Frictional Keratosis Research Articles

A Retrospective Analysis of the Prevalence of Distribution of Oral Mucosal Lesions (OMLs) among the People Of Delhi NCR

INTRODUCTION: The presence of Oral Mucosal Lesions (OMLs) in one’s oral mucosa can lead to unwanted consequences and mostly are due to tobacco use.
 AIM: To document the prevalence of OMLs among patients of Delhi NCR and provide health education counselling to those under the grip of this evil practice. 
 MATERIAL AND METHODS: We retrospectively analyzed the data of a total of 402 subjects visiting various screening camps in Delhi NCR and recalled a total of 174 patients, out of which 161 reported back to us for further diagnosis and screening of OMLs. The examination of patients in the camp were an ADA type III examination. All patients we given a health education while tobacco users were also given a specialized one-on-one health education regarding the tobacco and its ill effects as well as techniques for cessation. A descriptive analysis of the sample was first performed using means (±standard deviation (SD)) for continuous variables and frequencies (proportions) for categorical variables. The chi-square test was used for statistical analysis and to find significant difference, if any.
 RESULTS: Among the 402 subjects screened, the mean age was 33.24±6.74 Years and most of the study population belonged to the age group of 25-60 Years [178(44.3%)]. 301(74.8%) of the study population were males. The main chief complaint was periodontal problem [187(46.5%)], while 15 patients (3.73%) came for regular check-up. The prevalence of leukoplakia was found to be 8.70% and OSMF was found to be 6.21%. A significant difference was seen among gingivitis with respect to age and gender (p<.05), leukoplakia and frictional keratosis was seen significant in relation to gender. In all significant cases, Males were more prone to get these OMLs as compared to females
 CONCLUSION: It is advised that regular Oral Health Drives and counselling sessions be arranged for the people of elhi NCR to reduce the burden of the OMLs.

Loricrin expression and its implication in oral submucous fibrosis, hyperkeratosis and normal mucosa with association to habits – An immunohistochemical study

ObjectiveThe coarse fibres of areca nut and the continuous friction from occluding teeth are major causes of mechanical stress to the oral mucosa in conditions like oral submucous fibrosis and frictional keratosis. The continuous micro trauma provided in areca nut chewers, creates an environment where the keratinocytes exhibit alteration. Loricrin, is expressed abundantly in keratinizing epithelium in response to mechanical stress. Their expression or absence could play a role in malignant transformation. This study attempts to assess the potential of Loricrin as an early diagnostic marker in patients with chewing habit. Methods73 archival samples of formalin fixed, paraffin embedded tissue specimens histopathologically confirmed, were segregated as normal mucosa 11, hyperkeratotic 32 and oral submucous fibrosis 30 and stained with antibodies to Loricrin and graded as negative, mild, moderate and intense based on the staining intensity. Pearson's chi square test was done for statistical analysis. ResultsLoricrin expression was observed in all groups with staining in the stratum granulosum showing a significant association to habits (P = 0.000). ConclusionThis prominent staining indicates a compensatory cytoskeletal rearrangement of surface epithelium during cell division in early oral submucous fibrosis showing potential as an early marker of the condition.

Frictional Keratosis, Contact Keratosis and Smokeless Tobacco Keratosis: Features of Reactive White Lesions of the Oral Mucosa.

White lesions of the oral cavity are quite common and can have a variety of etiologies, both benign and malignant. Although the vast majority of publications focus on leukoplakia and other potentially malignant lesions, most oral lesions that appear white are benign. This review will focus exclusively on reactive white oral lesions. Included in the discussion are frictional keratoses, irritant contact stomatitis, and smokeless tobacco keratoses. Leukoedema and hereditary genodermatoses that may enter in the clinical differential diagnoses of frictional keratoses including white sponge nevus and hereditary benign intraepithelial dyskeratosis will be reviewed. Many products can result in contact stomatitis. Dentrifice-related stomatitis, contact reactions to amalgam and cinnamon can cause keratotic lesions. Each of these lesions have microscopic findings that can assist in patient management.

