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Mukherjee A, Ferrao T, Spadigam AE, Dhupar A. Oral Epithelial Dysplasia in Tobacco Non-habitués: A Case Report and Review of Literature. Cureus 2023; 15:e47362. [PMID: 38022123 PMCID: PMC10657477 DOI: 10.7759/cureus.47362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Oral potentially malignant disorders (OPMDs) encompass a diverse group of clinical lesions, which, on histopathological evaluation, may reveal features of hyperplasia, oral epithelial dysplasia (OED), or even early invasive squamous cell carcinoma. OEDs are often perceived to be associated with a deleterious habit such as tobacco chewing. It has emerged that OEDs may occur even in the absence of a tobacco habit and could be attributed to factors such as trauma, chronic inflammation, and inherent genetic aberrations. Authors have reported a preponderance of such lesions in young females, particularly at sites distinct from those noted in habitués. Additionally, the probability of malignant transformation of OED has been reported to be higher in non-habitués as compared to habitués when lesions are left unaddressed. There remains a paucity of data regarding the exact molecular basis, behavior, and response to treatment of OED among tobacco non-habitués. In view of the increasing number of oral lesions demonstrating epithelial dysplasia in the absence of exposure to significant risk factors, we highlight the scenario with a case. A 39-year-old female, non-habitué, presented with a non-scrapable, white lesion on the maxillary buccal gingiva. Incisional biopsy revealed features of moderate epithelial dysplasia that, on further evaluation of the excisional specimen, confirmed features of severe epithelial dysplasia. Genotyping for human papillomavirus (HPV) was carried out to assess the presence of high-risk HPV strains (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68), which are usually associated with OED and/or oral squamous cell carcinomas (OSCCs) in non-habitués. A comprehensive review of various tissue and molecular factors, which play a key role in the pathophysiology of non-habit-associated OED has been illustrated in this report. While the etiological focus of OPMDs is often directed toward deleterious habits and exposure to carcinogens, it is essential to be vigilant for this entity even among non-habitués. A meticulous screening of the oral cavity, for all patients, shall facilitate the prevention and early diagnosis of OED, particularly in individuals not exposed to habit-forming risk factors.
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Affiliation(s)
- Anupama Mukherjee
- Oral and Maxillofacial Pathology, Goa Dental College and Hospital, Bambolim, IND
| | - Twyla Ferrao
- Oral and Maxillofacial Pathology, Goa Dental College and Hospital, Bambolim, IND
| | - Anita E Spadigam
- Oral and Maxillofacial Pathology, Goa Dental College and Hospital, Bambolim, IND
| | - Anita Dhupar
- Oral and Maxillofacial Pathology, Goa Dental College and Hospital, Bambolim, IND
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Muacevic A, Adler JR. Role of Advanced Diagnostic Aids in the Detection of Potentially Malignant Disorders and Oral Cancer at an Early Stage. Cureus 2023; 15:e34113. [PMID: 36843823 PMCID: PMC9949752 DOI: 10.7759/cureus.34113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/20/2023] [Indexed: 01/25/2023] Open
Abstract
One of the most prevalent malignancies diagnosed today is cancer of the mouth or oral cancer. Compared to systemic malignancies like lung cancer, colon cancer, etc., oral cancer tends to get less attention from the general public. However, these lesions may be lethal if not treated, even if diagnosed early. Early diagnosis improves the prognosis for successful therapy. Delayed diagnosis is hypothesized to be a pivotal contributor to the dismal oral cancer survival rate over five years. The current standard of care for diagnosis and detection is based on clinical evaluation, the histological study of biopsy material, and genetic methods. There have been several advancements in the diagnostic technologies available to detect oral cancer at the initial phase. This study aims to dissect the cutting-edge methods for detecting oral cancer in its earliest stages.
