Skip to main content
Top
Published in: BMC Oral Health 1/2022

Open Access 01-12-2022 | Leukoplakia | Research

Association between socioeconomic status and severity of oral epithelial dysplasia using a Taiwanese Nationwide Oral Mucosal Screening Program: a retrospective analysis

Authors: Tien-En Chiang, Yu-Chun Lin, Chi-Tsung Wu, Sheng-Tang Wu, Yuan-Wu Chen

Published in: BMC Oral Health | Issue 1/2022

Login to get access

Abstract

Background

The study aimed to investigate the association between socioeconomic status and severity of oral epithelial dysplasia (OED) using current data from the Taiwanese Nationwide Oral Mucosal Screening Program (TNOMSP).

Methods

This retrospective analysis was conducted in the Department of Oral and Maxillofacial Surgery at a general hospital in Taipei, Taiwan. A total of 134 participants were analysed from a previous study database of 150 patients. The inclusion criteria included age > 20 years and a history of either tobacco or betel nut use. Background information, including para-habits such as betel and tobacco use, was analysed using the Pearson chi-square (χ2) test; furthermore, the correlation of background information with OED severity was investigated using logistic regression (mild or moderate/severe).

Results

High school education level (P < 0.001), poor self-awareness (P = 0.002), current betel use (P < 0.001), and tobacco use (P = 0.003) were highly correlated with moderate- and severe OED (P < 0.05). The odds ratio (OR) of education status above senior high school was 0.03 (95% confidence interval [CI] 0.01–0.15, P < 0.001), while that of junior high school was 1. Current betel chewing (OR 6.57 [95% CI 1.17–37.0], P = 0.033) was significantly associated with OED severity compared with never or ex-use of betel.