Leukoplakia of the Marginal Gingiva: A Report of Two Cases

IntroductionLeukoplakia of the marginal gingivae is uncommon and in most cases reported up to date represents a manifestation of proliferative verrucous leukoplakia. The clinical and pathologic features of two cases of leukoplakia confined to the marginal gingiva are described and their biologic significance is discussed.Case PresentationThe cases involved two female patients, non‐smokers, aged 82 and 57. The lesions clinically appeared as small, well‐demarcated white plaques on the marginal gingiva of posterior teeth. After being totally excised, microscopic examination showed keratosis of unknown significance in the first patient and verrucous hyperplasia in the latter, while immunohistochemistry for p16INK4A was negative for both. There was no recurrence in 7 months and 5 months after excision, respectively.ConclusionA white plaque on the marginal gingiva may be overlooked due to its small size or may be misdiagnosed as frictional keratosis. However, it may represent leukoplakia, a potentially malignant disorder. Therefore, diagnosis and management should follow the established guidelines for leukoplakia.

Prevalence and Distribution of Oral Mucosal Lesions by Sex and Age Categories: A Retrospective Study of Patients Attending Lebanese School of Dentistry.

Background Prevalence and distribution of oral mucosal lesions in a sample of Lebanese population attending the School of Dentistry of Lebanese University is necessary to evaluate their oral health situation. Objectives The aim of the present study was to determine the prevalence and distribution of oral mucosal lesions of patients attending the School of Dentistry. Methods A descriptive study was carried out by retrospectively examining a total of 231 medical and clinical examination record files of patients, attending the School of Dentistry Lebanese University for multidisciplinary dental treatments. 178 medical records were retained. Each medical and clinical examination record was done by an undergraduate student and then evaluated by a doctor. The record file included a civil status, chief complaint, medical history, and extraoral and intraoral clinical examination during the period between October 2014 and May 2015. Exclusion criteria were lack of written information in their medical and clinical examination record and being nonevaluated by a doctor. Data regarding age, gender, socioeconomic status, chief complaint, systemic diseases, and drugs intake were collected by using a questionnaire while the type of extraoral and oral mucosal lesions by clinical examination. Results The sample consisted of 102 (57.3%) females and 76 (42.7%) males. The age ranged from 10 to 92 years with a mean age of 40.1 years. Among these subjects, 110 (61.8%) presented with one or more lesions. All patients were Lebanese. The most common lesion diagnosed was coated/hairy tongue affecting 17.4% of the subjects, followed by melanotic macule (11.2%), gingivitis (9.6), linea alba (6.2%), tongue depapillation (5.1), leukoplakia (5.1), traumatic fibroma (4.5), frictional keratosis (3.9%), fissured tongue (3.9%), hemangiomas (3.9%), Fordyce granules (3.9%), dry mucosa (3.4), angular cheilitis (2.2), gingival hyperplasia (2.2), and crenulated tongue (1.7%). Overall, the prevalence of oral mucosal lesions did not significantly differ between sex and age groups. Conclusions The high prevalence of oral mucosal lesions necessitates adequate awareness and management of these lesions in the general population. Dental clinicians should be knowledgeable and familiar with the etiopathogenesis, clinical presentation, diagnosis, and management of these lesions.

APAKAH SHISHA BERBAHAYA BAGI KESEHATAN RONGGA MULUT ?

Background: In recent years, the use of tobacco in Indonesia increasingly varied in the forms and methods of consumption, one of which is shisha. Smoking shisha is increasingly popular due to a misperception that smoking shisha is harmless and lack of knowledge about the effects of shisha smoking in oral health.Literature analysis: “PubMed” used as a search tool to identify all empirical studies related to the effects of shisha smoking on health, especially in oral cavity.Discussion: Shisha smoke contained various toxic substances such as Nicotine, Tobacco Specifc Nitrosamines, Polycyclic Aromatic Hydrocarbons, Volatile Organic Compounds, Carbon Monoxide, Tar, and high-temperature metal heating causing shisha smoke contained toxic heavy metals such as arsenic, nickel, cobalt, chromium, lead, and cadmium. The content of these toxic substances showed that smoked shisha is associated with dependence, acute and long-term negative health effects similar to cigarette smoking. Toxic substances may cause various infections of microorganism such as Candida sp, Herpes Simplex Virus (HSV-1), Epstein Barr Virus, Mycobacterium tuberculosis, Human Immunodefciency Virus; Oral mucosal changes such as Hairy Tongue, Smoker’s Melanosis, Nicotine Stomatitis, Frictional Keratosis, Fissured Tongues, gingival or periodontal inflammation, and leukodema; and lead to malignant lesions such as Keratosis, Leukoplakia, Erythroplakia, Oral Submucous Fibrosis and Lichenoid Lesions.Conclusion: Smoking shisha gives bad impact for human health especiallyoral health. Shisha smoking can lead to the development of various infectious diseases and potentially lead to malignancy in the oral mucosa. These foundings breaks the belief that shisha smoking is safe for health.

