Lesões de mucosa bucal em estudos de base populacional : revisão sistemática e estudo transversal em gestantes

Abstract

Population-based studies evaluating the prevalence of oral mucosal lesions (OMLs) are uncommon in the literature. Cross-sectional analyzes conducted in specialized services are usually carried out, which, in combination with the diversity of methodologies used, makes difficult the comparisons between studies. The objective of this study was to perform a systematic review to evaluate methodological aspects of population-based studies on the prevalence of OMLs, in addition to investigating the prevalence of these lesions in a study with a cohort of pregnant women. In the review, Pubmed, Web of Science and Scopus databases were searched. Data regarding sample size, sex and age of the subjects, diagnostic criteria used, lesion characteristics, and measures of agreement among the examiners were extracted from the studies and analyzed descriptively. In the cross-sectional population-based study, the pregnant women answered a questionnaire and received oral clinical examination. Clinical diagnoses and characteristics of OMLs were collected, as well as dental history. The data were analyzed descriptively in the STATA program version 12.0. Twenty-nine studies were included in the systematic review, being observed a lack of standardization of methodologies, especially regarding diagnostic criteria, training and calibration of the examiners, adequate response rate and appropriate presentation of the results. Of the 2481 pregnant women included in the cross-sectional study, 409 (16.49%) had OMLs. The most frequent clinical diagnoses were exostoses (79-16.39%), coated tongue (70-14.52%), and benign oral brownish pigmentation (65-13.49%). When grouped, developmental alterations, benign oral brownish pigmentations and infectious diseases, represented mainly by parulides, were the most prevalent groups, in descending order. Almost 50% of women never performed oral self-examination and more than 86% reported no oral hygiene orientation during gestation. It was concluded that the few population-based studies on the prevalence of OMLs present deficiencies in their methodologies. The study performed with pregnant women, despite of revealing a relatively low prevalence of OMLs, used standardized methodology and was the first study to provide data on the occurrence of this outcome in pregnant women.