Population Studies
of Oral
Diseases
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| ©The Maxillofacial Center for Diagnostics & Research | ||
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Annual incidence of salivary tumors, Rochester, Minnesota, 1935-1984 |
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The Maxillofacial Center, 165 Scott Avenue, Suite 100, Morgantown, WV 26508 MFCenter@aol.com
Prevalence of
Benign Oral
Mucosal & Soft Tissue Lesions
(Excludes Precancer Studies & Site-Specific Studies)
Listed by Size of
Population Studied
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Click on Author Name(s) to See Data Table |
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Author(s) * |
Year | Country | Population Size | Population Type |
| Knapp | 1971 | USA | 181,338 | Army recruits (young males) |
| Kleinman, et al. | 1993 | USA | 39,206 | School children (5-17 y/o) |
| Bouquot | 1986 | USA | 23,616 | Over 35 years of age |
| Bouquot (expanded) ** | 2000 | USA | 23,616 | Over 35 years of age |
| Axéll | 1976 | Sweden | 20,233 | Adults |
| Ross, Gross | 1971 | USA | 11,884 | Over 35 years of age |
| Zain, et al. | 1997 | Malaysia | 11,707 | Over 25 years of age |
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The following studies are on another web page of this site [click on author name(s)]. |
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| Diaz-Guzman, Castellanos | 1991 | Mexico | 7,292 | Adults (avg. age: 32 years) |
| Ikeda, et al. | 1995 | Cambodia | 5,000 | Adults |
| Zachariah | 1966 | India | 5,000 | Adults, rural |
| Prout, et al. | 1997 | USA | 4,611 | Tobacco users > 40 y/o |
| Baciero, et al | 2000 | Spain | 3,282 | Over 65 years of age |
| Fatahzaden, Keno, Sirois | 2000 | USA | 1,125 | Adults |
| Hand, Whitehall | 1986 | USA | 976 | Elderly (nursing home) |
| Guggenheimer, et al. | 2000 | USA | 673 | Adults; diabetics & controls |
* Complete references are above each data table
** Expanded listing of Dr. Bouquot's 1986-1988 data; previously unpublished data
are included
Table 1 (Knapp): Prevalence rates (per 1,000 persons) for oral mucosal lesions found in clinical exams of 181,338 Army recruits, predominantly men 18-22 years of age.
Reference: Knapp MJ. Oral disease in 181,338 consecutive oral examinations. J Amer Dent Assoc 1971; 83:1288-1293.
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Clinical Diagnosis |
# Lesions |
# Lesions/1,000 Persons |
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Papillary hyperplasia |
1292 |
7.12 |
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Papilloma |
405 |
2.23 |
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Irritation fibroma |
216 |
1.19 |
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Other, includes 49 different diagnoses |
111 |
0.61 |
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Inflammatory ulcer |
87 |
0.48 |
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Epulis fissuratum |
67 |
0.37 |
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Oral tonsils, hyperplastic (lingual & other) |
48 |
0.26 |
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Mucocele |
44 |
0.24 |
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Leukoplakia |
37 |
0.20 |
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Frictional keratosis (cheek bite) |
34 |
0.19 |
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Verruca vulgaris |
22 |
0.12 |
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Hemangioma |
21 |
0.12 |
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Pyogenic granuloma |
15 |
0.08 |
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Lichen planus |
13 |
0.07 |
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Dental fistula |
13 |
0.07 |
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Geographic tongue |
12 |
0.07 |
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Median rhomboid glossitis |
12 |
0.07 |
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Amalgam tattoo |
10 |
0.06 |
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Hairy tongue (black) |
6 |
0.03 |
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Erythema multiforme |
6 |
0.03 |
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Angular cheilitis |
4 |
0.02 |
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Smokeless tobacco keratosis |
4 |
0.02 |
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Nicotine palatinus |
2 |
0.01 |
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White sponge nevus |
2 |
0.01 |
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Candidiasis |
2 |
0.01 |
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Actinic cheilosis |
1 |
0.01 |
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Darier's disease |
1 |
0.01 |
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Mucoepidermoid carcinoma |
1 |
0.01 |
Table 2 (Kleinman, et al): Prevalence rates (per 1,000 persons) for oral mucosal lesions found in clinical exams of 39,206 school children, ages 5-17 years. This was part of the 1986/87 National Survey of Oral Health performed by NIH (NIDR).
