Periodontal Disease, Socioeconomic Position, and Tobacco Chewing are Associated with Oral Potentially Malignant Disorders in India

Objectives: To examine for the risk indicators of oral potentially malignant disorders (OPMD) among rural population in India.
Methods: A population based cross-sectional study was conducted among rural population of India from 2011 to 2012. A multistage stratified cluster randomized sampling was followed to recruit 1401 participants aged 35-54 years. Face-to-face interviews were conducted to collect data on sociodemographic factors, tobacco and alcohol use. Oral examinations were done to record OPMD, periodontal findings and missing teeth. Univariate, bivariate and multivariable analyses were done using SPSS v 16. OPMD (including leukoplakia, erythroplakia, oral submucous fibrosis and suspicious malignant lesion) whether present or absent was considered as the outcome variable; age, sex, socioeconomic factors, smoking status, tobacco-chewing status, alcohol use, periodontal disease and missing teeth were used as the predictors.
Results: A total of 873 people participated in the study. Among them 44 people were detected with 47 lesions. Leukoplakia (n=21), erythroplakia (n=3), oral submucous fibrosis (n=21), and suspicious malignant lesions (n=2) were present. Low educational attainment [Odds ratio (OR) = 3.74 (95% CI = 1.07-13.09)], current tobacco-chewing status [OR = 17.47 (95% CI = 6.90-44.24)] and moderate-severe periodontal disease [OR = 3.10 (95% CI = 1.10-8.77] were associated with OPMD.
Conclusions: Periodontal disease was a risk indicator for OPMD independent of socioeconomic factors and tobacco-chewing. Low educational attainment and tobacco-chewing were strongly associated with OPMD in a rural Indian population.