Nass use,cigarette smoking,alcohol consumption and risk of oral and oesophageal precancer

In a cross sectional study, conducted in Uzbekistan, an area with a high incidence of oral and oesophageal cancer, 1569 men were interviewed regarding use of nass quid, cigarette smoking and alcohol drinking. All subjects in the study had an oral examination, and oesophagoscopy was performed in 1344 men. Nass use and cigarette smoking emerged as independent risk factors for oral leukoplakia. The prevalence odds ratio (OR) for life-time nass intake equivalent rose from 1.0 in never-users to 5.17 [95% confidence interval (CI), 3.10–8.61] in the highest category; for total pack-years of cigarettes smoked the risk rose from 1.0 in never-smokers to 10.03 (95% CI, 4.9–20.6) in the highest category. There was a significant trend in risk (P < 0.001), for both factors. In the group with oral leukoplakia, the effect of nass use and cigarette smoking appeared to be additive. Cigarette smoking was also found to be an independent risk factor for oesophageal lesions and was significantly associated with chronic oesophagitis. The risk of chronic oesophagitis in the group with the highest pack-years of cigarettes smoked was approximately double that among non-smokers [Odds ratio (OR) = 2.47; 95% CI 1.34–4.56]. There was a weak association between nass use and oesophageal pathology: the highest life-time intake equivalent was associated with an OR of 1.56 (95% CI 1.09–2.23). Alcohol intake was not found to be independently associated with the presence of oral and oesophageal precancerous lesions.     

The effects of chewing areca/betel quid with and without cigarette smoking on oral submucous fibrosis and oral mucosal lesions

OBJECTIVES: The purpose of this study was to investigate the risk of areca/betel quid chewing with or without cigarette smoking on oral submucous fibrosis (OSF) and other oral mucosal lesions. METHODS: A stratified case-control study was designed. There were in total 102 patients with oral mucosal lesions or OSF (confirmed pathologically) in the case group. OSF (n = 62) and oral mucosal lesions (n = 62) in 102 subjects were separately analyzed for men and women investigating their risks. RESULTS: For OSF, people with both smoking and chewing habits had a statistically significant odds ratio (OR) 8.68 (95% CI = 1.87, 40.23). For the group of people with chewing habit only and without any lifetime cigarette smoking habit, the OR was 4.51 (95% CI = 1.20, 16.94). For other oral mucosal lesions, people with mixed habits and chewing only had also significant risks (OR = 8.37 and 3.95, respectively). For both OSF and other oral lesions, the ORs of mixed habits and chewing only were both higher in women than in men. Conclusions: The areca/betel quid used in Taiwan does not contain any tobacco product. The only way of areca/betel quid could synergize with any tobacco product is through cigarette smoking. A statistically significant association with oral mucosal lesions and OSF was still found in the group of areca/betel quid chewing only.     

Oral problems and quality of life of preschool children: self‐reports of children and perception of parents/caregivers

The purpose of this study was to evaluate the association between oral health problems and oral health‐related quality of life (OHRQoL) of preschool children according to both self‐reports and the reports of parents/caregivers. A school‐based, cross‐sectional study was conducted with 769 preschool children and their parents/caregivers. The OHRQoL was evaluated using the Scale of Oral Health Outcomes for Five‐Year‐Old Children (SOHO‐5). Based on logistic regression for complex samples, the following variables were found to be associated with poorer OHRQoL in the parent/caregiver version: toothache (OR = 6.77; 95% CI: 3.95–11.59); consequences of untreated dental caries (OR = 2.69; 95% CI: 1.27–5.70); and anterior open bite (OR = 2.01; 95% CI: 1.13–3.56). The following variables were associated with poorer OHRQoL in the child self‐report version: toothache (OR = 3.34; 95% CI: 2.11–5.29); cavitated lesions (anterior teeth) (OR = 2.20; 95% CI: 1.26–3.84); occurrence of traumatic dental injury (OR = 1.77; 95% CI: 1.19–2.61); and anterior open bite (OR = 1.95; 95% CI: 1.16–3.29). We conclude that children with dental caries (or its sequelae) had poorer OHRQoL. Having experienced a traumatic dental injury and having a malocclusion were also associated with a poorer OHRQoL.     