Reference: Kleinman DV, Swango PA, Pindborg JJ. Epidemiology of oral mucosal lesions in United States schoolchildren: 1986-87. Community Dent Oral Epidemiol 1994; 22:243-253.
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Clinical Diagnosis |
# Lesions |
# Lesions
per |
Estimated # U.S. Children Affected |
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Aphthous ulcer |
524 | 12.3 | 533,588 |
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Herpes labialis |
323 | 7.8 | 337,869 |
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Smokeless tobacco keratosis * |
251 | 7.1 | 308,578 |
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Geographic tongue |
235 | 6.0 | 260,503 |
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Other ** |
108 | 2.9 | 123,819 |
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Tumors, non-specific *** |
78 | 1.9 | 80,850 |
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Unknown |
48 | 1.1 | 48,999 |
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Ulcers, non-specific |
25 |
0.9 | 38,280 |
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Mucocele |
17 | 0.4 | 16,458 |
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Acute necrotizing ulcerative gingivitis |
10 | 0.3 | 13,413 |
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Verruca vulgaris |
12 | 0.3 | 12,057 |
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Gingival hyperplasia |
12 | 0.3 | 16,493 |
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Primary herpetic gingivostomatitis |
4 | 0.2 | 9,766 |
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Candidiasis |
1 | 0.1 | 315 |
* Almost all cases were found in
white males 12 years of age and older.
** Most of the
"other" lesions were chronic cheek bit and lip bite, unspecified
pigmented macules and
dental
abscesses.
*** Tumors were usually firm and of normal color, i.e. were probably mostly
irritation fibromas
Table 3 (Bouquot): Prevalence rates (per 1,000 persons) for visible oral lesions found in 23,616 adults (predominantly whites) over 35 years of age who attended well publicized oral cancer screening clinics in 13 communities in Minnesota, USA. The represents approximately 2/3 of all older adults in the smaller communities (11 of the 13 communities studies).
Reference: Bouquot JE. Common oral lesions found during a mass screening examination. J Amer Dent Assoc 112:50-57, 1986.
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Clinical Diagnosis |
# lesions/1,000 persons |
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Males |
Females |
Total |
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Leukoplakia |
43.2 |
20.9 |
28.9 |
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Lesion, NOS, oral |
23.5 |
17.6 |
19.7 |
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Torus palatinus |
13.2 |
21.7 |
18.7 |
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Irritation fibroma |
13.0 |
11.4 |
12.0 |
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Fordyce granules |
17.7 |
5.2 |
9.7 |
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Torus mandibularis |
9.6 |
7.9 |
8.5 |
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Lesion, NOS, other |
3.5 |
6.9 |
5.7 |
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Hemangioma, oral |
8.4 |
4.1 |
5.6 |
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Inflammatory ulcer |
5.4 |
5.1 |
5.2 |
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Inflammatory erythema, oral |
4.5 |
4.8 |
4.7 |
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Papilloma |
5.3 |
4.2 |
4.6 |
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Epulis fissuratum |
3.5 |
4.4 |
4.1 |
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Varicosities, lingual |
3.5 |
3.4 |
3.5 |
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Fissured tongue |
3.5 |
3.1 |
3.3 |
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Inflammatory erythema, oropharynx |
3.5 |
3.0 |
3.2 |
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Geographic tongue |
3.4 |
3.0 |
3.1 |
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Trauma, NOS (not otherwise specified), oral |
2.9 |
3.2 |
3.1 |
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Papillary hyperplasia |
