The prevalence of oral mucosal lesions in U.S. adults: data from the Third National Health and Nutrition Examination Survey, 1988-1994.
BACKGROUND
Most reports of oral lesion prevalence 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 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 a total of 6,003 lesions. Denture-related lesions (stomatitis, hyperplasia, ulcers, inflammation and angular cheilitis) composed 8.4 percent and tobacco-related lesions (smokeless tobacco-related and nicotinic stomatitis) composed 4.7 percent of all lesions. Discounting denture-related lesions, amalgam tattoos were the most prevalent lesions (3.30 percent), followed closely by cheek/lip bites (3.05 percent) and frictional white lesions (2.67 percent). Smokeless-tobacco users (odds ratio, or OR, = 3.90) and removable denture wearers (OR = 3.57) had the highest odds of having a lesion.


CONCLUSIONS
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.
Shulman
Jay D
JD
Department of Public Health Sciences, Baylor College of Dentistry, Texas A&M University System Health Science Center, Dallas 75246, USA. JShulman@bcd.tamhsc.edu
Beach
M Miles
MM
Rivera-Hidalgo
Francisco
F
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001734:Bites, Human / Q000453:epidemiology; D002613:Cheilitis / Q000453:epidemiology; D003723:Dental Amalgam; D003778:Dentures / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D017573:Focal Epithelial Hyperplasia / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000453:epidemiology*; D009061:Mouth Mucosa / Q000293:injuries; D019226:Oral Ulcer / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013282:Stomatitis, Denture / Q000453:epidemiology; D013653:Tattooing / Q000706:statistics & numerical data; D014030:Tobacco, Smokeless; D014481:United States / Q000453:epidemiology
D003723:Dental Amalgam