Conclusions

We found a strong correlation between the severity of OED and current betel use and low education status. The current study revealed that the socioeconomic status, poor self-awareness, and para-habit history of the patients with OED should be evaluated to identify high-risk individuals using TNOMSP.
Literature
1.
go back to reference Odell E, Kujan O, Warnakulasuriya S, Sloan P. Oral epithelial dysplasia: recognition, grading and clinical significance. Oral Dis. 2021;27:1947–76.PubMedCrossRef Odell E, Kujan O, Warnakulasuriya S, Sloan P. Oral epithelial dysplasia: recognition, grading and clinical significance. Oral Dis. 2021;27:1947–76.PubMedCrossRef
2.
go back to reference Arnaoutakis D, Bishop J, Westra W, Califano JA. Recurrence patterns and management of oral cavity premalignant lesions. Oral Oncol. 2013;49:814–7.PubMedCrossRef Arnaoutakis D, Bishop J, Westra W, Califano JA. Recurrence patterns and management of oral cavity premalignant lesions. Oral Oncol. 2013;49:814–7.PubMedCrossRef
3.
go back to reference Kuribayashi Y, Tsushima F, Morita KI, Matsumoto K, Sakurai J, Uesugi A, et al. Long-term outcome of non-surgical treatment in patients with oral leukoplakia. Oral Oncol. 2015;51:1020–5.PubMedCrossRef Kuribayashi Y, Tsushima F, Morita KI, Matsumoto K, Sakurai J, Uesugi A, et al. Long-term outcome of non-surgical treatment in patients with oral leukoplakia. Oral Oncol. 2015;51:1020–5.PubMedCrossRef
4.
go back to reference Pitiyage G, Tilakaratne WM, Tavassoli M, Warnakulasuriya S. Molecular markers in oral epithelial dysplasia: review. J Oral Pathol Med. 2009;38:737–52.PubMedCrossRef Pitiyage G, Tilakaratne WM, Tavassoli M, Warnakulasuriya S. Molecular markers in oral epithelial dysplasia: review. J Oral Pathol Med. 2009;38:737–52.PubMedCrossRef
5.
go back to reference Kujan O, Sloan P. Dilemmas of oral cancer screening: an update. Asian Pac J Cancer Prev. 2013;14:3369–73.PubMedCrossRef Kujan O, Sloan P. Dilemmas of oral cancer screening: an update. Asian Pac J Cancer Prev. 2013;14:3369–73.PubMedCrossRef
6.
go back to reference Speight PM, Epstein J, Kujan O, Lingen MW, Nagao T, Ranganathan K, et al. Screening for oral cancer-a perspective from the Global Oral Cancer Forum. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017;123:680–7.PubMedCrossRef Speight PM, Epstein J, Kujan O, Lingen MW, Nagao T, Ranganathan K, et al. Screening for oral cancer-a perspective from the Global Oral Cancer Forum. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017;123:680–7.PubMedCrossRef
7.
go back to reference Warnakulasuriya S, Johnson NW, van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J Oral Pathol Med. 2007;36:575–80.PubMedCrossRef Warnakulasuriya S, Johnson NW, van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J Oral Pathol Med. 2007;36:575–80.PubMedCrossRef
8.
go back to reference Warnakulasuriya S, Kujan O, Aguirre-Urizar JM, Bagan JV, González-Moles MÁ, Kerr AR, et al. Oral potentially malignant disorders: a consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer. Oral Dis. 2021;27:1862–80.PubMedCrossRef Warnakulasuriya S, Kujan O, Aguirre-Urizar JM, Bagan JV, González-Moles MÁ, Kerr AR, et al. Oral potentially malignant disorders: a consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer. Oral Dis. 2021;27:1862–80.PubMedCrossRef
9.
go back to reference Rajaraman P, Anderson BO, Basu P, Belinson JL, D’Cruz A, Dhillon PK, et al. Recommendations for screening and early detection of common cancers in India. Lancet Oncol. 2015;16:e352–61.PubMedCrossRef Rajaraman P, Anderson BO, Basu P, Belinson JL, D’Cruz A, Dhillon PK, et al. Recommendations for screening and early detection of common cancers in India. Lancet Oncol. 2015;16:e352–61.PubMedCrossRef
10.
