Prevalence Of Oral Leukoplakia Research Articles

Epidemiological Trends and Clinicopathological Characteristics of Oral Leukoplakia: A Retrospective Analysis From a Single Institution in Chennai, Tamil Nadu, India.

Background India has a high prevalence of oral potentially malignant disorders and malignant transformation. Cases of oral leukoplakia are not commonly encountered, and only a small cohort of patients undergo biopsies for the same. This study aims to assess the various etiological factors causing leukoplakia, the clinical features, histopathological findings, and treatment received by the patients who were histopathologically diagnosed with oral leukoplakia. Methodology Oral leukoplakia cases were included in this study from total biopsy samples received in the oral pathology department. Details were collected from the Dental Information Archival Software of our institution. The period analyzed was from January 1, 2021, to December31, 2023. Relevant clinical and histopathological details were retrieved and tabulated. Statistical analysis (chi-square test) was used to assess the association between the clinicopathological parameters using SPSS software version 21.0 (IBM Corp., Armonk, NY, USA) with a significance level set at a p-value <0.05. Results A total of 76 oral leukoplakia cases were retrieved from 2,600 biopsy samples. The prevalence of oral leukoplakia was 3.1% to 3.4% for the three years. Leukoplakia was commonly observed in those aged 51 to 60 years (33%). Overall, 21% of the patients with leukoplakia showed severe epithelial dysplasia, 22% showed mild epithelial dysplasia, and 39% showed moderate epithelial dysplasia. Moreover, 30% of the patients presented with leukoplakia and oral submucous fibrosis and showed varying degrees of epithelial dysplasia. Finally, 45% of the patients were managed conservatively using pharmacotherapy. Conclusions Severe epithelial dysplasia was commonly associated with oral leukoplakia. Oral submucous fibrosis was also found to be associated with leukoplakia and showed epithelial dysplasia. None of our proliferative verrucous leukoplakia cases showed any association with oral submucous fibrosis. Surgical management was the preferred treatment.

Prevalence of oral leukoplakia in oral cancer prevention in the state of Paraná-Brazil between 1989 and 2017

Prevalence of oral leukoplakia in oral cancer prevention in the state of Paraná-Brazil between 1989 and 2017

Dental fluorosis and oral health in the African Esophageal Cancer Corridor: Findings from the Kenya ESCCAPE case-control study and a pan-African perspective.

There are no studies of oral health in relation to esophageal cancer in Africa, or of Eastern Africa's endemic dental fluorosis, an irreversible enamel hypo‐mineralization due to early‐life excessive fluoride intake. During 2014–18, we conducted a case–control study of squamous cell esophageal cancer in Eldoret, western Kenya. Odds ratios (AORs (95% confidence intervals)) were adjusted for design factors, tobacco, alcohol, ethnicity, education, oral hygiene and missing/decayed teeth. Esophageal cancer cases (N = 430) had poorer oral health and hygiene than controls (N = 440). Compared to no dental fluorosis, moderate/severe fluorosis, which affected 44% of cases, had a crude OR of 20.8 (11.6, 37.4) and on full adjustment was associated with 9.4‐fold (4.6, 19.1) increased risk, whilst mild fluorosis (43% of cases) had an AOR of 2.3 (1.3, 4.0). The prevalence of oral leukoplakia and tooth loss/decay increased with fluorosis severity, and increased cancer risks associated with moderate/severe fluorosis were particularly strong in individuals with more tooth loss/decay. Using a mswaki stick (AOR = 1.7 (1.0, 2.9)) rather than a commercial tooth brush and infrequent tooth brushing also independently increased risk. Geographic variations showed that areas of high esophageal cancer incidence and those of high groundwater fluoride levels have remarkably similar locations across Eastern Africa. In conclusion, poor oral health in combination with, or as a result of, high‐altitude susceptibility to hydro‐geologically influenced dental fluorosis may underlie the striking co‐location of Africa's esophageal cancer corridor with the Rift Valley. The findings call for heightened research into primary prevention opportunities of this highly fatal but common cancer.

