Prevalence of oral mucosal lesions in children and youths in the USA.

INTRODUCTION: There is a dearth of studies of oral lesions in children and youths using probability samples of a general population. The present paper describes the results of the Third National Health and Nutrition Examination Survey, 1988-1994 (NHANES III), and compares them to those of the National Survey of Oral Health in US Schoolchildren, 1986-1987.

METHODS: The NHANES III was a large US study based on a multistage probability sample. Dentist examiners were trained to recognize, classify and record, in a standard manner, the clinical characteristics of each of the 48 conditions of interest using procedures based on the World Health Organization's Guide to Epidemiology and Diagnosis of Oral Mucosal Diseases.

RESULTS: Examinations were performed on 10,030 individuals (10.26%) aged between 2 and 17 years, 914 of whom had a total of 976 lesions. The lip was the most frequent site of lesions (30.7%), followed by the dorsum of the tongue (14.7%) and the buccal mucosa (13.6%). Lesions were more prevalent in males (11.76%) than females (8.67%). The most prevalent lesions were lip/cheek bite (1.89%), followed by aphthous stomatitis (1.64%), recurrent herpes labialis (1.42%) and geographic tongue (1.05%). The prevalence of recurrent aphthous stomatitis in the NHANES III child and youth survey was substantially higher than that for adults, while the NHANES III adult estimates for geographic tongue (1.85%; 95% CI 1.42, 2.28) and cheek/lip bite (3.05%; 95% CI 2.36, 3.74) were substantially greater than those for children and youths (0.97% and 2.05%, respectively).

CONCLUSION: Reported prevalences for rare conditions in other studies employing more selected samples (especially if standard errors or confidence intervals are not provided) should be interpreted with caution. Studies of adult populations, however valid, may have limited applicability to children.