go back to reference IARC Working Group on the Evaluation of Carcinogenic Risks to Humans: Human Immunodeficiency Viruses and Human T-Cell Lymphotropic Viruses. Lyon, France, 1–18 June 1996. IARC Monogr Eval Carcinog Risks Hum 1996;67:1–424. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans: Human Immunodeficiency Viruses and Human T-Cell Lymphotropic Viruses. Lyon, France, 1–18 June 1996. IARC Monogr Eval Carcinog Risks Hum 1996;67:1–424.
11.
go back to reference Ko YC, Huang YL, Lee CH, Chen MJ, Lin LM, Tsai CC. Betel quid chewing, cigarette smoking and alcohol consumption related to oral cancer in Taiwan. J Oral Pathol Med. 1995;24:450–3.PubMedCrossRef Ko YC, Huang YL, Lee CH, Chen MJ, Lin LM, Tsai CC. Betel quid chewing, cigarette smoking and alcohol consumption related to oral cancer in Taiwan. J Oral Pathol Med. 1995;24:450–3.PubMedCrossRef
12.
go back to reference Shiu MN, Chen TH, Chang SH, Hahn LJ. Risk factors for leukoplakia and malignant transformation to oral carcinoma: a leukoplakia cohort in Taiwan. Br J Cancer. 2000;82:1871–4.PubMedPubMedCentralCrossRef Shiu MN, Chen TH, Chang SH, Hahn LJ. Risk factors for leukoplakia and malignant transformation to oral carcinoma: a leukoplakia cohort in Taiwan. Br J Cancer. 2000;82:1871–4.PubMedPubMedCentralCrossRef
13.
go back to reference Warnakulasuriya S. Significant oral cancer risk associated with low socioeconomic status. Evid Based Dent. 2009;10:4–5.PubMedCrossRef Warnakulasuriya S. Significant oral cancer risk associated with low socioeconomic status. Evid Based Dent. 2009;10:4–5.PubMedCrossRef
14.
go back to reference Petti S, Masood M, Scully C. The magnitude of tobacco smoking-betel quid chewing-alcohol drinking interaction effect on oral cancer in South-East Asia. A meta-analysis of observational studies. PLoS ONE. 2013;8:e78999.PubMedPubMedCentralCrossRef Petti S, Masood M, Scully C. The magnitude of tobacco smoking-betel quid chewing-alcohol drinking interaction effect on oral cancer in South-East Asia. A meta-analysis of observational studies. PLoS ONE. 2013;8:e78999.PubMedPubMedCentralCrossRef
15.
go back to reference Walsh T, Warnakulasuriya S, Lingen MW, Kerr AR, Ogden GR, Glenny AM, et al. Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy adults. Cochrane Database Syst Rev. 2021;12:CD010173.PubMed Walsh T, Warnakulasuriya S, Lingen MW, Kerr AR, Ogden GR, Glenny AM, et al. Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy adults. Cochrane Database Syst Rev. 2021;12:CD010173.PubMed
16.
go back to reference Kao SY, Chu YW, Chen YW, Liu TY. Detection and screening of oral cancer and pre-cancerous lesions. J Chin Med Assoc. 2009;72:227–33.PubMedCrossRef Kao SY, Chu YW, Chen YW, Liu TY. Detection and screening of oral cancer and pre-cancerous lesions. J Chin Med Assoc. 2009;72:227–33.PubMedCrossRef
17.
go back to reference Chen YK, Huang HC, Lin LM, Lin CC. Primary oral squamous cell carcinoma: an analysis of 703 cases in southern Taiwan. Oral Oncol. 1999;35:173–9.PubMedCrossRef Chen YK, Huang HC, Lin LM, Lin CC. Primary oral squamous cell carcinoma: an analysis of 703 cases in southern Taiwan. Oral Oncol. 1999;35:173–9.PubMedCrossRef
18.
go back to reference Hashibe M, Jacob BJ, Thomas G, Ramadas K, Mathew B, Sankaranarayanan R, et al. Socioeconomic status, lifestyle factors and oral premalignant lesions. Oral Oncol. 2003;39:664–71. PubMedCrossRef Hashibe M, Jacob BJ, Thomas G, Ramadas K, Mathew B, Sankaranarayanan R, et al. Socioeconomic status, lifestyle factors and oral premalignant lesions. Oral Oncol. 2003;39:664–71. PubMedCrossRef
19.
go back to reference Conway DI, Petticrew M, Marlborough H, Berthiller J, Hashibe M, Macpherson LM. Socioeconomic inequalities and oral cancer risk: a systematic review and meta-analysis of case-control studies. Int J Cancer. 2008;122:2811–9.PubMedCrossRef Conway DI, Petticrew M, Marlborough H, Berthiller J, Hashibe M, Macpherson LM. Socioeconomic inequalities and oral cancer risk: a systematic review and meta-analysis of case-control studies. Int J Cancer. 2008;122:2811–9.PubMedCrossRef
20.