Assessment of Betel Quid Habits and Risk of Precancerous Oral Lesions Among Paniya Tribes of Wayanad, India - A Cross-Sectional Study

Background: Betel quid habits in India is widely prevalent and responsible for increased incidence of head and neck cancer in the country. Head and neck cancer is a major public health problem among Paniya tribes, a marginalized tribal group in Kerala state, India. Previous studies among Paniya tribals in Wayanad have documented a high prevalence of betel quid habit. Oral leukoplakia (OL) and oral submucous fibrosis (OSF) are the most common oral mucosal diseases that have a very high malignant transformation rate. Aim: Aim of this study was to evaluate the risks imposed by betel quid habits in the development of oral leukoplakia and oral submucous fibrosis among Paniya tribes of Wayanad. Methods: A cross-sectional study was carried out in 300 residents between September 01, 2009 and March 31, 2017 using a structured questionnaire containing details of betel quid habits and socio-demographic details. Descriptive statistics and testing of hypothesis were used for the analysis using EPI INFO and SPSS 16 software. Results: In the 300 subjects, the mean age was 32.4 ±SD 11.4 years, gender distribution (57.5% males vs. 42.5% females). 32.5% out of the study population were betel quid chewers (46.5% of males and 14.6% of females). The prevalence of OL and OSF was 12.9% and 13.02%, respectively among betel quid chewers. Conclusion: Awareness of head and neck cancer by betel quid habits varied with socioeconomic status among Paniya tribes of Wayanad. Despite their awareness of tobacco chewing as a risk factor for head and neck cancer, most of them still continue to chew. There is an urgent need to develop and implement culturally appropriate awareness-raising activities to target betel quid habit.

A 10-yr Study of Smokeless Tobacco Use in a Professional Baseball Organization

Professional baseball players frequently use smokeless tobacco and are at risk of oral leukoplakia. There are limited long-term data on current trends in tobacco use and resultant oral health in this high-risk group. The purpose of this study was to monitor the prevalence of smokeless tobacco use in a professional baseball organization over a 10-yr period, looking for changes in the patterns of use and resultant changes in the incidence of oral leukoplakia. During 10 successive spring training camps (1991-2000), players and management personnel were surveyed on their use of smokeless tobacco. A detailed mouth examination of each participant was performed by an examiner blinded to the questionnaire results. The main outcome measures were trends in self-reported tobacco use and the presence of oral leukoplakia on examination. We performed 2266 mouth examinations on participants with a completed questionnaire, with the yearly sample size ranging from 190 to 259. The prevalence of smokeless tobacco use declined, falling from 41.1% in year 1 to 25.6% in year 10 (P=0.029). Tobacco use was strongly associated with the prevalence of oral leukoplakia. As the overall prevalence of smokeless tobacco use fell, the prevalence of oral leukoplakia in the entire population declined; falling from 22.6% of all participants in year 1 to only 9.4% in year 10 (P<0.001). The prevalence of smokeless tobacco use showed a steady decline in this professional baseball organization over the 10 yr of the study, with a concomitant decline in the prevalence of oral leukoplakia in this population. We postulate that changes in league rules regarding tobacco use and regular education and support for tobacco cessation might explain the declining use.

Prevalence of oral cancer and potentially malignant lesions among shammah users in Yemen

The purpose of this study was to assess the prevalence of oral precancerous lesions and squamous cell carcinoma (OSCC) in Yemeni users of shammah, a traditional smokeless tobacco habit known in the Arabian Peninsula. The study group comprised 199 male and one female shammah users who were interviewed via a standardised questionnaire and clinically examined in 48 Yemeni villages and cities. Cases with oral leukoplakia (OL) or mucosal burns (MB) were compared with users without any lesion. MB were detected in 31%, of which 46.8% were located on the tongue or floor of the mouth, and OL in 27%, of which 59.2% were located in the same region. In addition, two cases (1%) of apparent OSCC were identified. Statistically significant increased OR (95% CI) of OL were (a) 6.91 (2.66-17.95) for an average duration of the respective shammah application >5min.; (b) 4.90 (1.99-12.08) for a daily frequency of those applications >10; and (c) 4.22 (1.43-12.43) for a daily duration >6h of chewing qat, also a traditional habit in Yemen. Likewise, decreased OR were (a) 0.39 (0.18-0.85) for rinsing the mouth after the shammah application; (b) 0.36 (0.17-0.78) for successful attempts to stop the use in the past; and (c) 0.26 (0.09-0.72) for existing knowledge about the carcinogenicity of shammah that was present in only 19% overall. In conclusion, evidence was shown for a significant association between the prevalence of OL and the daily duration of shammah application in a dose-dependent manner. An appropriate public health program might help to reduce this potential OSCC burden in shammah users.