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Affiliation(s)
- Alexander Muacevic
- Department of Oral Maxillofacial Surgery (OMFS) and Diagnosis Sciences, College of Dentistry, Riyadh Elm University, Riyadh, SAU
| | - John R Adler
- Department of Oral Maxillofacial Surgery (OMFS) and Diagnosis Sciences, College of Dentistry, Riyadh Elm University, Riyadh, SAU
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Shah JS, Dubey J. Prevalence and factors associated with oral potentially malignant disorders and oral squamous cell carcinoma: An institutional study. J Cancer Res Ther 2023; 19:S536-S544. [PMID: 38384016 DOI: 10.4103/jcrt.jcrt_759_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/04/2022] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Incidence & prevalence of OPMDs & OSCC is increasing day by day, thereby escalating the burden of oral cancer in India. Oral cancer ranks in the top three of all cancers in India and is quickly becoming a health priority. This study aims to assess prevalence and associated factors of OPMDs and OSCC in patients attending dental OPD and its association with age, gender, habit (type & duration), clinical presentation and site of involvement. MATERIAL AND METHODS A prospectively 12 months study was conducted in the outpatient department. Patient's data whether suspected or proven cases of OPMDs & OSCC and fits in clinical criteria were reviewed and analysed for demographic data, oral adverse habit, clinical presentation and site of involvement. RESULTS Overall 38,588 patient's data were analysed for 12 month time duration. Out of this 552 (1.43%) cases of OPMDs and 58 (0.15%) cases of OSCC were reported. Out of 552 maximum patients were reported with OSMF (34.4%), followed by other lesions and minimum with LP (7.9%). Age group most commonly affected was above 45 years (44.9%) of age. Males (81.1%) were affected more than females. OPMDs (92%) and OSCC (96.5%) were mostly associated with smokeless or smoking form of tobacco. CONCLUSION Present study evaluated the prevalence rates and associated factors of OPMDs & OSCC, which is beneficial for general practitioner in early diagnosis, formulating better treatment plan and to educate general population about risk factors, early signs and symptoms of these lesions.
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Affiliation(s)
- Jigna S Shah
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Ahmedabad, Gujarat, India
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Hadjigol S, Shah BA, O’Brien-Simpson NM. The 'Danse Macabre'-Neutrophils the Interactive Partner Affecting Oral Cancer Outcomes. Front Immunol 2022; 13:894021. [PMID: 35784290 PMCID: PMC9243430 DOI: 10.3389/fimmu.2022.894021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/12/2022] [Indexed: 12/11/2022] Open
Abstract
Over the past few decades, tremendous advances in the prevention, diagnosis, and treatment of cancer have taken place. However for head and neck cancers, including oral cancer, the overall survival rate is below 50% and they remain the seventh most common malignancy worldwide. These cancers are, commonly, aggressive, genetically complex, and difficult to treat and the delay, which often occurs between early recognition of symptoms and diagnosis, and the start of treatment of these cancers, is associated with poor prognosis. Cancer development and progression occurs in concert with alterations in the surrounding stroma, with the immune system being an essential element in this process. Despite neutrophils having major roles in the pathology of many diseases, they were thought to have little impact on cancer development and progression. Recent studies are now challenging this notion and placing neutrophils as central interactive players with other immune and tumor cells in affecting cancer pathology. This review focuses on how neutrophils and their sub-phenotypes, N1, N2, and myeloid-derived suppressor cells, both directly and indirectly affect the anti-tumor and pro-tumor immune responses. Emphasis is placed on what is currently known about the interaction of neutrophils with myeloid innate immune cells (such as dendritic cells and macrophages), innate lymphoid cells, natural killer cells, and fibroblasts to affect the tumor microenvironment and progression of oral cancer. A better understanding of this dialog will allow for improved therapeutics that concurrently target several components of the tumor microenvironment, increasing the possibility of constructive and positive outcomes for oral cancer patients. For this review, PubMed, Web of Science, and Google Scholar were searched for manuscripts using keywords and combinations thereof of "oral cancer, OSCC, neutrophils, TANs, MDSC, immune cells, head and neck cancer, and tumor microenvironment" with a focus on publications from 2018 to 2021.
