Prevalence of hypodontia in 10- to 14-year-olds seeking orthodontic treatment at a group of clinics in Puerto Rico.

OBJECTIVE: To estimate the prevalence of hypodontia in a group of 10- to 14-year-olds from a group of orthodontic clinics in Puerto Rico. METHODS: A cross-sectional study was conducted to estimate the prevalence of hypodontia in 10- to 14-year-olds from orthodontic clinics located in each of 9 regions (as determined by the government-run health insurance program, Reforma) in Puerto Rico. A total of 1,911 patients, ranging in age from 10 to 14 years, were evaluated using patient charts covering from May 2004 through June of that same year. A logistic regression model was done to evaluate the relation between the prevalence of hypodontia in the study group and clinic location, gender, and age; a 5% significance level was used. RESULTS: The overall weighted prevalence of hypodontia was 6.02%. Females showed a higher weighted prevalence of hypodontia than did males (7.02% vs. 4.72%, respectively: p = 0.06). The prevalence also varied by geographic region, ranging from 3.21% at the San Juan clinic to 10.68% at the Aibonito clinic (p = 0.01). The most prevalent missing teeth were the maxillary lateral incisors, followed by the lower second premolars (1.9%). CONCLUSION: The prevalence of hypodontia in Puerto Rico was 6.02%. Females presented a higher prevalence of hypodontia than did males. Each of the clinics in Fajardo, Bayamón, San Juan, and Guayama had a lower prevalence of hypodontia than the Aibonito clinic did. The tooth most frequently missing in the study group was the maxillary right lateral incisor.

Smoking and drinking in relation to oral potentially malignant disorders in Puerto Rico: a case-control study.

BACKGROUND: Oral cancer incidence is high on the Island of Puerto Rico (PR), particularly among males. As part of a larger study conducted in PR, we evaluated smoking and drinking as risk factors for oral potentially malignant disorders (OPMDs). METHODS: Persons diagnosed with either an OPMD (n = 86) [oral epithelial dysplasia (OED), oral hyperkeratosis/epithelial hyperplasia without OED] or a benign oral tissue condition (n = 155) were identified through PR pathology laboratories. Subjects were interviewed using a standardized, structured questionnaire that obtained information, including detailed histories of smoking and drinking. Odds ratios (ORs) for smoking and drinking in relation to having an OPMD, relative to persons with a benign oral tissue condition, were obtained using logistic regression and adjusted for age, gender, education, fruit/vegetable intake and smoking or drinking. RESULTS: For persons with an OPMD and relative to individuals with a benign oral tissue condition, the adjusted OR for current smoking was 4.32 (95% CI: 1.99-9.38), while for former smokers, the ORadj was 1.47 (95% CI: 0.67-3.21), each ORadj relative to never smokers. With regard to drinking, no adjusted ORs approached statistical significance, and few point estimates exceeded 1.0, whether consumption was defined in terms of ever, current, level (drinks/week), or beverage type. CONCLUSIONS: In this study, conducted in Puerto Rico, current smoking was a substantial risk factor for OPMDs while former smokers had a considerably reduced risk compared to current smokers. There was little evidence suggesting that alcohol consumption was positively associated with OPMD risk.

A deficit in biopsying potentially premalignant oral lesions in Puerto Rico.

BACKGROUND: Intraoral lesions clinically suspicious for cancer/precancer should be biopsied and diagnosed histopathologically. We evaluated whether the frequency of oral cancer (OC) cases diagnosed in Puerto Rico (PR) is disproportionately high relative to the frequency of persons with histopathologic diagnoses that would have appeared clinically suspicious for OC/precancer at biopsy. METHODS: All pathology reports for oral (ICD-O-3 C01-C06) soft tissue biopsies generated during 1/2004-5/2005 by seven PR and two New York City (NYC) pathology laboratories were reviewed. The analysis was restricted to persons diagnosed with invasive oral squamous cell carcinoma (OSCC), epithelial dysplasia, or hyperkeratosis/epithelial hyperplasia (HK/EH), i.e., diagnoses associated with lesions clinically suspicious for OC/precancer. The OC relative frequency measured the percentage of persons diagnosed with OSCC among persons with OSCC, dysplasia, or HK/EH. OC relative frequencies for PR and NYC laboratories were compared. RESULTS: Overall, the OC relative frequency was 67% in PR and 40% and 4% in the NYC general and oral pathology laboratories, respectively (each p<0.001). In PR, the OC relative frequency was highest for males (80%). When OC relative frequencies were stratified by pathology laboratory type (general/oral) and compared across PR and NYC, age/gender-specific OC relative frequencies were always higher in PR; however, differences were consistently statistically significant for males only. CONCLUSION: A disparity in the OC relative frequency exists in PR vs. NYC indicating a shortfall in biopsying potentially precancerous oral lesions in PR. PR residents with intraoral lesions suspicious for oral cancer/precancer are most likely to be biopsied only after developing an invasive OC.