Oral cancer and pre‐cancer in Myanmar: a short review

Cancer in Myanmar is one of the 10 leading causes of morbidity and mortality. In 1974, the Yangon Cancer Registry was established. From 1974 to 2001 a total of 85 298 cancer cases were registered. From 1963 to 1972 the average annual incidence rate of oral cancer was calculated to be 363 per 100 000 population. The tongue was mostly affected (31.2%). In one study, the prevalence of oral leukoplakia was 1.7%, erythroplakia 0.1%, and submucous fibrosis 0.1%. No epidemiologic studies of the prevalence of betel quid chewing (BQC) in Myanmar have been performed. One study showed that among 773 individuals over the age of 6 years, 46.4% were habitual smokers. A recent symposium on oral health stressed the necessity to introduce concepts of prevention, focusing on BQC habits and smoking as high-risk factors for oral cancer and pre-cancer in Myanmar.

PD.35 Prevalence of oral leukoplakia and lichen planus in 1167 Iranian textile workers

PD.35 Prevalence of oral leukoplakia and lichen planus in 1167 Iranian textile workers

The prevalence of oral leukoplakia in 138 patients with oral squamous cell carcinoma

To determine the relationship between oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC), and to evaluate possible differences between those carcinomas with and without associated leukoplakia. A total of 138 patients were studied at the Stomatology Service of the University General Hospital, Valencia, Spain. These patients were divided into two groups: group 1, patients with oral cancer and leukoplakia, and group 2, patients with OSCC but with no associated premalignant lesions. The relationship between this precancerous lesion and the OSCC was evaluated, as well as the possible clinical and histological differences between the tumours of the two groups. Leukoplakia was detected in 27 (19.56%) patients with OSCC. No differences were found between the two groups regarding age and tumour location. However, statistically significant differences were observed with respect to the form, tumour stage and the presence of adenopathies in the cancers with and without leukoplakia; in that the tumours associated with leukoplakia were diagnosed as being at a more initial stage. Those patients with OL associated with oral cancer presented with tumours at a less advanced stage than those where no associated leukoplakia existed.

Prevalence of oral leukoplakia and lichen planus in 1167 Iranian textile workers.

To evaluate the prevalence of oral precancerous lesions in textile workers. A cross-sectional study was undertaken to assess a total of 1167 textile factory workers randomly selected from a total of 6947. An overall 97 women and 1070 men aged 18-69 years (mean=31.8 years) were studied. Regular smoking during the past 6 months was considered as the smoker group. Leukoplakia lesions were classified in accordance to Axell criteria [Axell T, Pindborg JJ, Smith CJ and Van-der-waal I (1996). J Oral Pathol Med 25: 49]. The results showed that 115 workers (9.9%) had red and white lesions. Among these 43 positive detections (3.7%) had leukoplakia and six cases (0.5%) had lichen planus. The smoking habits of the workers were limited to cigarette smoking. There was a statistically significant positive correlation between tobacco smoking and oral leukoplakia (P<0.001). There was a statistically significant positive correlation between tobacco smoking and leukoplakia in this relatively young cohort with generally mild tobacco use. The prevalence of leukoplakia had an inverse relationship with the level of education.