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Affiliation(s)
- Sara Hadjigol
- ACTV Research Group, Division of Basic and Clinical Oral Sciences, Centre for Oral Health Research, Melbourne Dental School, Royal Dental Hospital, The University of Melbourne, Carlton, VIC, Australia
| | | | - Neil M. O’Brien-Simpson
- ACTV Research Group, Division of Basic and Clinical Oral Sciences, Centre for Oral Health Research, Melbourne Dental School, Royal Dental Hospital, The University of Melbourne, Carlton, VIC, Australia
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Machine-Learning Applications in Oral Cancer: A Systematic Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115715] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Over the years, several machine-learning applications have been suggested to assist in various clinical scenarios relevant to oral cancer. We offer a systematic review to identify, assess, and summarize the evidence for reported uses in the areas of oral cancer detection and prevention, prognosis, pre-cancer, treatment, and quality of life. The main algorithms applied in the context of oral cancer applications corresponded to SVM, ANN, and LR, comprising 87.71% of the total published articles in the field. Genomic, histopathological, image, medical/clinical, spectral, and speech data were used most often to predict the four areas of application found in this review. In conclusion, our study has shown that machine-learning applications are useful for prognosis, diagnosis, and prevention of potentially malignant oral lesions (pre-cancer) and therapy. Nevertheless, we strongly recommended the application of these methods in daily clinical practice.
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Kaunein N, Ramani RS, Koo K, Moore C, Celentano A, McCullough M, Yap T. A Systematic Review of MicroRNA Signatures Associated with the Progression of Leukoplakia with and without Epithelial Dysplasia. Biomolecules 2021; 11:biom11121879. [PMID: 34944523 PMCID: PMC8699326 DOI: 10.3390/biom11121879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 01/07/2023] Open
Abstract
Oral cancer is a significant public health issue, being the eighth most common cancer worldwide with over 300,000 cases diagnosed annually. Early diagnosis and adequate management of oral potentially malignant disorders (OPMDs) before transformation into oral squamous cell carcinoma (OSCC) is critical to reduce deaths, morbidity, and to improve overall prognosis. MicroRNAs (miRNAs) are small noncoding RNAs involved in the post-transcriptional regulation of protein expression and implicated in the control of numerous cellular pathways and impacting physiological, developmental, and pathological processes. Dysregulation of miRNAs has been reported in many cancers and has been demonstrated to play a critical role in cancer initiation, progression, apoptosis, invasion and metastasis. This systematic review provides a comprehensive summary of the prevailing literature on miRNA signatures in OPMDs, specifically leukoplakia with or without oral epithelial dysplasia, and their utility in predicting malignant transformation into OSCC. Eighteen articles describing 73 unique and differentially expressed microRNAs met the criteria for inclusion in this review. We reviewed the characteristics and methodology for each of these studies and assessed the sensitivity and specificity of the studied miRNAs in predicting malignant transformation. This systematic review highlights the significant interest in miRNAs and their tremendous potential as prognostic markers for predicting the malignant transformation of OPMDs into OSCC.
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Affiliation(s)
- Nadia Kaunein
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia; (R.S.R.); (K.K.); (C.M.); (A.C.); (M.M.)
- Correspondence: (N.K.); (T.Y.); Tel.: +61-39-341-1485 (T.Y.)
| | - Rishi Sanjay Ramani
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia; (R.S.R.); (K.K.); (C.M.); (A.C.); (M.M.)
| | - Kendrick Koo
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia; (R.S.R.); (K.K.); (C.M.); (A.C.); (M.M.)
- Royal Melbourne Hospital, Victorian Comprehensive Cancer Centre, Parkville, VIC 3053, Australia
| | - Caroline Moore
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia; (R.S.R.); (K.K.); (C.M.); (A.C.); (M.M.)
| | - Antonio Celentano
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia; (R.S.R.); (K.K.); (C.M.); (A.C.); (M.M.)
| | - Michael McCullough
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia; (R.S.R.); (K.K.); (C.M.); (A.C.); (M.M.)
| | - Tami Yap
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia; (R.S.R.); (K.K.); (C.M.); (A.C.); (M.M.)
- Royal Melbourne Hospital, Victorian Comprehensive Cancer Centre, Parkville, VIC 3053, Australia
- Correspondence: (N.K.); (T.Y.); Tel.: +61-39-341-1485 (T.Y.)