Risk factors associated with oral lesions in HIV-infected heterosexual people and intravenous drug users in Thailand

This study aimed to identify factors associated with the presence of oral lesions in HIV-infected individuals in Thailand, to determine the influence of gender and route of HIV transmission on the prevalence of the lesions, and to investigate whether total lymphocyte cell counts can be used as a serologic marker to predict the occurrence of oral lesions. Two hundred and seventy-eight HIV-infected heterosexual persons and intravenous drug users (IVDUs) were enrolled (230 males, 48 females). Eighty-six HIV-free subjects from the same population were included as controls (61 males, 25 females). Oral candidiasis was the most common oral lesion among HIV-infected individuals (39.6%), followed by hairy leukoplakia (HL) (26.3%), exfoliative cheilitis (18.3%), and linear gingival erythema (LGE) (11.5%). Odds ratios (ORs) for factors associated with the presence of oral lesions were as follows for advanced HIV disease defined by clinical status: symptomatic stage [OR= 18.6; 95% confidence interval (CI) 7.3-47.2], AIDS stage [OR 7.3; 95% CI 3.4-15.7] and laboratory investigation of total number of lymphocyte cell counts of 1,000-2,000 cell/mm3 [OR 2.7; 95% CI 1.4-5.1] and <1,000 cell/mm3 [OR 4.0; 95% CI 2.3-7.0], alcohol consumption [OR 3.4; 95% CI 1.3-9.1], and poor oral health [OR 1.7; 95% CI 1.0-2.9]. Men were significantly more likely to have oral lesions than women. No statistically significant difference in the presence of oral lesions was observed between heterosexuals and IVDUs. This study should help predict the risk of acquiring various types of oral lesions, given that the person is exposed to multiple risk factors compared to another who is not exposed to these factors.     

Mode of HIV transmission associated with risk of oral lesions in HIV‐infected subjects in Thailand

J Oral Pathol Med (2010) 39 195–200 Background: The aim of this study was to determine if route of human immunodeficiency virus (HIV) transmission is associated with the risk of oral lesions in HIV‐infected subjects in Thailand. Methods: A cross‐sectional study was performed in 186 HIV‐infected heterosexuals (aged 21–65 years, mean 32 years), and 82 HIV‐infected intravenous drug users (IVDUs) (aged 16–50 years, mean 30 years). The following information was recorded: route of HIV transmission, total lymphocyte cell counts, weight, smoking habit, alcohol consumption, medications, presence of denture, plaque index, and presence of oral lesions. The association between mode of HIV transmission and the risk of oral lesions among the subjects was determined by multiple logistic regression analysis. Results: Oral lesions were found in 138 HIV‐infected heterosexuals (75%) and in 37 HIV‐infected IVDUs (46%). Oral candidiasis (OC) was the most common lesion among both groups (44% vs. 28%), followed by hairy leukoplakia (HL) (33% vs. 10%). Multiple logistic regression analysis showed a significant association between mode of HIV transmission and the risk of oral lesions after controlling for the total lymphocyte cell counts and other confounding factors [OR 3.1; 95% CI 1.5–6.4; P = 0.002]. OC was significantly associated with heterosexual route of HIV transmission [OR 2.4; 95% CI 1.2–4.7; P = 0.014]. Similar association was also observed with HL [OR 3.7; 95% CI 1.5–9.1; P = 0.004]. Conclusions: Mode of HIV transmission is associated with the risk of oral lesions in HIV‐infected subjects in Thailand. Further studies should be performed to determine if the risk of oral lesions is associated with differences in HIV‐subtypes.     

Does smoking increase the incidence of postoperative complications in simple exodontia?

