment modalities for patients with CIP.

No abstract