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Oral potentially malignant disorders: clinical diagnosis and current screening aids: a narrative review. Eur J Cancer Prev 2021; 29:65-72. [PMID: 30921006 DOI: 10.1097/cej.0000000000000510] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Around 300 000 patients are estimated to have oral cancer worldwide annually, and the incidence is higher in South Asian countries. In 2005, at the Congress of WHO, the term potentially malignant disorder (PMD)/lesion was suggested as a replacement for premalignant oral lesions and conditions. PMDs are those lesions of the oral mucosa that are at an increased risk of malignant transformation compared with the healthy mucosa. PMDs consist of leukoplakia, erythroplakia, oral lichen planus, oral submucous fibrosis, and other miscellaneous lesions. A literature search was performed using PubMed, Scopus, and Web of Science without any language restrictions. There is no standardized method for identifying a site for biopsy and various methods such as toluidine blue stain, methylene blue, Lugol's iodine, and chemiluminescence have been proposed in the literature. Despite easy access to the oral cavity, there has been significant mortality associated with oral cancer as they are often diagnosed late because of the inability of healthcare professionals to identify them at early premalignant states. This article aims to provide healthcare professionals with the knowledge to identify potentially malignant disorders and to aid them in biopsy site identification.
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Ghazi N, Khorasanchi M. Markers associated with malignant transformation of oral lichen planus: A review article. Arch Oral Biol 2021; 127:105158. [PMID: 34022545 DOI: 10.1016/j.archoralbio.2021.105158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 11/29/2022]
Abstract
Oral lichen planus (OLP) is one of the autoimmune diseases associated with chronic inflammation that involves several complications including the potential for malignant transformation into oral squamous cell carcinoma. Pathogenesis of OLP are yet to be fully comprehended however, it has been demonstrated that the epithelial cells in OLP lesions are affected by cytotoxic T lymphocytes leading to immunological reactions. Various factors are reported to act as diagnostic markers for predicting and monitoring the cancerous progression. Hence, in this review, we summarize and present the latest studies regarding the predictive markers associated with malignant potential of OLP.
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Affiliation(s)
- Narges Ghazi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Maryam Khorasanchi
- Student Research Committee, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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Srivastava R, Sharma L, Pradhan D, Jyoti B, Singh O. Prevalence of oral premalignant lesions and conditions among the population of Kanpur City, India: A cross-sectional study. J Family Med Prim Care 2020; 9:1080-1085. [PMID: 32318471 PMCID: PMC7114062 DOI: 10.4103/jfmpc.jfmpc_912_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 12/04/2019] [Accepted: 12/26/2019] [Indexed: 02/06/2023] Open
Abstract
Background The habit of smoking and chewing tobacco is associated with various types of oral mucosal lesions and conditions, many of which pose a potential threat to cancer growth. The present study aims to evaluate the prevalence of potentially malignant lesions (PML) and oral cancer in North India and to identify the associated risk factors. Materials and Methods A cross-sectional study was carried out in the Department of Oral Medicine and Radiology Rama Dental College Hospital and research center Kanpur over a period of 5 years with1,10,625 patients. Participants were divided into study group with a positive history of the chewing habit as well as oral lesions and control group who had a positive history of habits with no oral lesions. Detailed case history and clinical examination were carried out under visible light by trained professionals to assess any oral mucosal changes. Results The study group consisted of 76.31% males and 23.69% females. In total, 84.34% participants in the study group were literate. However, 57.56% subjects were having oral submucous fibrosis, 23.7% were having leukoplakia, 13.12% were having Lichen planus, and 5.62% were having oral cancer. Conclusion Results from the present study indicate that tobacco smoking, chewing of betel quid with and/or without tobacco chewing are the major risk factors for PML and oral cancer.