go back to reference Lee CH, Ko AM, Warnakulasuriya S, Ling TY, Rajapakse PS, Zain RB, et al. Population burden of betel quid abuse and its relation to oral premalignant disorders in South, Southeast, and East Asia: an Asian Betel-quid Consortium Study. Am J Public Health. 2012;102:e17-24.PubMedPubMedCentralCrossRef Lee CH, Ko AM, Warnakulasuriya S, Ling TY, Rajapakse PS, Zain RB, et al. Population burden of betel quid abuse and its relation to oral premalignant disorders in South, Southeast, and East Asia: an Asian Betel-quid Consortium Study. Am J Public Health. 2012;102:e17-24.PubMedPubMedCentralCrossRef
21.
go back to reference Huang YT, Ho PS, Jou YY, Wu CY, Wang YW, Yang YH. Determining high prevalence of betel-quid chewing and cigarette smoking by occupation using the Taiwan National Health Interview Survey. Subst Use Misuse. 2020;55:1472–82.PubMedCrossRef Huang YT, Ho PS, Jou YY, Wu CY, Wang YW, Yang YH. Determining high prevalence of betel-quid chewing and cigarette smoking by occupation using the Taiwan National Health Interview Survey. Subst Use Misuse. 2020;55:1472–82.PubMedCrossRef
22.
go back to reference Ko YC, Chiang TA, Chang SJ, Hsieh SF. Prevalence of betel quid chewing habit in Taiwan and related sociodemographic factors. J Oral Pathol Med. 1992;21:261–4.PubMedCrossRef Ko YC, Chiang TA, Chang SJ, Hsieh SF. Prevalence of betel quid chewing habit in Taiwan and related sociodemographic factors. J Oral Pathol Med. 1992;21:261–4.PubMedCrossRef
23.
go back to reference Wen CP, Tsai SP, Cheng TY, Chen CJ, Levy DT, Yang HJ, et al. Uncovering the relation between betel quid chewing and cigarette smoking in Taiwan. Tob Control. 2005;14:i16-22.PubMedPubMedCentralCrossRef Wen CP, Tsai SP, Cheng TY, Chen CJ, Levy DT, Yang HJ, et al. Uncovering the relation between betel quid chewing and cigarette smoking in Taiwan. Tob Control. 2005;14:i16-22.PubMedPubMedCentralCrossRef
24.
go back to reference Lee CH, Ko AM, Warnakulasuriya S, Yin BL, Zain RB, Ibrahim SO, et al. Intercountry prevalences and practices of betel-quid use in south, southeast and eastern Asia regions and associated oral preneoplastic disorders: an international collaborative study by Asian betel-quid consortium of south and east Asia. Int J Cancer. 2011;129:1741–51.PubMedCrossRef Lee CH, Ko AM, Warnakulasuriya S, Yin BL, Zain RB, Ibrahim SO, et al. Intercountry prevalences and practices of betel-quid use in south, southeast and eastern Asia regions and associated oral preneoplastic disorders: an international collaborative study by Asian betel-quid consortium of south and east Asia. Int J Cancer. 2011;129:1741–51.PubMedCrossRef
25.
go back to reference Lee JJ, Hung HC, Cheng SJ, Chen YJ, Chiang CP, Liu BY, et al. Carcinoma and dysplasia in oral leukoplakias in Taiwan: prevalence and risk factors. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:472–80.PubMedCrossRef Lee JJ, Hung HC, Cheng SJ, Chen YJ, Chiang CP, Liu BY, et al. Carcinoma and dysplasia in oral leukoplakias in Taiwan: prevalence and risk factors. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:472–80.PubMedCrossRef
26.
go back to reference Lu Y, Sobue T, Kitamura T, Matsuse R, Kitamura Y, Matsuo K, et al. Cigarette smoking, alcohol drinking, and oral cavity and pharyngeal cancer in the Japanese: a population-based cohort study in Japan. Eur J Cancer Prev. 2018;27:171–9.PubMedCrossRef Lu Y, Sobue T, Kitamura T, Matsuse R, Kitamura Y, Matsuo K, et al. Cigarette smoking, alcohol drinking, and oral cavity and pharyngeal cancer in the Japanese: a population-based cohort study in Japan. Eur J Cancer Prev. 2018;27:171–9.PubMedCrossRef
27.
go back to reference Shiu MN, Chen TH. Impact of betel quid, tobacco and alcohol on three-stage disease natural history of oral leukoplakia and cancer: implication for prevention of oral cancer. Eur J Cancer Prev. 2004;13:39–45.PubMedCrossRef Shiu MN, Chen TH. Impact of betel quid, tobacco and alcohol on three-stage disease natural history of oral leukoplakia and cancer: implication for prevention of oral cancer. Eur J Cancer Prev. 2004;13:39–45.PubMedCrossRef