White oral mucosal lesions among the Yemeni population and their relation to local oral habits.

The aim of the present study was to assess the prevalence and risk factors of white oral mucosal lesions among Yemeni adults; in particular, those who chew khat and tobacco. The present cross-sectional study included 1052 dental patients aged 15years and older. A detailed oral examination was performed by a single examiner in accordance with standard international criteria. Overall, 25.2% of the study participants presented with one or more white lesions. The most prevalent lesions were khat-induced white lesion (8.8%), leukoedema (5.1%), and frictional keratosis (3.9%). Potentially malignant lesions, such as lichen planus, leukoplakia, and smokeless tobacco-induced lesions, were seen in 2.4%, 1.2%, and 1.7% of participants, respectively. Moreover, three cases of oral cancer were identified. The presence of white lesions was found to be significantly associated with advanced age (P=.004), male gender (P=.009), and khat/tobacco chewing habits (P<.001). The present study demonstrates a high prevalence of oral benign and potentially malignant white lesions. Further, it highlights the urgent need to develop and implement new government policies to regulate the sale of these products to reduce the prevalence of these lesions and the overall incidence of oral cancers in the Yemeni population.

Determination of Oral Health Status in Patients Admitted to a University Hospital: A Pilot Study

Aims: Oral mucosa, tongue, dentition and bone are important parameters for oral and systemic health care. A wide variety of lesions and conditions, either harmless or harmful, can affect the oral cavity. Identification and treatment of these conditions are an important part of oral health care. The aim of this study was to evaluate the general oral health status, by assessing the prevalence and types of mucosal, tongue, dental and jaw lesions, in a group of patients. Materials and methods: This study was conducted in a group of 314 dental outpatients. Participants’ oral mucosal, tongue, dental, jaw lesions and their locations were recorded. Data were analyzed using logistic regression analysis. Results: Three hundred and fourteen patients (40,1% female, 59,9% male), 148 (47,1%) of whom exhibited one or more mucosal lesions, 40 (12,7%) tongue lesions, 242 (77,1%) one or more acquired dental conditions, 61 (19,4%) one or more dental anomalies, and 22 (7%) bone manifestations in the jaws. The most commonly detected mucosal lesions were Fordyce’s granules (20,1%), linea alba buccalis (16,9%), melanoplakia (15,9%), and frictional keratosis (2,5%). Fissured tongue (8%), geographic tongue (1,6%), lingual varicosity (1,3%) and coated tongue (1,3%) were the most commonly determined tongue lesions. The most commonly detected dental anomalies were hypodontia (6,1%), microdontia (4,1%), dilaceration (4,1%), and enamel hypoplasia (2,5%). Exostoses (4,1%), enostoses (1%) and fibro-osseous lesions (1%) were the most commonly detected bone manifestations in the jaws. Conclusions: Oral mucosal and tongue lesions could be a sign of systemic diseases and also could form a base for oral cancers. In this study oral mucosal lesions and tongue lesions prevalence were high but fortunately all the detected conditions were harmless, benign conditions. This emphasizes the importance of familiarity, awareness, and differentiation of these lesions and conditions to avoid unnecessary treatments.

Squamous Cell Carcinoma as the Most Common Lesion of the Tongue in Iranians: a 22-Year Retrospective Study.

