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      Prevalence of oral mucosal normal variations and lesions in a middle-aged population: a Northern Finland Birth Cohort 1966 study

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          Abstract

          Background

          In this cross-sectional study we investigated the oral mucosal changes in a middle-aged Finnish population. We analyzed the prevalence of potentially malignant disorders and the influence of smoking, snuff and alcohol use on the mucosal changes.

          Methods

          Of the 12,068 members of the NFBC 1966, a total of 1961 participants (16.2%) constituted the study population. Mucosal changes were diagnosed and photographed by seven general dentists, and two specialists re-analyzed all the diagnoses based on the documentation Cross-tabulation with Chi-square tests and logistic regression analysis were used to analyze the data.

          Results

          Of the participants, 10.5% had some mucosal changes, of which 81.8% were diagnosed as oral mucosal lesions (OML) and 18.2% as normal variations. Of the normal variations, the most common were Fordyce granules (1.2%), fissured tongue (1.1%) and geographic tongue (0.9%). The most common OMLs were white lesions (6.5%), of which oral lichen planus (OLP) and lichenoid reactions (OLR), grouped as oral lichenoid diseases, were present in 3.5%, males more often (3.8% vs . 3.1%). OLP was found in 1.5% of all participants, females more often (1.8% vs . 1.2%), while OLR was more common in males (2.7% vs. 1.3%). Leukoplakia was identified in 0.5% of the population; twice more often in males (0.6% vs. 0.3%). Erythroplakia was not found. Current smokers had higher risk for oral mucosal changes than former or non-smokers (OR 3.0, 95% CI 2.11–4.28), and snuff, used occasionally or regularly, also raised the risk (OR 2.6, 95% CI 1.48–4.70).

          Conclusions

          In the middle-aged northern Finland population, 4% of OMLs were potentially malignant disorders, including OLR (2%), OLP (1.5%) and leukoplakia (0.5%). In particular, smoking and snuff use increased the risk for having any oral mucosa changes.

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          Most cited references27

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          Oral potentially malignant disorders: risk of progression to malignancy.

          Oral potentially malignant disorders (OPMDs) have a statistically increased risk of progressing to cancer, but the risk varies according to a range of patient- or lesion-related factors. It is difficult to predict the risk of progression in any individual patient, and the clinician must make a judgment based on assessment of each case. The most commonly encountered OPMD is leukoplakia, but others, including lichen planus, oral submucous fibrosis, and erythroplakia, may also be seen. Factors associated with an increased risk of malignant transformation include sex; site and type of lesion; habits, such as smoking and alcohol consumption; and the presence of epithelial dysplasia on histologic examination. In this review, we attempt to identify important risk factors and present a simple algorithm that can be used as a guide for risk assessment at each stage of the clinical evaluation of a patient.
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            Potentially malignant disorders of the oral cavity and oral dysplasia: A systematic review and meta‐analysis of malignant transformation rate by subtype

            Potentially malignant disorders of the oral cavity (OPMD) are a heterogeneous group of lesions associated with a variable risk of malignant transformation (MT) to invasive cancer. Leukoplakia (LE), lichen planus (LP), oral lichenoid lesions (OLL), oral erythroplakia (OE), oral submucous fibrosis (OSF), and proliferative verrucous leukoplakia (PVL) are among the most common of these lesions. Oral dysplasia is a mucosal area characterized by cellular and architectural derangement, which may be associated with OPMDs or not.
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              Prevalence of oral mucosal lesions in elderly people in Santiago, Chile.

              Oral prevalence studies are important to know the state of health and the needs of treatment. Our aim was to determine the prevalence of oral mucosal lesions and associated factors among aging Chileans. A random sample by age, gender, and socioeconomic status was obtained, comprising 889 individuals older than 65 years. Individuals were interviewed and examined in Santiago, the capital of Chile, according to the World Health Organization guidelines. The prevalence of one or more oral mucosal lesions in the sample was 53%. Logistic regression model revealed that denture use increased the probability of one or more oral mucosal lesions by threefold, while age, gender, smoking, medication use, xerostomia, and social or cultural factors had no effect. The most common lesion was denture stomatitis (22.3%), followed by irritative hyperplasia (9.4%), oral mucosal varicosities (9%), solitary pigmented lesions (4%), traumatic ulcer (3.5%), angular cheilitis (2.9%), multiple pigmented lesions (2.8%), hemangioma (2.3%), lichen planus (2.1%), leukoplakia (1.7%), recurrent aphthous stomatitis (1.4%), nicotine stomatitis (1.3%), median rhomboid glossitis (0.9%), actinic cheilitis (0.9%), pyogenic granuloma (0.7%), oral squamous papiloma (0.6%), and mucocele (0.2%). One case of oral cancer was observed. Different factors increased the probability of specific oral mucosal pathologies. We can conclude that oral mucosal lesions are common in elderly people in Santiago, suggesting the necessity for improved standards of prevention, and diagnostic and opportune treatment of these lesions.
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                Author and article information

                Contributors
                tuula.salo@helsinki.fi
                Journal
                BMC Oral Health
                BMC Oral Health
                BMC Oral Health
                BioMed Central (London )
                1472-6831
                9 December 2020
                9 December 2020
                2020
                : 20
                : 357
                Affiliations
                [1 ]GRID grid.10858.34, ISNI 0000 0001 0941 4873, Cancer and Translational Medicine Research Unit, Faculty of Medicine, , University of Oulu, ; P.O. Box 5281, 90014 Oulu, Finland
                [2 ]GRID grid.10858.34, ISNI 0000 0001 0941 4873, Infrastructure for Population Studies, Faculty of Medicine, , University of Oulu, ; P.O. Box 5000, 90014 Oulu, Finland
                [3 ]GRID grid.10858.34, ISNI 0000 0001 0941 4873, Research Unit of Oral Health Sciences, , University of Oulu, ; P.O. Box 5281, 90014 Oulu, Finland
                [4 ]GRID grid.9668.1, ISNI 0000 0001 0726 2490, Institute of Dentistry, Faculty of Health Sciences, , University of Eastern Finland, ; P.O. Box 1627, 70211 Kuopio, Finland
                [5 ]GRID grid.410705.7, ISNI 0000 0004 0628 207X, Department of Oral Diagnostics, Educational Dental Clinic, , Kuopio University Hospital, ; Yliopistonranta 1 C, 70210 Kuopio, Finland
                [6 ]GRID grid.412326.0, ISNI 0000 0004 4685 4917, Medical Research Center Oulu, , Oulu University Hospital and University of Oulu, ; P.O. Box 5281, 90014 Oulu, Finland
                [7 ]GRID grid.7737.4, ISNI 0000 0004 0410 2071, Institute of Oral and Maxillofacial Disease, , University of Helsinki, ; 00014 Helsinki, Finland
                [8 ]GRID grid.15485.3d, ISNI 0000 0000 9950 5666, HUSLAB, Department of Pathology, , Helsinki University Hospital, ; Helsinki, Finland
                Author information
                http://orcid.org/0000-0001-6039-0088
                Article
                1351
                10.1186/s12903-020-01351-9
                7727189
                33298037
                fbb03597-ca9c-4af3-8f1f-327db31e4291
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 12 May 2020
                : 30 November 2020
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Dentistry
                nfbc,cross-sectional study,middle-aged population,oral mucosa,normal variations and lesions,oral lichen planus,oral lichenoid reaction,prevalence,leukoplakia

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