Abstract
The prevalence of oral mucosal lesions in elderly population is 22.8% to 61.6%. Conventional oral examination (COE) is usually carried out to detect oral mucosal lesions (OML). However, new diagnostic aids have been introduced to improve OML detection. This study aimed to determine the utility of autofluorescence (AF) imaging in detecting OML from normal oral mucosa and its anatomic variation among institutionalised elderly Malaysian when compared with COE. Fifty subjects randomly selected from 9 nursing homes and COE and AF imaging using VELscope Vx, (LED Dental, Vancouver, British Columbia, Canada) were carried out. Sensitivity, specificity, positive (PPV) and negative predictive value (NPV) and accuracy of AF imaging were calculated. From the study, fifteen subjects had normal oral mucosa, 15 anatomic variations and 36 lesions were identified. The sensitivity and specificity of AF imaging were 100% and 70% whereas the PPV and NPV were 80% and 100% respectively. The accuracy of AF imaging was 86.37% when compared to COE. In conclusion AF imaging was able to detect OML and differentiate them from normal oral mucosa. However it has limited usefulness in differentiating between these lesions. This study however, was able to detail the AF imaging profile of normal oral mucosa, its normal variants and some common reactive or infective lesions which can be used in future OML studies as comparison to oral potentially malignant lesions.
Highlights
Identification of oral mucosal lesions (OML) is important as it help in clinical diagnosis and treatment planning
The accuracy of AF imaging was 86.37% when compared to Conventional oral examination (COE) (Table 3)
Buccal mucosa predominantly appears green with AF imaging, in few small areas of buccal mucosa, dark patches can be seen which are due to mild trauma or inflammation as buccal mucosa is a high risk site for trauma
Summary
Identification of oral mucosal lesions (OML) is important as it help in clinical diagnosis and treatment planning. Oral mucosal lesions are described as any abnormal changes on the mucous membrane lining of the oral cavity [1] such as red, white, mixed white and red, pigmented, ulcerative lesions and swelling. The prevalence of OML in elderly population has been reported as low as 22.8% to high as 61.6% [1] and the prevalence in Malaysia was reported as 22.8% [3]. Various factors affect the prevalence of OML in this population and one major factor is the denture status [1]. Normal oral mucosa is pink in colour and consists histologically of two layers: the epithelium and the stroma [4].
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