The tongue has been globally considered as an indicator of general health for millennia. This study aimed to determine the prevalence and distribution of tongue lesions in an Iranian population. In this retrospective study, data from 6,435 oral biopsy reports over a 22-year period (1992-2014) were retrieved from archives of Oral and Maxillofacial Pathology Department, Shahid Beheshti Dental School, Tehran, Iran. These reports were analyzed according to age, sex, type of lesion and location. Prevalence of tongue lesions were reported as percentages. Out of total oral lesions, 238 (3.7%) were found in the tongue, with the incidence peak (42%) being between 41-60 years. Men constituted 53% and women 47%of patients. The youngest patient was a 3-year-old girl with pyogenic granuloma and the oldest one was a 93-year-old man with squamous cell carcinoma (SCC). SCC was the most common (25%) lesion generally found in the lateral border of the tongue with a male predilection. The second and third most prevalent lesions of the tongue were benign keratosis (frictional keratosis) (13.4%) and leukoplakia (13%).White-red lesions (38.6%) were the most frequent subgroup followed by neoplastic lesions (28%). Moreover, irritation fibroma, non-specific ulcers, squamous papilloma, and hemangioma were found as the most frequent lesions in their related subgroups.Given the high rate of SCC of the tongue in Iranian patients, this area should be examined more carefully by dental practitioners and physicians.

Prevalence of Oral Mucosal Abnormalities in Dental Patients in Tamil Nadu

ABSTRACT Aim The incidence of oral mucosal lesions is increasing day by day due to adverse oral habits and emerging infections. Hence, a novel attempt is made to assess the prevalence of oral mucosal abnormalities in patients visiting dental department of ESIC Hospital and Medical College, KK Nagar, Chennai, Tamil Nadu. Materials and methods A retrospective study was designed to assess the prevalence of oral mucosal abnormalities in ESIC Hospital and Medical College, KK Nagar, Chennai. A total of 2315 patients were assessed between May 2014 and October 2014 to find the prevalence of oral mucosal abnormalities. Results and conclusion The prevalence of oral mucosal abnormalities was found to be 13.31%. The most prevalent oral mucosal abnormalities were smoker's palate, frictional keratosis, aphthous ulcers, oral submucous fibrosis, and traumatic ulcers. Clinical significance Knowing the prevalence of oral mucosal abnormalities is very significant because early detection and prompt treatment of the same would help in reducing the morbidity and enhancing the patients’ quality of life. How to cite this article Vijayabala GS, Mohanavalli S, Gunasekar C, Janagarathinam VA, Kumar SS, Kumar UR. Prevalence of Oral Mucosal Abnormalities in Dental Patients in Tamil Nadu. World J Dent 2016;7(4):186-188.

Prevalence of Oral Mucosal Lesions and Relationship with Habits: A Cross-Sectional Prospective Clinical Study

Background: Epidemiologic researches about oral mucosal lesions (OML) and possible relationships between OML and some habits or conditions have been performed in different populations. Objective: To determine the prevalence of oral mucosal lesions and relationship between OML and black tea, tooth brushing-habits, smoking, alcohol consumption, denture use on the oral mucosal lesions. Subjects and Methods: In this cross-sectional prospective clinical study, randomize selected 930 dermatology outpatients were examined using WHO criteria for oral mucosal lesions in our tertiary state hospital in Istanbul, Turkey, between September 2012 and December 2012. Results: Oral mucosal lesion was recorded in 500 (53.8%) subjects (164 (%32.8) female). The mean age of the patients was 41.3±1.99 years (ranging from 18 to 88). Frictional keratosis, nicotine stomatitis, and gingivitis were significantly more prevalent among the alcohol drinkers. Frictional keratosis was seen significantly higher in patients with denture. Heavy smoking was the risk factor for nicotine stomatitis, pigmentation, frictional keratosis, and gingivitis. Drinking black tea was found to be a significant risk factor for occurrence of nicotine stomatitis, xerostomia and gingivitis. Conclusion: This study has provided information about the epidemiologic aspect of oral mucosal lesion in this region. Public health policies should be implemented in order to manage this problem rationally.

Oral mucosal lesions in older people: relation to salivary secretion, systemic diseases and medications.