Primary prevention of mouth carcinoma and oral precancerous conditions

Epidemiologic data for the prevalence of oral cancer show marked geographic differences. The incidence of oral cancer in younger individuals seems to be on the increase. Prevalence of oral leukoplakia in German men is 2.3%, in women 0.9%. Risk factors for oral cancer and most variants of oral leukoplakia are identical. Etiologically, tobacco and alcohol are the most important factors. Tobacco in smoked, chewed or snuffed varieties has toxic, tumorigenic and carcinogenic properties. Consumption of tobacco has markedly increased during the last 15 years in some geographic areas. In Germany tobacco consumption has increased 7.5% during the last 4 years. Alcohol affects the permeability of oral mucosa. Oral cancer as well as most forms of oral leukoplakia are avoidable diseases. Strategies for prevention encompass primary, secondary and tertiary prevention. Primary prevention focuses on principal avoidance of tobacco. Anti-tobacco counselling and therapy is actively practiced in dental practices in some countries. Intervention includes the 4 A's as principles (ask, advise, assist, arrange) and is based on nicotine replacement therapy. General dental practice and hospital dentistry should introduce the principles of primary prevention of tobacco consumption. A questionnaire which was sent to EU countries indicated that dental teams are willing to introduce tobacco and alcohol counselling and relevant prevention strategies.

The association between smoking cessation and periodontal status and salivary proteinase levels.

Little information is available about the effects of the cessation of cigarette smoking on oral health, although cigarette smoking has been shown to be associated with a variety of oral diseases. The aim of this study was to compare periodontal status, salivary proteolytic activity, especially collagenase-2 (MMP-8) levels, and oral mucosal status in individuals who had quit smoking for at least 6 months (mean 3.5, SD 1.3 years) and in regular smokers. The subjects were 409 white male smokers aged 55 to 74 years with 15 or more remaining teeth. They had participated in a major cancer prevention study (ATBC Study). Eighty-two of the men had given up smoking and 327 were smokers. The subjects were examined clinically to determine the prevalence of periodontal pockets, gingival bleeding (BOP) and suppuration, and prevalence of keratotic oral mucosal lesions. The loss of alveolar bone was determined radiographically. Candida albicans was cultivated, and lesions showing leukoplakia were examined histopathologically. General proteolytic activity and collagenase-2 or matrix metalloproteinase-8 (MMP-8) levels in saliva, salivary pH, and buffering capacity were measured. Linear regression, logistic regression, or Fisher's exact test were used in statistical analysis. Salivary general proteolytic activity and MMP-8 levels were lower in current smokers than in ex-smokers (P <0.05 and P <0.05, respectively). The prevalence of > or = 4 mm deep pockets, gingival suppuration, and loss of crestal bone were statistically significantly lower (P = 0.003, P<0.001, and P<0.05, respectively) and salivary buffering capacity higher (P <0.05) in those who had quit smoking compared to current smokers; there was no difference in BOP. The prevalence of oral leukoplakia did not differ significantly between smokers and quitters, but was higher in those who smoked >15 cigarettes per day compared to quitters (odds ratio 3.5, 95% CI, 0.8 to 15.3). These data suggest that periodontal status and oral mucosal health are better in those who have quit cigarette smoking compared to current smokers. However, the data further suggest that smoking may significantly lower both general proteolytic enzyme activity and MMP-8 levels in saliva. Thus, care should be taken in interpreting results revealing salivary/mouthrinse proteinases as diagnostic markers for oral/periodontal disease activity.

Oral leukoplakia and adolescent smokeless tobacco use

The recent increase in smokeless tobacco (ST) use has prompted investigators to assess the health effects of ST use. This study attempted to evaluate the prevalence of oral leukoplakia among adolescent users and to determine factors associated with its presence. During their annual physical examination, 1116 teenaged football players (567 black, 546 white) answered a 34-question survey and received an oral screening examination. Results indicated that 0.5% of nonusers, 1.5% of previous users, and 13% of current users had clinically evident oral leukoplakia. Factors statistically associated with higher leukoplakia rates included history of ST use, regular ST use, years of ST use, and the weekly quantity consumed. Factors not associated included use of alcohol, use of cigarettes, type of ST used, and hours of ST use. One brand of snuff was found to be associated with a relative risk of leukoplakia higher than that of another brand of snuff. Overall, in ST users oral leukoplakia was six times more likely to develop than in nonusers. Earlier ages of ST use may lead to greater periods of use (in years) and to possible increases in deleterious long-term health effects in current adolescents.

