title: Oral potentially malignant disorders in a large dental population.
abstract: OBJECTIVE
  Oral cancer (OC) may be preceded by clinically evident oral potentially malignant disorders (OPMDs). Oral carcinogenesis is a multistep process that begins as epithelial hyperplasia and progresses to oral epithelial dysplasia and finally to fully malignant phenotypes. The aim of our study was to estimate the prevalence of OPMDs in a large population of dental patients.
  
  
  METHODS
  Patients were seen in the Oral Diagnosis and Oral Medicine clinics at Boston University Henry M. Goldman School of Dental Medicine between July 2013 and February 2014 and received a comprehensive oral examination to identify any possible mucosal lesions. Patients with a suspected OPMD (submucous fibrosis, oral lichen planus, leukoplakia and erythroplakia) that did not resolve in 2-3 weeks received a biopsy for definitive diagnosis. Logistic regression models were used to explore the relationship between OPMDs and associated risk factors.
  
  
  RESULTS
  A total of 3,142 patients received a comprehensive oral examination [median age: 43 (range: 18-97); 54.3% females]. Among these, 4.5% had an oral mucosal lesion with 0.9% being an OPMD (one submucous fibrosis, three epithelial dysplasias, fourteen with hyperkeratosis/epithelial hyperplasia and nine with oral lichen planus). Males and current smokers were associated with higher odds of having OPMD (OR 1.7, 95% CI 0.8-3.8; OR 1.9, 95% CI 0.8-4.1). Increasing age was associated with having OPMDs (p<0.01).
  
  
  CONCLUSIONS
  Optimal oral visual screening for OC remains a simple and essential tool to identify any suspicious lesions and potentially increase survival. Although OPMDs were rare, our results confirm the importance of a thorough chairside screening by dentists and dental students to detect any mucosal changes.
authors.affiliation: Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, United States.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Villa
authors.affiliation: Department of General Dentistry, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, United States.
authors.forename: Anita
authors.initials: A
authors.lastname: Gohel
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D001706:Biopsy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000453:epidemiology* / Q000473:pathology*; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000209:etiology / Q000473:pathology; D015999:Multivariate Analysis; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D014481:United States / Q000453:epidemiology; D055815:Young Adult