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Oral Potential Malignant Lesions Screening Among Administrative Staff in Faculty of Dentistry, Universitas Padjadjaran, Indonesia

Elizabeth Fitriana Sari1, Wahyu Hidayat2, Nicola Cirillo3

PhD Candidate of Melbourne Dental School, The University of Melbourne. Academic Staff of Faculty of Dentistry, UNPAD OBJECTIVE  

METHODS  AND  MATERIALS  

CONCLUSIONS  

DISCUSSION  

RESULTS  

REFERENCES  

INTRODUCTION  

CONTACT  

CONTACT  :  Email:  esari@student.unimelb.edu.au  Royal  Dental  Hospital  Melbourne  Melbourne  Dental  School  720  Swanston  St,  Carlton,  VIC,  3053  The  University  of  Melbourne  Australia  

Oral cancer is one of the sixth most common cancers world wide.[1] Tobacco exposure and alcohol drinking have been established as major risk factors of oral cancer in most of countries in the world. [1] According to the Indonesian national census in 2015, the population of Indonesia was about 255.5 million. [2] Indonesia has the third largest number of smokers in the world. There are over 61 million tobacco users in Indonesia. Over one-third (36%) of Indonesians use tobacco in either a smoking and/or smokeless form. A high porpotion, 67% of males smoke, while the female rate is low (4.5%). In Indonesia, smoking kills at least 235,000 people annually. [3] In addition to smoking, some areas in Indonesia have traditional customs of chewing betel nuts. It has already been revealed that the long term use of betel nuts is strongly related to oral cancer. [4] The majority of oral cancers are preceded by visible changes of the oral mucosa. This changes refer to Oral potentially malignant Lesions (OPML) which may transform to oral cancer through various histopathological stages[5]

Early detection of oral pre-cancer result in better prognosis and much lower mortality rate [5] It has been proposed that the large number of smoker is a result of the extensive cigarette advertisement allowed by the Government of Indonesia, and that the price and tax of cigarettes are relatively cheap in Indonesia. A further reason for the huge number of smokers is the lack of awareness due to minimum information about the danger in consuming tobacco and insufficient government program toward oral cancer. [3]

The study was descriptive-cross sectional. We did clinical assessment utilizing white light for intra oral examination to find any alteration such as changes of colour and texture, swelling, and/ or ulceration as well as extra oral examination on head and neck. Questionnaire was given to determine the oral cancer risk factors.

Our results clearly show that the number of OPML among administrative staff is high. This might be due to their low of awareness towards oral cancer risk factors, however further research is needed to confirm this hypothesis

Our study was focused on detection of oral potentially malignant lesions (OPML) and their correlation with oral cancer risk factors. Specifically, we undertook a screening among administrative staff of Faculty of Dentistry, Universitas Padjadjaran, Indonesia. We hypothesized that these staff members may be at higher risk because they are perceived to habitually smoke during work.

1.  Paul Brocklehurst, Omar Kujan, Anne-Marie Glenny, Richard Oliver, Philip Sloan, at al. Screening programmes for the early detection and prevention of oral cancer. 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

2.  Data Kependudukan Indonesia. Available at www.bps.go.id. [Cited November 21 2015].

3.  Jiloha RC. Tobacco Use. Health and Behavior. New Age International (P0 Limited Publisher. 2008. New Delhi

4.  Sirait AM. Risk Factor of Oral and Oropharingeal Cancer in Indonesia (Indonesia Basic Health Research 2007). Media Litbangkes Vol. 23, no.3, Sept 2013, 122-129.

5.  Bhawna Gupta, and Newell W. Johnson. Systematic Review and Meta-Analysis of Association of Smokeless Tobacco and of Betel Quid without Tobacco with Incidence of Oral Cancer in South Asia and the Pacific. PLoS One. 2014; 9(11): e113385.

Chart 1. Distribution of Respondents Having Orang Petential Malignant Lesion (OPML)

0 5

10 15 20 25 30 35

Respondents

OPML Non-OPML

There were 32 respondents (6 females and 26 males) with an age range between 20 and 60. About16 respondents (50%) had OPML Leukoplakia type, whom 15 of them were male and 1 was female.

Table 1. Respondents with OPML Related with Oral Malignant Risk Factors

Odd Ratios (OR) OR ( Smoker) = 25 OR (Smoker and Alcohol drinker) = 12,4 This is consider Very High

Relative Risk (RR) = 7,14 RR = a/(a+b) : c/(c+d) a = Smokers with OPML b = Smokers without OPML c = Nonsmokers with OPML d = Non smokers without OPML

Respondents with OPML Yes No

Smokers 15 6 Smokers and

Alcohol Drinkers

4 0

Non - Smokers 1 9 Total 16 16

0 5 10 15

Male

Female

Retromolar pad Lingual Buccal

Chart 2. Site Distribution of OPML

The most common site of OPML was on buccal mucosa. In male, it was found 13 times on buccal mucosa, 4 times on retromolar pad and once at lingual mucosa. While in female it was only found once on buccal mucosa.

Leukoplakia