Clinical risk factors of oral leukoplakia in a representative sample of the US population.

Studies on the risk factors of oral leukoplakia (OL) are relatively scarce. The objectives of this paper are to assess the clinical risk factors of OL in a representative sample of the US population. Data from the oral mucosal tissue assessment and some other covariates of 15,811 participants in the US National Health and Nutrition Examination Survey (NHANES III) were included. The clinical definition of OL was applied according to the WHO criteria. Tobacco smoking was found as the strongest independent risk factor. The OR were 3.00 (0.77-11.8) for < or =10 cigarettes/day up to 6.01 (2.4-15.0) for >20 cigarettes/day. Diabetes, age and socio-economic status were found as independent predictors of OL. Alcohol consumption, race/ethnicity, years of education and BMI showed no independent association with OL. Females with a history of estrogen use were less likely to have OL with an OR of 0.34 (0.11-1.07). In conclusion, the role of diabetes and estrogen in the pathogenesis of OL should be further investigated.