1.7 |
3.8 |
3.0 |
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Herpes labialis |
2.4 |
2.6 |
2.5 |
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Mucocele |
1.9 |
2.6 |
2.4 |
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Scar tissue |
2.4 |
1.9 |
2.1 |
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Angular cheilitis |
1.8 |
1.9 |
1.9 |
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Smokeless tobacco keratosis |
4.2 |
0.2 |
1.7 |
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Hyperplastic lingual tonsil |
2.4 |
1.2 |
1.6 |
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Hematoma/echhymosis |
1.9 |
1.3 |
1.5 |
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Frictional keratosis (cheek bite) |
0.7 |
1.4 |
1.1 |
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Hyperplastic pharyngeal tonsil |
1.5 |
0.9 |
1.1 |
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Lichen planus |
1.2 |
1.1 |
1.1 |
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Squamous cell carcinoma |
2.5 |
0.1 |
0.9 |
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Severe epithelial dysplasia |
2.1 |
0.3 |
0.9 |
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Buccal exostosis |
0.9 |
0.9 |
0.9 |
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Leaf-shaped fibroma (beneath denture) |
0.4 |
1.2 |
0.9 |
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Amalgam tattoo |
0.6 |
1.0 |
0.8 |
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Median rhomboid glossitis |
0.8 |
0.5 |
0.6 |
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Hairy tongue (black) |
1.2 |
0.3 |
0.6 |
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Glossitis, atrophic |
0.6 |
0.5 |
0.6 |
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Nicotine palatinus |
1.2 |
0.2 |
0.6 |
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Epidermoid cyst |
0.7 |
0.4 |
0.5 |
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Nevocellular nevus, oral |
0.1 |
0.7 |
0.5 |
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Oral melanotic macule |
0.5 |
0.3 |
0.4 |
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Non-lingual oral tonsils, hyperplastic |
0.5 |
0.3 |
0.4 |
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Leukoedema |
0.4 |
0.3 |
0.3 |
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Herpes zoster, intraoral |
0.5 |
0.2 |
0.3 |
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Lipoma |
0.1 |
0.4 |
0.3 |
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Pseudomembranous candidiasis |
0.4 |
0.2 |
0.3 |
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Herpes simplex, intraoral |
0.1 |
0.3 |
0.2 |
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Ranula |
0.2 |
0.1 |
0.2 |
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Sialolithiasis |
0.0 |
0.3 |
0.2 |
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Bifid uvula |
0.4 |
0.0 |
0.1 |
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White coated tongue |
0.4 |
0.0 |
0.1 |
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Gingival hyperplasia |
0.1 |
0.1 |
0.1 |
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Hyperplastic buccinator node |
0.1 |
0.1 |
0.1 |
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Commissural lip pits |
0.1 |
0.1 |
0.1 |
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Cyst of Blandin-Nuhn |
0.0 |
0.1 |
0.1 |
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Basal cell carcinoma, vermillion |
0.1 |
0.0 |
0.0 |
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Macroglossia |
0.0 |
0.1 |
0.0 |
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Pyogenic granuloma |
0.0 |
0.1 |
0.0 |
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Nasoalveolar cyst |
0.0 |
0.1 |
0.0 |
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Neurofibroma |
0.0 |
0.1 |
0.0 |
Table 4 (Bouquot, Extended): Gender-specific prevalence rates for all mucosal, soft tissue and bony oral and oropharyngeal lesions clinically diagnosed in 23,616 white U.S. adults (97% whites; 8,477 males, 15,139 females) over 35 years of age, ranked by total prevalence.
References: Modified and extended from Bouquot's earlier published papers.