To determine the prevalence of oral mucosal lesions in a sample of older Danish people and to investigate their associations with age, gender, systemic diseases, medications, xerostomia and salivary secretion. A total of 668 community-dwelling individuals aged 65-95 years underwent a clinical examination, measurements of unstimulated and stimulated whole and labial salivary flow rates and an interview regarding xerostomia, general health, medication, tobacco and alcohol habits. Seventy-five per cent of all participants and 70% of the non-medicated ones had one or more oral mucosal lesions. The most prevalent lesions were lingual varicosities (28.3%), denture stomatitis (12.7%), candidiasis (11.8%), fissured tongue (9.1%) and frictional keratosis (8.4%). Lesions were generally associated with smoking and xerostomia. Varicosities were more common in participants with systemic diseases and medication intake, particularly with cardiovascular diseases and agents. Fissured tongue and atrophic tongue were associated with female gender, xerostomia and low unstimulated whole and labial salivary secretion. Oral candidiasis was associated with older age; being male; current smoker; having >3 diseases, intake of medications and low salivary flow rates; and identified in relation to denture stomatitis, fissured tongue and atrophic tongue and median rhomboid glossitis. Oral mucosal lesions are prevalent in older Danish people and generally associated with changes in both local and systemic factors. Tongue lesions in particular appeared as indicators that may identify patients with specific need of oral intervention.

Prevalence and distribution of oral mucosal lesions in a geriatric Indian population.

BackgroundOral health is important to individuals of all age groups. Previous epidemiologic studies of the oral health status of the general population in India provided very little information about oral mucosal lesions in the elderly. Hence, the purpose of the present study was to determine the prevalence of the oral lesions in a geriatric Indian population.Methods5,100 patients were clinically evaluated, with age ranging from 60 to 98 years. There were 3,100 males and 2,000 females, with a mean age of 69 ± 6.3 yrs. The statistical analysis was done using the SPSS software, where p < .05 was considered to be significant.Results64% of the patients presented with one or more oral lesions, associated to tobacco, betel nut consumption, and lesions secondary to trauma and prosthesis. Males were more affected than females and this difference was clinically not significant (p > .05). The lesions were more frequently observed between 65 to 70 yrs. The most common alterations observed were smoker’s palate (43%), denture stomatitis (34%), oral submucous fibrosis (30%), frictional keratosis (23%), leukoplakia (22%), and pyogenic granuloma (22%). Hard palate was the most commonly affected site (23.1%).ConclusionsThe findings of the present study provide important information when clinically evaluating oral cavity in elderly. Close follow-up and systematic evaluation is required in the elderly population to plan future treatment needs.

Oral leukoplakia, the ongoing discussion on definition and terminology.

In the past decades several definitions of oral leukoplakia have been proposed, the last one, being authorized by the World Health Organization (WHO), dating from 2005. In the present treatise an adjustment of that definition and the 1978 WHO definition is suggested, being : “A predominantly white patch or plaque that cannot be characterized clinically or pathologically as any other disorder; oral leukoplakia carries an increased risk of cancer development either in or close to the area of the leukoplakia or elsewhere in the oral cavity or the head-and-neck region”. Furthermore, the use of strict diagnostic criteria is recommended for predominantly white lesions for which a causative factor has been identified, e.g. smokers’ lesion, frictional lesion and dental restoration associated lesion. A final diagnosis of such leukoplakic lesions can only be made in retrospect after successful elimination of the causative factor within a somewhat arbitrarily chosen period of 4-8 weeks. It seems questionable to exclude “frictional keratosis” and “alveolar ridge keratosis” from the category of leukoplakia as has been suggested in the literature. Finally, brief attention has been paid to some histopathological issues that may cause confusion in establishing a final diagnosis of leukoplakia. Key words:Oral leukoplakia, potentially malignant oral disorders, definition.

Prevalence of oral soft tissue lesions and medical assessment of geriatric outpatients in North India

Introduction: Oral health reflects overall well-being for the elderly population. Compromised oral health may be a risk factor for systemic diseases commonly occurring in old age. Oral health evaluation should be an integral part of the physical examination, and dentistry is essential to qualify geriatric patient care. Aim: To determine the prevalence of oral soft tissue lesions and systemic diseases in institutionalized geriatric population in North India. Materials and Methods: Geriatric patients were clinically evaluated using a standard questionnaire and assessed for known medical illnesses and prevalence of oral soft tissue lesions. Four hundred patients (71% males and 29% females) with age ranging from 60 to 100 years were considered in the study group. Twenty-two (33.8%) patients were edentulous and seven patients (10.8%) were denture wearers. Forty-four (67.69%) patients reported with tobacco habits. Results: Most prevalent medical illness reported was diminished vision (15.5%), followed by hypertension (10%) and diabetes mellitus (6.25%). Several oral soft tissue lesions were reported among the study population. The most prevalent lesions were leukoplakia (12%), smoker's melanosis (10%), smoker's palate (9%), pigmentation on tongue (6%), frictional keratosis (5%), lichen planus (3%), denture stomatitis (2.5%), aphthous ulcers (2%), angular chelitis (1.5%), oral submucous fibrosis (1.5%), melanotic macule (1.5%), candidiasis (1.5%), irritation fibroma (1%), geographic tongue (1%), median rhomboid glossitis (1%), and traumatic ulcer (1%). Conclusion: The findings observed in this population are important and can have a determinant effect on the overall quality of life in this population. This information is a crucial prerequisite for health awareness programs involving the community health workers, oral physicians, and medical professionals.