28.
go back to reference Sankaranarayanan R, Mathew B, Jacob BJ, Thomas G, Somanathan T, Pisani P, et al. Early findings from a community-based, cluster-randomized, controlled oral cancer screening trial in Kerala, India. The Trivandrum Oral Cancer Screening Study Group. Cancer. 2000;88:664–73.PubMedCrossRef Sankaranarayanan R, Mathew B, Jacob BJ, Thomas G, Somanathan T, Pisani P, et al. Early findings from a community-based, cluster-randomized, controlled oral cancer screening trial in Kerala, India. The Trivandrum Oral Cancer Screening Study Group. Cancer. 2000;88:664–73.PubMedCrossRef
29.
30.
go back to reference Tsai KY, Su CC, Chiang CT, Tseng YT, Lian IB. Environmental heavy metal as a potential risk factor for the progression of oral potentially malignant disorders in central Taiwan. Cancer Epidemiol. 2017;47:118–24.PubMedCrossRef Tsai KY, Su CC, Chiang CT, Tseng YT, Lian IB. Environmental heavy metal as a potential risk factor for the progression of oral potentially malignant disorders in central Taiwan. Cancer Epidemiol. 2017;47:118–24.PubMedCrossRef
31.
go back to reference Mello FW, Miguel AF, Dutra KL, Porporatti AL, Warnakulasuriya S, Guerra EN, et al. Prevalence of oral potentially malignant disorders: a systematic review and meta-analysis. J Oral Pathol Med. 2018;47:633–40.PubMedCrossRef Mello FW, Miguel AF, Dutra KL, Porporatti AL, Warnakulasuriya S, Guerra EN, et al. Prevalence of oral potentially malignant disorders: a systematic review and meta-analysis. J Oral Pathol Med. 2018;47:633–40.PubMedCrossRef
32.
go back to reference Napier SS, Speight PM. Natural history of potentially malignant oral lesions and conditions: an overview of the literature. J Oral Pathol Med. 2008;37:1–10.PubMedCrossRef Napier SS, Speight PM. Natural history of potentially malignant oral lesions and conditions: an overview of the literature. J Oral Pathol Med. 2008;37:1–10.PubMedCrossRef
33.
go back to reference Wang YY, Tail YH, Wang WC, Chen CY, Kao YH, Chen YK, et al. Malignant transformation in 5071 southern Taiwanese patients with potentially malignant oral mucosal disorders. BMC Oral Health. 2014;14:99.PubMedPubMedCentralCrossRef Wang YY, Tail YH, Wang WC, Chen CY, Kao YH, Chen YK, et al. Malignant transformation in 5071 southern Taiwanese patients with potentially malignant oral mucosal disorders. BMC Oral Health. 2014;14:99.PubMedPubMedCentralCrossRef
34.
go back to reference Chung CH, Yang YH, Wang TY, Shieh TY, Warnakulasuriya S. Oral precancerous disorders associated with areca quid chewing, smoking, and alcohol drinking in southern Taiwan. J Oral Pathol Med. 2005;34:460–6.PubMedCrossRef Chung CH, Yang YH, Wang TY, Shieh TY, Warnakulasuriya S. Oral precancerous disorders associated with areca quid chewing, smoking, and alcohol drinking in southern Taiwan. J Oral Pathol Med. 2005;34:460–6.PubMedCrossRef
35.
go back to reference Liu W, Bao ZX, Shi LJ, Tang GY, Zhou ZT. Malignant transformation of oral epithelial dysplasia: clinicopathological risk factors and outcome analysis in a retrospective cohort of 138 cases. Histopathology. 2011;59:733–40.PubMedCrossRef Liu W, Bao ZX, Shi LJ, Tang GY, Zhou ZT. Malignant transformation of oral epithelial dysplasia: clinicopathological risk factors and outcome analysis in a retrospective cohort of 138 cases. Histopathology. 2011;59:733–40.PubMedCrossRef
36.
go back to reference Reibel J, Gale N, Hille J, Hunt JL, Lingen M, Müller S, et al. Oral potentially malignant disorders and oral epithelial dysplasia. In: El Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ, editors., et al., WHO Classification of head and neck tumours. 4th ed. Lyon: IARC Press; 2017. p. 112–5. Reibel J, Gale N, Hille J, Hunt JL, Lingen M, Müller S, et al. Oral potentially malignant disorders and oral epithelial dysplasia. In: El Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ, editors., et al., WHO Classification of head and neck tumours. 4th ed. Lyon: IARC Press; 2017. p. 112–5.