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Clinical Diagnosis |
# Lesions/1,000 persons |
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Male |
Female |
Total |
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| Leukoplakia | 42.47 | 13.14 | 23.67 |
| Lesion, NOS, oral | 23.48 | 17.64 | 19.73 |
| Torus palatinus | 13.21 | 21.73 | 18.67 |
| Irritation fibroma | 12.98 | 11.36 | 11.94 |
| Fordyce granules | 17.69 | 5.15 | 9.65 |
| Torus mandibularis | 9.56 | 7.86 | 8.47 |
| Lesion, NOS, other | 3.54 | 6.94 | 5.72 |
| Hemangioma, oral | 8.38 | 4.10 | 5.63 |
| Inflammatory ulcer | 5.43 | 5.09 | 5.21 |
| Inflammatory erythema, oral | 4.48 | 4.76 | 4.66 |
| Papilloma | 5.31 | 4.16 | 4.57 |
| Epulis fissuratum | 3.42 | 4.36 | 4.02 |
| Varicosities | 3.54 | 3.43 | 3.47 |
| Fissured tongue | 3.54 | 3.10 | 3.26 |
| Inflammatory erythema, oropharynx | 3.54 | 2.97 | 3.18 |
| Geographic tongue | 3.42 | 2.97 | 3.13 |
| Trauma, NOS, oral | 2.95 | 3.24 | 3.13 |
| Papillary hyperplasia | 1.65 | 3.77 | 3.01 |
| Herpes labialis | 2.36 | 2.64 | 2.54 |
| Mucocele | 1.89 | 2.64 | 2.37 |
| Scar tissue | 2.36 | 1.92 | 2.07 |
| Angular cheilitis | 1.77 | 1.85 | 1.82 |
| Hyperplastic lingual tonsil | 2.36 | 1.19 | 1.61 |
| Hematoma/echhymosis | 2.01 | 1.39 | 1.61 |
| Frictional keratosis (cheek bite) | 0.71 | 1.39 | 1.14 |
| Hyperplastic pharyngeal tonsil | 1.53 | 0.86 | 1.10 |
| Lichen planus | 1.18 | 1.06 | 1.10 |
| Smokeless tobacco keratosis | 2.71 | 0.07 | 1.02 |
| Buccal exostosis | 0.94 | 0.86 | 0.89 |
| Leaf-shaped fibroma (beneath denture) | 0.35 | 1.19 | 0.89 |
| Amalgam tattoo | 0.59 | 0.99 | 0.85 |
| Median rhomboid glossitis | 0.83 | 0.53 | 0.64 |
| Hairy tongue (black) | 1.18 | 0.26 | 0.59 |
| Glossitis, atrophic | 0.59 | 0.53 | 0.55 |
| Epidermoid cyst | 0.71 | 0.40 | 0.51 |
| Nevocellular nevus, oral | 0.12 | 0.66 | 0.47 |
| Leukoedema | 0.83 | 0.13 | 0.38 |
| Oral melanotic macule | 0.47 | 0.33 | 0.38 |
| Non-lingual oral tonsils, hyperplastic | 0.47 | 0.33 | 0.38 |
| Nicotine palatinus | 0.59 | 0.13 | 0.30 |
| Herpes zoster, intraoral | 0.47 | 0.20 | 0.30 |
| Lipoma | 0.12 | 0.40 | 0.30 |
| Pseudomembranous candidiasis | 0.35 | 0.20 | 0.25 |
| Ranula | 0.12 | 0.33 | 0.25 |
| Herpes simplex, intraoral | 0.12 | 0.26 | 0.21 |
| Sialolithiasis | 0.00 | 0.26 | 0.17 |
| Bifid uvula | 0.35 | 0.00 | 0.13 |
| White coated tongue | 0.35 | 0.00 | 0.13 |
| Gingival hyperplasia | 0.12 | 0.13 | 0.13 |
| Hyperplastic buccinator node | 0.12 | 0.07 | 0.08 |
| Commissural lip pits | 0.12 | 0.07 | 0.08 |
| Cyst of Blandin-Nuhn | 0.00 | 0.13 | 0.08 |
| Basal cell carcinoma, vermilion | 0.12 | 0.00 | 0.04 |
| Macroglossia | 0.00 | 0.07 | 0.04 |
| Pyogenic granuloma | 0.00 | 0.07 | 0.04 |
| Nasoalveolar cyst | 0.00 | 0.07 | 0.04 |
| Neurofibroma | 0.00 | 0.07 | 0.00 |
Diagnoses of biopsied oral leukoplakias: |
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| Hyperkeratosis without dysplasia | 9.67 | 3.30 | 5.59 |
| Severe epithelial dysplasia | 2.36 | 0.33 | 1.06 |
| Squamous cell carcinoma I | 2.71 | 0.07 | 1.02 |
| Clinical Diagnosis, Face/Neck Lesions: | |||
| Lesion, NOS, face/neck * | 11.09 | 9.78 | 10.25 |
| Nevocellular nevus, face/neck | 5.66 | 6.61 | 6.27 |
| Actinic keratosis, face/neck | 3.66 | 4.03 | 3.90 |
| Cervical adenopathy, inflammatory | 3.07 | 4.03 | 3.68 |
| Enlarged thyroid gland | 0.47 | 3.17 | 2.20 |
| Basal cell carcinoma, face | 3.19 | 1.65 | 2.20 |
| Seborrheic keratosis, face/neck | 1.53 | 1.39 | 1.44 |
| Lipoma, face/neck | 1.42 | 0.99 | 1.14 |
| Sebaceous cyst, face/neck | 1.65 | 0.79 | 1.10 |
| Verruca vulgaris, face/neck | 1.30 | 0.46 | 0.76 |
| Hemangioma, face | 0.59 | 0.33 | 0.42 |
| Xanthoma/xanthelasma, face | 0.24 | 0.20 | 0.21 |
| Osteoma, facial bones/skull | 0.12 | 0.13 | 0.13 |
| Thyroglossal duct cyst, neck | 0.24 | 0.00 | 0.08 |
| Nasal polyp | 0.12 | 0.00 | 0.04 |
| Malignant melanoma, face | 0.00 |
0.07 | 0.04 |
| Butterfly rash of lupus | 0.00 | 0.07 | 0.04 |
| History of Oral Cancer: | |||