Objective: To investigate whether smoking has adverse effects in simple exodontia. Methods: A single‐centre, prospective study of postoperative inflammatory complications in simple exodontia was performed. All procedures were conducted under similar and sterile conditions. Postoperative complications (PCs) in exodontia were classified as alveolar osteitis (AO) or alveolar infection (AI) and their incidences then added. Results: A logistic regression model for PCs revealed tooth sectioning [odds ratio (OR) = 4.3, 95% confidence interval (CI) 1.0–18.8; P = 0.050], smoking (OR = 4.5, 95% CI 1.0–18.9; P = 0.03) and amount of smoking (> 20 cigarettes/day: OR = 12.3, 95% CI 1.0–149.8; P = 0.04) to be associated with the occurrence of PCs. Conclusions: Tooth sectioning, smoking and degree of smoking are all associated with the development of PCs such as AO and AI after simple exodontia. Dentists must be alert to these factors when performing simple exodontia in smokers in view of the increased risk for PCs.     

Oral manifestations in patients with aplastic anemia.

OBJECTIVE: The aim of the present study was to characterize the prevalence and risks of oral complications in aplastic anemia (AA). STUDY DESIGN: Approximately 79 patients with AA (age, 37 +/- 17 years) and 66 control patients with schizophrenia (age, 33 +/- 12 years) were examined. Records were reviewed for demographic, clinical, and radiographic information. Prior medical therapy, laboratory values, disease duration, and medical treatment response were noted for patients with AA. Odds ratios (OR) and 95% CI were calculated for oral manifestations in cases and in control subjects. Univariate analysis identified important variables for logistic regression. RESULTS: Patients with AA presented more frequently with oral petechiae (OR = 49; 95% CI, 2.9-825), gingival hyperplasia (OR = 27; 95% CI, 1.6-463.5), spontaneous gingival bleeding (OR = 27; 95% CI, 1.6-463.5), and herpetic lesions (OR = 27; 95% CI, 1.6-463.5). Prior cyclosporine use was associated with gingival hyperplasia (P =.0001). No other predictors for oral manifestations or treatment outcomes were found. CONCLUSIONS: Oral soft tissue changes and infections were more common in patients with AA. Prior cyclosporine use was predictive of the presence of gingival hyperplasia.     

Factors associated with prevalence and severity of caries experience in preschool children

Abstract – Objectives: The aim of the present study was to examine the prevalence and severity of caries experience in the primary dentition of preschool children and to assess the association of disease distribution with oral hygiene levels, reported oral health behaviours and socio‐demographic factors. Methods: Study samples comprised 1250 3‐year‐old and 1283 5‐year‐old pre‐school children from four distinct geographical areas in Flanders. Information on oral hygiene and dietary habits, oral health behaviours and socio‐demographic variables was collected using questionnaires completed by the parents. Clinical examinations were performed using standardized criteria. Caries experience was recorded at the level of cavitation (d₃ level). Simple as well as multivariable logistic regression analyses were performed in order to identify factors associated with prevalence and severity of caries experience. Results: Visible plaque was present in 31% of 3‐year‐olds and 37% of 5‐year‐olds. In 3‐year‐olds, 7% presented with caries experience while this was the case in 31% of 5‐year‐olds. Multivariable logistic regression revealed significant associations, in 3‐year‐olds, of caries experience with presence of dental plaque (OR = 7.93; 95% CI: 2.56–24.55) and reported consumption of sugared drinks at night (OR = 7.96; 95% CI: 1.57–40.51). In 5‐year‐olds, significant associations were seen with age (OR = 7.79; 95% CI: 2.38–25.43), gender (OR = 0.37 with 95% CI: 0.19–0.71 for girls), presence of visible dental plaque (OR = 3.36; 95% CI: 1.64–6.89) and reported habit of having sugar‐containing drinks in between meals (OR = 2.60 with 95% CI: 1.16–5.84 and OR = 3.18 with 95% CI: 1.39–7.28, respectively for 1×/day and > 1×/day versus not every day). In 5‐year‐olds with caries experience (30.8% of total sample), the severity of disease was further analysed (d₃mft between 1 and 4 versus d₃mft 5 or higher). Multivariable analyses showed a significant association with gender [girls more likely to have higher disease levels; OR = 4.67 (95% CI: 1.65–13.21)] and with presence of plaque (OR = 3.91 with 95% CI: 1.23–12.42). Conclusions: Presence of visible plaque accumulation and reported consumption of sugared drinks were associated with prevalence of caries experience in Flemish preschool children. Severity of disease was associated with gender and with presence of plaque. Results underline the importance of plaque control and diet management from very young age on.     