37.
go back to reference Iocca O, Sollecito TP, Alawi F, Weinstein GS, Newman JG, De Virgilio A, et al. Potentially malignant disorders of the oral cavity and oral dysplasia: a systematic review and meta-analysis of malignant transformation rate by subtype. Head Neck. 2020;42:539–55.PubMedCrossRef Iocca O, Sollecito TP, Alawi F, Weinstein GS, Newman JG, De Virgilio A, et al. Potentially malignant disorders of the oral cavity and oral dysplasia: a systematic review and meta-analysis of malignant transformation rate by subtype. Head Neck. 2020;42:539–55.PubMedCrossRef
38.
go back to reference Mehanna HM, Rattay T, Smith J, McConkey CC. Treatment and follow-up of oral dysplasia—a systematic review and meta-analysis. Head Neck. 2009;31:1600–9.PubMedCrossRef Mehanna HM, Rattay T, Smith J, McConkey CC. Treatment and follow-up of oral dysplasia—a systematic review and meta-analysis. Head Neck. 2009;31:1600–9.PubMedCrossRef
39.
go back to reference Yan F, Reddy PD, Nguyen SA, Chi AC, Neville BW, Day TA. Grading systems of oral cavity pre-malignancy: a systematic review and meta-analysis. Eur Arch Oto-Rhino-L. 2020;277:2967–76.CrossRef Yan F, Reddy PD, Nguyen SA, Chi AC, Neville BW, Day TA. Grading systems of oral cavity pre-malignancy: a systematic review and meta-analysis. Eur Arch Oto-Rhino-L. 2020;277:2967–76.CrossRef
40.
go back to reference Chau L, Jabara JT, Lai W, Svider PF, Warner BM, Lin HS, et al. Topical agents for oral cancer chemoprevention: a systematic review of the literature. Oral Oncol. 2017;67:153–9.PubMedCrossRef Chau L, Jabara JT, Lai W, Svider PF, Warner BM, Lin HS, et al. Topical agents for oral cancer chemoprevention: a systematic review of the literature. Oral Oncol. 2017;67:153–9.PubMedCrossRef
41.
go back to reference Kawczyk-Krupka A, Waskowska J, Raczkowska-Siostrzonek A, Kościarz-Grzesiok A, Kwiatek S, Straszak D, et al. Comparison of cryotherapy and photodynamic therapy in treatment of oral leukoplakia. Photodiagnosis Photodyn Ther. 2012;9:148–55.PubMedCrossRef Kawczyk-Krupka A, Waskowska J, Raczkowska-Siostrzonek A, Kościarz-Grzesiok A, Kwiatek S, Straszak D, et al. Comparison of cryotherapy and photodynamic therapy in treatment of oral leukoplakia. Photodiagnosis Photodyn Ther. 2012;9:148–55.PubMedCrossRef
42.
go back to reference Kuribayashi Y, Tsushima F, Morita KI, Matsumoto K, Sakurai J, Uesugi A, et al. Long-term outcome of non-surgical treatment in patients with oral leukoplakia. Oral Onco. 2015;51:1020–5.CrossRef Kuribayashi Y, Tsushima F, Morita KI, Matsumoto K, Sakurai J, Uesugi A, et al. Long-term outcome of non-surgical treatment in patients with oral leukoplakia. Oral Onco. 2015;51:1020–5.CrossRef
43.
go back to reference Roosaar A, Yin L, Johansson AL, Sandborgh-Englund G, Nyrén O, Axéll T. A long-term follow-up study on the natural course of oral leukoplakia in a Swedish population-based sample. J Oral Pathol Med. 2007;36:78–82.PubMedCrossRef Roosaar A, Yin L, Johansson AL, Sandborgh-Englund G, Nyrén O, Axéll T. A long-term follow-up study on the natural course of oral leukoplakia in a Swedish population-based sample. J Oral Pathol Med. 2007;36:78–82.PubMedCrossRef
44.
go back to reference Holmstrup P, Vedtofte P, Reibel J, Stoltze K. Long-term treatment outcome of oral premalignant lesions. Oral Onco. 2006;42:461–74.CrossRef Holmstrup P, Vedtofte P, Reibel J, Stoltze K. Long-term treatment outcome of oral premalignant lesions. Oral Onco. 2006;42:461–74.CrossRef
Metadata
Title
Association between socioeconomic status and severity of oral epithelial dysplasia using a Taiwanese Nationwide Oral Mucosal Screening Program: a retrospective analysis
Authors
Tien-En Chiang
Yu-Chun Lin
Chi-Tsung Wu
Sheng-Tang Wu
Yuan-Wu Chen
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2022
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-022-02084-7

Other articles of this Issue 1/2022

BMC Oral Health 1/2022 Go to the issue