Prevalence of Potentially Malignant Oral Mucosal Lesions among Tobacco Users in Jeddah, Saudi Arabia

Smoking is recognized as a health problem worldwide and there is an established tobacco epidemic in Saudi Arabia as in many other countries, with tobacco users at increased risk of developing many diseases. This cross sectional study was conducted to assess the prevalence of oral mucosal, potentially malignant or malignant, lesions associated with tobacco use among a stratified cluster sample of adults in Jeddah, Saudi Arabia. A sample size of 599 was collected and each participant underwent clinical conventional oral examination and filled a questionnaire providing information on demographics, tobacco use and other relevant habits. The most common form of tobacco used was cigarette smoking (65.6 %) followed by Shisha or Moasel (38.1%), while chewing tobacco, betel nuts and gat accounted for 21-2%, 7.7%, and 5% respectively. A high prevalence (88.8%) of soft tissue lesions was found among the tobacco users examined, and a wide range of lesions were detected, about 50% having hairy tongue, 36% smoker's melanosis, 28.9% stomatitis nicotina, 27% frictional keratosis, 26.7% fissured tongue, 26% gingival or periodontal inflammation and finally 20% leukodema. Suspicious potentially malignant lesions affected 10.5% of the subjects, most prevalent being keratosis (6.3%), leukoplakia (2.3%), erythroplakia (0.7%), oral submucous fibrosis (0.5%) and lichenoid lesions (0.4%), these being associated with male gender, lower level of education, presence of diabetes and a chewing tobacco habit. It is concluded that smoking was associated with a wide range of oral mucosal lesions , those suspicious for malignancy being linked with chewable forms, indicating serious effects.

Breastfeeding Keratosis: This Frictional Keratosis of Newborns May Mimic Thrush

We report the first example, to our knowledge, of a frictional keratosis from exuberant sucking in a breastfeeding infant. A 2-month-old girl was referred for evaluation of a well-demarcated, nonsloughing white keratotic plaque of the lower lip mucosa, just inside the vermilion border. The plaque had a slightly irregular surface, had no surrounding erythema, and was the only such plaque in the mouth. It had been present for at least 3 weeks and had been unsuccessfully treated by her pediatrician via oral Mycostatin (nystatin). Her parents sought a second opinion when the infant was prescribed a full course of oral Diflucan (fluconazole). A cytopathology smear (Papanicolaou test) revealed abundant mature keratinocytes with no evidence of Candida. The mother admitted that the infant "worked hard" at sucking during breastfeeding and continued sucking long after feeding. The parents were unaware of any other habit or potential irritation of the lips. After 3 months of age the infant's sucking pattern became more "normal" and the keratosis disappeared; it did not recur during 3 years of follow-up. We propose the term "breastfeeding keratosis" for this entity.

White lesions in the oral cavity: a clinicopathological study from a tertiary care dermatology centre in kerala, India.

