The prevalence of oral mucosal lesions in US adults - Data from the Third National Health and Nutrition Examination Survey, 1988-1994

Background. Most reports of oral lesions prevalance are based on studies of atypical populations. There are no published studies on oral mucosal lesion prevalence in U.S. adults that are based on a national probability sample. Methods. The Third National Health and Nutrition Examination Survey, or NHANES III employed a complex, multistage sample of 33,994 civilian, noninstitutionalized people from from 19,528 households. Dentist examiners were trained to recognize, classify and record in a standardized manner the clinical characteristics of each of the 48 conditions of interest to include diagnosis, size, location, surface morphology, color consistency, pain, duration and history using procedures based on the World Health Organization's Guide to Epidemiology and Diagnosis of Oral Mucosal Diseases. Results. Examinations were performed on 17,235 people aged 17 years and older, of whom 4,801 (27.9 percent) had total of 6,003 lesions. Denture-related lesions (stomatitis, hyperplasia, ulcers, inflammation and angular cheilitis) composed 8.4 percent and tobacco-related lesions (smoke less tobacco-related and nicotine stomatitis) composed 4.7 percent of all lesions. Discounting denture-related lesions, amalgam tattoos were the most prevalent lesions (3.30 percent), followed closely ny cheek/lip nited (3.05 percent). Smokeless-tobacco tobacco users (odds ratio, OR, = 3.90) and removable denture wearers (OR = 3.57) had the highest odds of having a lesion. Conclusion. Lesion prevalences differed significantly by age, sex, race/ethnicity denture wearing and tobacco use. When lesion-specific prevalences are cited in the literature , they should be stratified by covariates known to be associated with them.