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Affiliation(s)
- Rahul Srivastava
- Department of Oral Medicine and Radiology, Rama Dental College Hospital and Research Centre, Kanpur, India
| | - Lokesh Sharma
- Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, India
| | - Devina Pradhan
- Department of Public Health Dentistry, Rama Dental College Hospital and Research Centre, Kanpur, India
| | - Bhuvan Jyoti
- Department of Dental Surgery, Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi, Jharkhand, India
| | - Omveer Singh
- Department of Public Health Dentistry, King George Medical University, Lucknow, Uttar Pradesh, India
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Bugshan A, Farooq I. Oral squamous cell carcinoma: metastasis, potentially associated malignant disorders, etiology and recent advancements in diagnosis. F1000Res 2020; 9:229. [PMID: 32399208 PMCID: PMC7194458 DOI: 10.12688/f1000research.22941.1] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2020] [Indexed: 12/12/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is a commonly occurring head and neck cancer. It has a high prevalence in certain parts of the world, and is associated with a high mortality rate. In this review, we describe metastasis related to OSCC, and disorders that could lead to OSCC with common etiological factors. In addition, a brief account of the diagnosis of OSCC and role of salivary biomarkers in its early detection has also been highlighted. Google Scholar and PubMed search engines were searched with keywords including “oral squamous cell carcinoma”, “OSCC”, “oral cancer”, “potentially malignant disorders in oral cavity”, “etiological factors of OSCC”, “diagnosis of OSCC”, and “salivary biomarkers and OSCC” to gather the literature for this review. The review concludes that OSCC has the potential for regional as well as distant metastasis, and many potentially malignant diseases can transform into OSCC with the help of various etiological factors. Diagnosis of OSCC involves traditional biopsy, but salivary biomarkers could also be utilized for early recognition.
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Affiliation(s)
- Amr Bugshan
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia
| | - Imran Farooq
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia
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Knowledge assessment among the fourth and fifth year students on the potentially malignant lesions of oral cavity. BALKAN JOURNAL OF DENTAL MEDICINE 2020. [DOI: 10.2478/bjdm-2020-0003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background/Aim: Potentially malignant oral lesions (PMOL) are lesions that have an increased risk of malignant transformation concerning healthy oral mucosa. This research aimed to assess the knowledge of students of final years of study on the potentially malignant lesions of the oral cavity. Material and Methods: 120 students of the fourth and fifth years of study participated in this research,60 respondents were fourth-year students, 60 respondents were fifth-year students. All of the respondents signed informed consent.According to the type of research, this is a cross-sectional study which was conducted by completing a 15-item questionnaire. The results were statistically analyzed and processed in the SPSS Statistics 21.0 program. Results: The results indicate that during the clinical examination the fourth and fifth-year students examine the oral mucosa as well. 61% of the students find themselves poorly informed on the PMOL. In the fourth year of study, only 5,5% of students responded that they were well informed, while in the fifth year that number totaled 28,5%. When knowledge self-assessment is concerned the difference has shown itself to be statistically significant between the fourth and fifth-year students. When asked what knowledge on the prevention of oral cancer they expect to receive during their studies, 78% of the students expected more knowledge than at that moment - 36% of which were fifth-year students, and 42% were fourth-year students. Conclusions: Even though the oral cavity is easily accessible to examination, the discovery of oral cancer occurs quite late. Ours, as well as results of other studies, impose the need for better theoretical and practical education of the students.
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Saintrain MVDL, Bandeira ABV, Pequeno LL, Bizerril DO, Marques PLP, Viana FAC. Oral health of older people: tracking soft tissue injuries for the prevention of oral cancer. Rev Esc Enferm USP 2018; 52:e03380. [PMID: 30484486 DOI: 10.1590/s1980-220x2017033603380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 05/15/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To detect oral soft tissue injuries in older people. METHOD A quantitative analytical cross-sectional study conducted in Fortaleza, Ceará. Individual interviews addressed age, gender, marital status, income, and education. The community oral health indicator was used to detect oral soft tissue injuries and their location. RESULTS Most of the 821 participants aged 60-100 years were women (580; 70.6%), attended school for up to 5 years (401; 48.8%), were illiterate (201; 24.5%), were retired (608; 74.1%), and received up to 2 wages (701; 85.4%). A total of 604 participants (73.6%) wore dentures. Injuries included red patches (152; 55.9%), blisters (58; 21.3%), lesions and/or wounds (39; 14.3%), and white patches (30; 11%). Locations of injuries were the roof of the mouth (167; 61.4%), gums (62; 22.8%), cheeks (39; 14.3%), tongue (15; 5.5%), lips (15; 5.5%), and the floor of the mouth (12; 4.4%). Injuries were associated with age (p<0.001), retirement (p=0.005), education (p=0.010), dentures (p<0.001) and red patches (p<0.001). CONCLUSION Tracking soft tissue injuries and referring older adults with suspected malignant lesions to the health team should be included as oral cancer identification and prevention measures. Furthermore, health care providers should raise older adults' awareness of the importance of regular preventive examinations.
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