Context:White lesions in the oral cavity may be benign, pre-malignant or malignant. There are no signs and symptoms which can reliably predict whether a leukoplakia will undergo malignant change or not. Many systemic conditions appear initially in the oral cavity and prompt diagnosis and management can help in minimizing disease progression and organ destruction.Aim:The aim of the paper was to study the clinical and histopathological patterns of white lesions in the oral cavity presented at the study setting and to study the factors associated with the histopathological patterns of the lesions.Settings and Design:A hospital based cross-sectional study of patients with white lesions in the oral cavity attending the Department of Dermatology and Venereology, Medical College, Thiruvananthapuram was done.Materials and Methods:After taking a detailed history, microscopic examination of Potassium hydroxide smear and an oral biopsy with histopathologial examination was done.Results:Out of the 50 patients in the study, clinically the diagnoses made were Lichen planus (32 patients; 64%), Frictional Keratosis (4;8%), Dysplasia (2;4%), Oral Hairy Leukoplakia (1;2%), Pemphigus Vulgaris (2;4%), Cutaneous Lupus Erythematosus (1;2%), Oral Submucous fibrosis (3;6%) and Oral Candidiasis alone (5;10%). Out of the 45 patients who had undergone biopsy, 25 (55.6%) had Lichen planus, 9 (20%) had Frictional Keratosis and mild Dysplasia was found in 4 (8.9%) patients.Conclusion:The measure of agreement between the clinical and pathological diagnosis was only 32%. Older age, difficulty in opening the mouth, consumption of non-smoked tobacco, site of the lesion (gingival, floor of mouth or lingual vestibule) and presence of tenderness on the lesion were significantly associated with Dysplasia.

Prevalence and the relationship of oral mucosal lesions in tobacco users and denture wearers in the North Indian population

Aim:The aim of the present study was to determine the prevalence and the relationship of oral mucosal lesions in tobacco users and denture wearers in a North Indian population.Materials and Methods:The study comprised 3,749 patients attending the Department of Oral Medicine and Radiology, Jodhpur Dental College General Hospital between September 2008 and December 2012, for the treatment of dental problems other than oral mucosal lesions. The ages ranged from 28 years to 83 years, with a mean age of 49.7 years. The results were evaluated using the Pearson Chi-square test, with Yate’s correction and ANOVA tests.Results:A total of 2,318 patients were diagnosed with lesions associated with the use tobacco and the wearing of dentures. The most frequently seen lesion was melanin pigmentation (29.9%) followed by linea alba (22.2%) and frictional keratosis (19.9%). Ulcers (6.1%) were the most common oral lesion seen in patients who wore dentures, followed by hyperplasia (4.8%). A statistically significant relation (P < 0.05) was established between tobacco and melanin pigmentation, frictional keratosis, traumatic ulcerations and leukoplakia. In those who wore dentures a statistically significant relation (P < 0.05) was found between candidiasis, traumatic ulceration and frictional keratosis.Conclusion:The results of the present study indicate that the association of frictional keratosis with tobacco users and wearers of dentures can help in determining the diagnosis and treatment plan for oral cancer. Wearers of dentures should also be recalled for periodic checks at regular intervals and optimum preventive measures implemented.

Prevalence of oral mucosal lesions in dental patients with tobacco smoking, chewing, and mixed habits: A cross-sectional study in South India

Background:A variety of oral mucosal lesions and conditions are associated with the habit of smoking and chewing tobacco, and many of these carry a potential risk for the development of cancer. There have been no studies that report the prevalence of habits and associated oral changes in the population in Dharwad region, of Karnataka, south India.Materials and Methods:A hospital–based, cross-sectional study was carried out at SDM Dental College (Dharwad, Karnataka). A total of 2400 subjects (1200 subjects with and 1200 subjects without habits) attending the dental hospital were interviewed and examined by trained professionals to assess any oral mucosal changes.Results:Oral mucosal lesions were found in 322 (26.8%) subjects who had tobacco smoking and chewing habits as compared to 34 (2.8%) subjects without those habits. Oral leukoplakia (8.2%) and oral submucous fibrosis (OSF) (7.1%) were the prevalent oral mucosal lesions found in subjects who had those habits, while the other lesions (1.7%) namely; oral candidiasis, median rhomboid glossitis, recurrent apthous ulcer, frictional keratosis, and oral lichen planus (0.9%) were frequently reported among individuals without those habits. The odds of developing oral lesions in subjects with tobacco habits was nearly 11.92 times that of abstainers (odds ratio, OR = 11.92, 95% confidence intervals, CI = 10.61-14.59%).Conclusion:The study showed that the risk of the development of oral lesions associated with tobacco smoking, chewing, or both is quite high. Males who had one or more of these habits showed more frequent oral changes than females. The study reinforces the association of OSF with gutkha and areca nut chewing, and leukoplakia, erythroplakia, and oral cancer with tobacco smoking, chewing, or mixed habits.