Oral pre-cancer and the associated risk factors among industrial workers in Japan''s overseas enterprises in the UK

BACKGROUND: Screening at industries has been advocated as a method of early detection for cancer. This study describes the prevalence of oral pre-cancerous lesions and other mucosal diseases following oral mucosal screening, and associated risk factors among Japanese industrial workers in the UK. METHODS: Oral mucosal screening was by invitation at 51 industrial locations in the UK. A self-administered questionnaire was used to record socio-behavioural factors and frequency of daily intake of fruits and vegetables. RESULTS: Four hundred and eighty-four subjects attended for oral mucosal screening (mean age 39.9 +/- 8.3 years) and their mean period of residence in UK was 5.3 +/- 4.5 years. 63.4% examined were male. 31.3% of males and 26.6% of females smoked daily. The gender differences were striking compared with Japan's national rates. A higher proportion of managerial staff was regular heavy (20+ per day) smokers. The intake of more than five portions per day of vegetables and/or fruits during the weekend was significantly higher in females than in males (P = 0.022). One hundred and six subjects (22%) were detected with oral mucosal lesions, including 16 leukoplakia lesions (3.3%) and three with oral lichen planus (1%). The rate of positive detections was higher in managers (7.5%). Odds ratios were estimated by socio-behavioural variables. Among subjects positive for oral leukoplakia, managers accounted for 68.8% (OR 5.26; 95% CI, 1.24-22.29). 87.5% of subjects detected with oral leukoplakia smoked daily and had done so for the past 10 years (OR 28.40; 95% CI, 5.63-143.28). Though regular alcohol drinking was a common feature among male leukoplakia cases, heavy alcohol misuse was not encountered. None reported an intake of five or more portions of fruits or vegetables. CONCLUSIONS: The Japanese nationals working in managerial positions in the UK and daily regular smokers in the industries visited were found to be at a high risk of oral pre-cancer. Regular dental/oral check up and tobacco education programmes are encouraged for oral cancer/pre-cancer control in industrial settings.     

Risk indicators for recurrent aphthous ulcers among adults in the US

BACKGROUND AND AIMS: Recurrent aphthous ulcers (RAU) in the oral cavity are painful, causing substantial morbidity in the US and elsewhere in the world. Despite this, there is a lack of population-based studies representative of the US national adult population to describe the epidemiology, and estimate the true disease burden and association with independent risk factors. Although several studies have investigated the role of various factors in RAU etiology, the epidemiology and etiology of RAU remain unclear. This study aims to establish the prevalence and describe the epidemiology of RAU in adults. METHODS: Data from the Third National Health and Nutrition Examination Survey (NHANES III) were analyzed in SUDAAN using multivariable logistic regression, modeling RAU occurrences. RESULTS: Overall, for all Americans regardless of age, prevalence of RAU was 1030 per 100,000 people (95% CI 830-1220). The prevalence of RAU among adults was 850 per 100,000 (95% CI 630-1070). The lower vestibule was the most commonly involved site. Multivariable analyses suggested that adjusted odds of RAU were greatest for those 17-29 years of age (adjusted OR 2.7; 95% CI 1.4-5.5), for men (adjusted OR 1.7; 95% CI 0.9-2.8), and for those with low serum insulin levels (OR 2.0; 95% CI 0.9-4.4). Never smokers had greater risk of RAU (OR 9.2, 95% CI 2.8-30.1) compared with those who smoked more than 10 cigarettes per day. CONCLUSION: This study establishes the prevalence of RAU among adults in the US and demonstrates that whereas cigarette smoking is associated with lesser odds, low insulin levels might be independently associated with greater odds of RAU.     