Smokeless Tobacco Use and Health Effects Among Baseball Players

The effects of smokeless tobacco (ST) use were studied in 1109 members of major and minor league professional baseball teams during spring training in 1988. The prevalence of current ST use was 39%. The median age at initiation among users was 18 years, and the median duration of use was 5 years. Among users, 75% cited a snuff brand as their usual ST product. Oral leukoplakia was present in 46% (196/423) of current-week ST users and 1.4% (7/493) of nonusers (odds ratio, 60; 95% confidence interval, 28 to 130). Prevalence of oral leukoplakia among ST users increased with hours used per day and decreased with time lapsed since last use, and was higher in snuff users than in chewing tobacco users. Of the subjects with oral leukoplakia who underwent punch biopsy, 91 had benign hyperkeratosis and one had mild dysplasia. Overall prevalence of dental caries, gingivitis, and plaque did not differ between ST users and nonusers. In analyses confined to facial surfaces of mandibular incisor teeth, where ST is most commonly used, there were significant increases among users in both gingival recession and attachment loss. Users of ST did not differ from nonusers in blood pressure, pulse, total or high-density lipoprotein cholesterol level, or white blood cell count, but among users high-density lipoprotein cholesterol levels were inversely associated with serum cotinine levels. The major health effects of ST use among professional baseball players are oral leukoplakia and localized periodontal disease. The study population was young, physically fit, and characterized by relatively moderate short-term ST use.

The prevalence of smokeless tobacco use among adolescent male athletes

In assessing the prevalence and perceptions of use of smokeless tobacco among adolescent male athletes, several findings have public health implications. Almost a third of the sample had tried smokeless tobacco and 8% were current users. Racial differences between blacks and whites were remarkable. Differences in income strata and urban/rural settings were not significant. Peer influence was the major factor that initiated smokeless tobacco use. Abnormal mucosal findings were much more prevalent in those who had dipped smokeless tobacco than in those who had not. Most significant was a prevalence of oral leukoplakia in 5.2% of those who had ever dipped, which was 50 times that of nondippers. Using smokeless tobacco for more than 2 years or using more than three tins per week seemed to be of possible predictive value regarding the incidence of oral leukoplakia. Fifteen percent of current users had observable leukoplakia. Components necessary for effective intervention/prevention programs were elucidated with an emphasis on an increased role by dentists and other health professionals.

Survey of a population with a high incidence of oral and oesophageal cancer.

The results of a survey of a population with a high incidence of oral and oesophageal cancer are presented. The population under study appears to have several epidemiologic characteristics, some of which may be associated with a high incidence of oral and oesophageal cancer. A remarkably high proportion (41%) of the men surveyed were nass users and this habit, like the use of other types of tobacco mixtures, has been related to oral cancer. Oral leukoplakia and chronic oesophagitis (conditions thought to be precursors of oral and oesophageal cancer) have been diagnosed in 11% and 60%, respectively, of the persons examined. Analysis of the relationship between nass use, cigarette smoking, oral leukoplakia and oesophagitis revealed that the prevalence of oral leukoplakia is highest among cigarette smokers who use nass. It appears that nass use does not affect the frequency of occurrence of chronic oesophagitis. However, a slight elevation of the prevalence odds ratio was observed for current smokers and drinkers. Biochemical analysis of the blood of a random sample of the surveyed population revealed low levels of riboflavin, vitamin A and carotenoids--vitamins that most probably have a protective effect against the development of cancer. The mutagenicity test has shown that nass contains a chemical or chemicals that exert a genotoxic effect. Chemical analysis revealed the presence in nass of tobacco-specific N-nitroso compounds.

Prevalence of oral leukoplakia in Havana City, Cuba.

A survey related to the detection of precancerous lesions of the oral cavity has been done in Cuba for the first time. The sample comprised 749 randomly selected workers from Havana City Province, taking into account the census records of the Cuban population up to 1979. Prevalence of lesions and their relation to age, sex and predisposing factors, such as smoking, alcohol habits and mechanical trauma were studied. 4.4% of leukoplakia and preleukoplakia considered together and 2.1% leukoplakia alone, and two cases of oral lichen planus and leukokeratosis nicotina palati (0.1% of each) were found. The former lesions were more frequently encountered in people above 50 years old, specially in males and specifically among those who had smoked for more than 10 years. Sites of location most frequently encountered were the buccal mucosa and the labial commissures.