| No lesion, history of oral cancer | 2.40 | 0.73 | 1.31 |
| No lesion, family history of oral cancer | 3.64 | 2.51 | 2.89 |
| Oral carcinoma, history of previous oral cancer | 0.51 | 0.00 | 0.18 |
| Oral leukoplakia, history of previous oral carcinoma | 1.37 | 0.18 | 0.59 |
* NOS = not otherwise specified; all cases biopsy proven and included in leukoplakia rates, except the single case of basal cell carcinoma of the vermilion border
Table 5 (Axéll): Prevalence rates (per 1,000 persons) of visible oral lesions among 8,696 Swedish adults attending special oral examination clinics.
Reference: Axell T. A preliminary report on prevalences of oral mucosal lesions in a Swedish population. Community Dent Oral Epidemiol 1975;3:143-145. Axell, T. A prevalence study of oral mucosal lesions in an adult Swedish population. Odont Revy 1976; 27 (suppl 26):1-103.
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Clinical Diagnosis |
# |
#
Lesions/ |
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Fordyce granules |
6,783 |
780.0 |
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Leukoedema |
3,994 |
459.3 |
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History of aphthous ulcers |
1,636 |
188.1 |
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Inflammatory erythema, oral ("denture sore mouth") |
1,127 |
129.6 |
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History of herpes labialis |
1,096 |
126.0 |
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Oral melanotic macule ("excessive pigmentation") |
873 |
100.4 |
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Amalgam tattoo |
713 |
82.0 |
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Flabby ridge |
624 |
71.8 |
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Geographic tongue |
624 |
71.8 |
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Smokeless tobacco keratosis ("snuff dipper's lesion") |
537 |
61.8 |
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Fissured tongue |
484 |
55.7 |
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Preleukoplakia |
472 |
54.3 |
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Frictional keratosis ("cheek & lip biting") |
411 |
47.3 |
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Herpes labialis |
279 |
32.1 |
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Leukoplakia |
272 |
31.3 |
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Angular cheilitis |
247 |
28.4 |
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Epulis fissuratum (denture hyperplasia) |
237 |
27.3 |
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Irritation fibroma & fibroepithelial polyp |
180 |
20.7 |
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Traumatic ulcer |
155 |
17.8 |
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Smooth red tongue (atrophic glossitis) |
152 |
17.5 |
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Lichen planus |
142 |
16.3 |
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Nicotine palatinus |
38 |
4.4 |
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Hairy tongue |
30 |
3.4 |
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Glossitis, NOS |
11 |
1.3 |
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Papilloma |
5 |
0.6 |
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Lipoma |
5 |
0.6 |
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Pseudomembranous candidiasis, acute |
4 |
0.5 |
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Gingival hyperplasia, Dilantin-related |
3 |
0.3 |
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Focal epithelial hyperplasia |
3 |
0.3 |
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Aphthous ulcers, major ("PMNR") |
2 |
0.2 |
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Lymphangioma |
2 |
0.2 |
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Hemangioma |
2 |
0.2 |
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Squamous cell carcinoma |
1 |
0.1 |