Demographic factors, denture status and oral health-related quality of life

OBJECTIVES: This study investigated the association between denture status, demographic factors, and oral health-related quality of life (OHRQoL). METHODS: OHRQoL was measured using the German version of the Oral Health Impact Profile (OHIP-G, 53 items), which was administered in a personal interview to 2050 subjects (60% of eligible subjects responded) 16-79 years of age in a national survey. Median regression was used to analyze the influence of denture status (no, removable, complete dentures), age, gender, education (less than 10 years of schooling, 10-12 years, more than 12 years), and residential area (rural, urban) on the OHIP-G summary score. RESULTS: In bivariable analyses, compared to the base category, the OHIP-G median increased 8.0 U for subjects with removable dentures, 20.0 U for subjects with complete dentures, 1.7 U for each 10-year age period, 2.0 U for men, 3.0 U for less than 10 years of schooling (compared to > or =10 years.), and 1.0 U for urban areas (P < 0.05 for all effects except for residential area). In the multivariable analysis, compared to subjects without dentures, subjects with removable dentures had a 7.5 (95% CI: 5.2-9.8) higher OHIP-G median and subjects with complete dentures had a 18.5 (95% CI: 14.7-22.4) higher median when demographic variables were controlled. No demographic variables were statistically significant except for residential area (P = 0.04). CONCLUSIONS: Denture status was a stronger predictor for impaired OHRQoL than demographic variables and rendered age and education almost negligible in their influence on OHRQoL.     

Assessment of risk factors for oral leukoplakia in West Virginia

OBJECTIVE: To assess risk factors associated with oral leukoplakia in a US population with high use of smoked tobacco and smokeless tobacco. METHODS: The RJ Gorlin Leukoplakia Tissue Registry was used to identify individuals with oral leukoplakia in West Virginia, USA. This case-control study consisted of 90 cases with oral leukoplakia and 78 controls with periapical cysts. Univariate-univariable (one dependent variable and one independent variable) and univariate-multivariable (one dependent variable and multiple independent variables) logistic regression modeling quantified the association between oral leukoplakia and potential explanatory variables. RESULTS: Unadjusted measures of association indicate that those with oral leukoplakia were more likely to be older [odds ratio of crude: OR(Crude) = 2.72; 95% confidence interval (CI): 1.45-5.11], more likely to currently use smokeless tobacco (OR(Crude) = 3.16; 95% CI: 1.10-9.07), and more likely to currently use snuff (OR(Crude) = 8.32; 95% CI: 1.83-37.80). Individuals currently using smokeless tobacco or currently using snuff were more likely to have oral leukoplakia [adjusted odds ratio, OR(Adj) = 9.21 and 30.08; 95% CI: 1.49-57.00 and 2.67-338.48, respectively], after simultaneously adjusting for age, gender, currently using smoked tobacco, currently using alcohol daily, and dental prostheses use. CONCLUSIONS: Generalizability is an issue when studying risk factors associated with oral leukoplakia because of geographical variations in the composition of smokeless tobacco (i.e. betel, lime, ash, and N-nitrosamines) and cultural variations in the use of tobacco (i.e. reverse smoking). Snuff was the main smokeless tobacco product currently used in West Virginia, and was strongly associated with oral leukoplakia, after adjusting for potential explanatory variables.     

Social gradients in oral health status in Korea population

ObjectivesThe aim of the present study was to investigate whether clinical (severe tooth loss) and subjective (chewing difficulties) indicators of oral health outcomes are associated with socioeconomic position and to explore the age-sex differences in the magnitude of the social gradient in Korea using data from the representative national data.MethodsData were acquired from 10,939 men and women, ≥30 years of age who participated in the Korea National Health and Nutrition Examination Surveys conducted from 2012 to 2014. Education and income were used as socioeconomic position. Self-rated chewing difficulties and severe tooth loss were assessed by dentists and trained interviewers. Confounding variables were demographic factors, general health behaviors, and systemic health status.ResultsSignificant differences in oral health outcomes were observed according to the quartiles of income and education. In particular, the quartiles of education were significantly associated with oral health outcomes in the fully adjusted model with a dose-response trend. In participants aged 40–49 (OR = 2.30, 95% CI = 1.37–3.88) and 50–59 years (OR = 2.16, 95% CI = 1.49–3.14), the associations between the lowest quartiles of income and chewing difficulties were stronger than in the total population.ConclusionsOur findings demonstrate a clear and distinct social gradient in clinical and subjective oral health indicators based on socioeconomic position.     

