Prevalence and associated factors of oral pigmented lesions among Yemeni dental patients: a large cross-sectional study

BACKGROUND: The literature is scarce and inconsistent regarding the prevalence, types, and risk factors of oral pigmented lesions (OPL). The present study investigated the prevalence, types, and distribution of OPL, as well as their associated factors among Yemeni dental patients. METHODS: This cross-sectional study was conducted among 1920 dental patients attending the dental clinics, Sanaa University, Yemen over a period of 10 months (from March to December 2021). A comprehensive clinical examination was conducted by a well-trained and calibrated examiner, and histopathological analysis was carried out in suspicious cases. RESULTS: Out of the 1920 subjects, 1091 (56.8%) were diagnosed with one or more OPL. The most common OPL were physiologic pigmentations (33.8%), smoker's melanosis (14.6%), melanotic macule (2.6%), and vascular-related pigmentations (varix, hemangioma, hematoma). Gingiva and buccal mucosa were the most involved sites. Male subjects showed higher prevalence of smoker's melanosis, black hairy tongue, vascular-related pigmentations, whereas physiologic pigmentation, melanotic macule and melanotic nevi were more common in females. The results revealed that being male (p < 0.001), over 40 years old (p = 0.001), smoker (p < 0.001), waterpipe smoker (p = 0.004), and being dark-skinned (p < 0.001) are determinant factors for the occurrence of OPLs. CONCLUSION: The prevalence of OPL among Yemeni population is high, with the gingiva and buccal mucosae are the most common sites of oral pigmentations. Male gender, smoking habits, and dark skin complexion are risk factors for developing OPLs. Understanding the etiology and clinical features of common OPL is paramount for accurate diagnosis and management of these lesions.