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口腔黏膜病损特征及其与社会经济地位和全身健康的关系:中国偏远农村地区连续采集口腔医学诊所数据的横断面研究。

Characteristics of Oral Mucosal Lesions and Their Association With Socioeconomic Status and Systemic Health: A Cross-Sectional Study of Consecutively Collected Oral Medicine Clinic Data in a Remote Rural Area of China.

机构信息

Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Front Public Health. 2022 May 23;10:897814. doi: 10.3389/fpubh.2022.897814. eCollection 2022.

Abstract

OBJECTIVES

Epidemiological data of oral mucosal lesions (OMLs) are required to develop practical oral care policies. However, limited data are available for rural areas in China. We aimed to estimate the spectrum and frequency of OMLs and to identify their associated socioeconomic status (SES) and systemic health in a remote rural area in Yunnan, China.

METHODS

We screened patients for OMLs in an oral medicine clinic in rural Yunnan, China, from August 2020 to February 2021. OMLs were documented. SES, including the highest education level achieved and the previous month's household income, as well as the patient's systemic health, including a history of smoking, alcohol use, and chronic disease, were obtained from the Medical History/Health Questionnaire Form and patient medical records.

RESULTS

A total of 146 patients were found to have OMLs. The most frequent OML was aphthous ulcer ( = 41, 28.1%), followed by burning mouth syndrome (BMS) ( = 16, 11.0%), viral ulcer ( = 14, 9.6%), and oral lichen planus (OLP) ( = 9, 6.2%). In these patients, the most common chronic diseases were sleep apnea ( = 35, 24.0%), hypertension ( = 23, 15.8%), bronchitis ( = 16, 11.0%), reflux (including gastroesophageal reflux disease) ( = 12, 8.2%), and arthritis ( = 11, 7.5%). On adjusted regression, the patients without chronic diseases had a lower risk of BMS than those with chronic diseases [odds ratio (OR), 0.2; 95% confidence interval (CI), 0.03-0.9]. Age was an independent protective factor for viral ulcers (OR, 1.0; 95% CI, 0.9-1.0). Patients with low-income levels had a lower risk of OLP than those with high-income levels (OR, 0.2; 95% CI, 0.05-0.9).

CONCLUSIONS

Our oral medicine clinic data in remote Yunnan, China, showed the most frequent OML was aphthous ulcer, which was followed by BMS, viral ulcer, and OLP. Oral care policies should be prioritized among patients with aphthous ulcer. Preventive strategy of BMS should be targeted to people with chronic disease for health equalities. Therefore, an individualized strategy for interventions of OMLs might be optimal, based on the specific epidemiologic characteristics in rural settings.

摘要

目的

为制定切实可行的口腔保健政策,需要有口腔黏膜病(OML)的流行病学数据。然而,中国农村地区的数据有限。我们旨在评估云南省偏远农村地区 OML 的种类和频率,并确定其与社会经济地位(SES)和全身健康的关系。

方法

我们于 2020 年 8 月至 2021 年 2 月在云南省农村的一个口腔医学诊所筛查患者的 OML。记录 OML。SES 包括所接受的最高教育程度和前一个月的家庭收入,以及患者的全身健康状况,包括吸烟、饮酒和慢性疾病史,这些信息从病史/健康问卷表和患者病历中获得。

结果

共发现 146 名患者患有 OML。最常见的 OML 是阿弗他溃疡(=41,28.1%),其次是灼口综合征(BMS)(=16,11.0%)、病毒性溃疡(=14,9.6%)和口腔扁平苔藓(OLP)(=9,6.2%)。在这些患者中,最常见的慢性疾病是睡眠呼吸暂停(=35,24.0%)、高血压(=23,15.8%)、支气管炎(=16,11.0%)、反流(包括胃食管反流病)(=12,8.2%)和关节炎(=11,7.5%)。在调整后的回归分析中,无慢性疾病的患者患 BMS 的风险低于有慢性疾病的患者[比值比(OR),0.2;95%置信区间(CI),0.03-0.9]。年龄是病毒性溃疡的独立保护因素(OR,1.0;95%CI,0.9-1.0)。低收入水平的患者患 OLP 的风险低于高收入水平的患者(OR,0.2;95%CI,0.05-0.9)。

结论

我们在云南省偏远地区的口腔医学诊所的数据显示,最常见的 OML 是阿弗他溃疡,其次是 BMS、病毒性溃疡和 OLP。对于阿弗他溃疡患者,应优先考虑口腔保健政策。对于患有慢性病的人群,应针对 BMS 制定预防策略,以实现健康公平。因此,基于农村地区的具体流行病学特征,对 OML 进行个体化干预可能是最佳策略。

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