Prevalence of oral mucosal lesions in alcohol misusers in south London

BACKGROUND: Information on alcohol-associated oral mucosal lesions (OMLs) and conditions is meagre. A prevalence survey among alcohol misusers in south London was therefore undertaken. METHODS: Six hundred and ninety-three subjects (388 alcohol misusers and 305 alcohol + substance abuse) attending several clinical care facilities in south London between 1994 and 1999 were interviewed on their alcohol and drug habits. A comprehensive oral mucosal examination was performed, and soft tissue lesions found were classified by the clinical criteria of Axéll. RESULTS: Mean age of the sample was 40.5 years. The majority was white (92.6%); of the whites, 29.9% were Celts (i.e. Irish, Scots resident in London). Many subjects reported misusing more than one type of beverage. Two hundred and twenty-seven OMLs were found in 195 subjects (28.1%). The highest prevalences were found for frictional keratosis (8.8%), scar tissue of the lips (4.8%) and candidiasis (3.8%). Angular cheilitis was present in 21 subjects (3.0%). The alcohol-related OMLs detected were three white patches compatible with a diagnosis of leukoplakia and one treated oral carcinoma. No erythroplakias were detected. The differences in prevalence of mucosal lesions in the two groups were not significant (chi(2) = 2.18; P = 0.14). The prevalence of tobacco smoking was high in both study groups. OMLs were found with all four types of beverages consumed, and there was little variation by the units per week consumed. Concurrent use of substances and alcohol did not make a significant difference to the prevalence of OML. In the logistic regression analysis, minority ethnic groups (Black or Asian), smokers, those with a body mass index (BMI) under 20 and beer drinkers had an increased risk of an OML in this group of alcohol misusers. CONCLUSIONS: In comparison with previous oral mucosal screening programmes undertaken in several settings in the UK, the present study has yielded a higher prevalence of oral mucosal diseases and conditions in this risk population. There are several ways in which alcohol could contribute to these detected oral lesions, either directly or indirectly.     

Oral health care patterns and the history of miscarriage

Objective: Oral infections can trigger the production of pro‐inflammatory mediators that may be risk factors for miscarriage. We investigated whether oral health care patterns that may promote or alleviate oral inflammation were associated with the history of miscarriage in 328 all‐Caucasian women. Materials and methods: Of 328 women in this cross‐sectional cohort, 74 had history of miscarriage (HMC). Medical, dental and sociodemographic data were collected through clinical examinations, medical record searches and structured questionnaires. Results: The multivariate regression analyses indicated that urgency‐based dental treatment demonstrated a significant association [odds ratio (OR) = 2.54; 95% confidence interval (CI): 1.21–5.37; P = 0.01] and preventive dental treatment demonstrated a marginally significant inverse association (OR = 0.53; CI: 0.26–1.06; P = 0.07) with HMC. Self‐rated poor oral health had a non‐significant positive association with HMC (OR 1.60; CI: 0.88–2.90). Conclusion: Our results provide sufficient evidence for hypothesis generation to test whether other precise measures of oral inflammation are associated with adverse birth outcomes.     

Prevalence and associated factors of dental erosion in children and adolescents of a private dental practice

International Journal of Paediatric Dentistry 2011; 21: 451–458 Background. The prevalence of dental erosion seems to be rising in young populations, particularly among individuals of higher socioeconomic status. Aim. To assess the prevalence and associated factors of dental erosion in children and adolescents of a private dental practice. Design. A total of 232 participants, aged 2–20 years, were examined. Dietary habits, oral hygiene, and medical data were collected from dental records. Logistic regression analyses were conducted. Results. Dental erosion prevalence was of 25.43% and was highest on the occlusal surfaces (76%). Associated factors were: frequent consumption of soft drinks (OR = 2.33; 95% CI = 1.01–5.38) and candies (OR = 3.23; 95% CI = 1.25–8.32); and interaction between these two factors (OR = 3.95; 95% CI = 1.60–9.75). On anterior teeth, associated factors were: frequent consumption of fruits (OR = 2.53; 95% CI = 1.09–5.91); and age (OR = 1.07 95% CI = 1.01–1.14). Milk consumption was associated with a lower prevalence of dental erosion (OR = 0.40; 95% CI = 0.17–0.94). Conclusions. A relatively high prevalence of erosion was found in association with frequent intake of soft drinks, candies, and fruits. The consumption of milk seemed to protect against dental erosion on anterior teeth.     

Clinical and community risk models of incident tooth loss in postmenopausal women from the Buffalo Osteo Perio Study

Bole C, Wactawski‐Wende J, Hovey KM, Genco RJ, Hausmann E. Clinical and community risk models of incident tooth loss in postmenopausal women from the Buffalo Osteo Perio Study. Community Dent Oral Epidemiol 2010; 38: 487–497. © 2010 John Wiley & Sons A/S Abstract – Objective: While risk factors for tooth loss in adults have been identified, limited studies describing factors associated with incident tooth loss in postmenopausal women exist. This study assessed both clinical and non‐clinical risk factors for incident tooth loss. Methods: Postmenopausal women (N = 1341) were recruited between 1997 and 2000 from 1847 eligible Observational Study participants of the Buffalo, NY center of the Women’s Health Initiative who had complete dental examinations to assess alveolar bone height, soft tissue attachment and general oral health, and completed questionnaires concerning demographics, general health, lifestyle and oral health (72.6% participation rate). Five years later (2002–2005), 1021 women (76.1%) repeated these examinations and questionnaires. Incident tooth loss was determined by oral examination. Results: After an average 5.1 years of follow‐up (SD, 0.38), a total of 323 teeth were lost in 293 women, resulting in 28.7% of women with incident loss of at least one tooth. In multivariable models, diabetes history, gum disease history, smoking, previous tooth loss, BMI and plaque index, baseline clinical measures including alveolar crestal height (ACH) (OR = 1.22 per mm loss, 95% CI 1.11, 1.35), clinical attachment loss (CAL) (OR = 1.13 per mm loss, 95% CI 1.05, 1.23), and pocket depth (PD) (OR = 1.26 per mm loss, 95% CI 1.13, 1.41) were significant risk factors of incident tooth loss. In a community model that included no clinical measures, diabetes history (OR = 2.45, 95% CI 1.26, 4.77), prior gum disease (OR = 1.97, 95% CI 1.43, 2.70), ever smoking (OR = 1.42, 95% CI 1.06, 1.89), number of teeth lost at baseline (OR = 1.05 per tooth, 95% CI 1.02, 1.08), and BMI (OR = 1.15 per 5 km/m² increase, 95% CI 1.01, 1.33) were associated with an increased risk of incident tooth loss. Conclusions: Clinical and questionnaire‐based models were found to provide similar risk estimates for incident tooth loss in postmenopausal women. These models identified high‐risk postmenopausal women where preventive strategies may be targeted.     

Predictors of untreated dental decay among 15–34-year-old Australians

Abstract – Objectives: To determine predictors of untreated dental decay among 15–34‐year‐olds in Australia. Methods: Data were from Australia’s National Survey of Adult Oral Health, a representative survey that utilized a three‐stage, stratified clustered sampling design. Models representing demographic, socioeconomic, dental service utilization and oral health perception variables were tested using multivariable logistic regression to produce odds ratios. Results: An estimated 25.8% (95% CI 22.4–29.5) of 15–34‐year‐old Australians had untreated dental decay. After controlling for other covariates, those who lived in a location other than a capital city had 2.0 times the odds of having untreated dental decay than their capital city‐dwelling counterparts (95% CI 1.29–3.06). Similarly, those whose highest level of education was not a university degree had 2.1 times the odds of experiencing untreated dental decay (95% CI 1.35–3.31). Perceived need of extractions or restorations predicted untreated coronal decay, with 2.9 times the odds for those who perceived a treatment need over those with no such treatment need perception (95% CI 1.84–4.53). Participants who experienced dental fear had 2.2 times the odds of having untreated dental decay (95% CI 1.38–3.41), while those who reported experiencing toothache, orofacial pain or food avoidance in the last 12 months had 1.9 times the odds of having untreated dental decay than their counterparts with no such oral health‐related quality‐of‐life impact (95% CI 1.20–2.92). The multivariate model achieved a ‘useful’ level of accuracy in predicting untreated decay (area under the ROC curve = 0.74; sensitivity = 0.63; specificity = 0.73). Conclusions: In the Australian young adult population, residential location, education level, perceived need for dental care, dental fear, toothache, orofacial pain or food avoidance together were predictors of untreated dental decay. The prediction model had acceptable specificity, indicating that it may be useful as part of a triage system for health departments wishing to screen by means of a questionnaire for apparently‐dentally healthy 15–34‐year‐olds.     

Familial risk in oral and pharyngeal cancer

We examined the relationship between a family history of cancer and risk of roal and pharyngeal cancer using epidemiological data from a large case-control investigation of these tumours. 487 (45.7%) of the cases and 485 (41.0%) of the controls reported cancer in a parent or a sibling. After controlling for age, race, sex, study location, respondent status and smoking and alcohol use, the OR associated with any cancer in the family was 1.1 [95% confidence interval (CI) 0.9–1.3]. Risks were non-significantly elevated among those with a history of cancers arising from the oral cavity/pharynx (OR = 1.2, 95% CI 0.7–2.3), oesophagus/larynx (OR = 1.6, 95% CI 0.7–3.8) and lung (OR = 1.2, 95% CI 0.8–1.8), with the excess risk primarily among those for whom a male relative, particularly a brother, was affected with these smoking-related cancers. In addition, an elevated risk of oral/pharynx cancer was found among those whose sisters developed other cancers (OR = 1.6, 95% CI 1.1–2.2). Subsite analyses revealed stronger elevated risks of smoking-related cancers in relatives of pharyngeal cancer cases (OR = 1.7, 95% CI 1.1–2.8) than of oral cancer patients. The data indicate that there is at most a weak familial aggregation of oral/pharynx cancers. Furthermore, since the excess familial risk of oral/pharynx cancer was associated with smoking-related cancers among male but not female relatives, it seems likely that environmental factors (notably smoking and drinking) contribute to the familial tendency observed in this study. The results underscore the need to collect risk profile information on relatives in future studies to disentangle genetic from environmental determinants.     

High prevalence of oral human papillomavirus infection in Fanconi's anemia patients

Oral Diseases 17 , 572–576 Background: Fanconi’s anemia (FA) is a rare recessive genetic disorder characterized by bone marrow failure, developmental and congenital abnormalities, which frequently evolves to aplastic anemia and neoplasias, primarily acute leukemia and head‐neck carcinomas. Risk of malignancies increases after hematopoietic stem cell transplantation (HSCT), and the role of human papillomavirus (HPV) in FA carcinogenesis have been proposed. Objective: To investigate prevalence of oral HPV in FA patients without oral malignant lesions. Materials and methods: After oral examination, 76 subjects without detectable oral malignant lesions were included and classified in four groups: 20 FA submitted to HSCT (I), 22 FA not submitted to HSCT (II), 18 severe aplastic anemia (SAA) submitted to HSCT (III) and 16 healthy subjects (IV). Liquid‐based cytology sampling, HPV screening by polymerase chain reaction and genotyping by reverse hybridization were performed. Results: The HPV detection rates were: group I 35%, group II 27.3%, group III 38% and group IV 6.25%. Prevalence of high risk HPV types, mainly HPV16, was detected. Compared with control group, suggestions for increased likelihood of being HPV infected in SAA (OR = 9.55, 95% CI: 1.01–125.41) and FA patients submitted to HSCT (OR = 8.08, 0.83–72.29) emerged. Conclusion: Patients without oral malignant lesions submitted to HSCT, have high prevalence of oral HPV. HPV screening and close follow up should be considered in these patients.