Background:
Oral Mucosal Lesions (OMLs) present a critical challenge in oncology due to their established potential for malignant transformation. While tobacco and alcohol are traditional markers for risk, the impact of polypharmacy and systemic health in general populations remains underexplored. This study utilized data from the Adult Maltese National Oral Health Survey to evaluate OML incidence. The survey was organized by the Faculty of Dental Surgery, University of Malta and employed a unique outreach methodology: participants included adults residing in Malta were screened by calibrated research assistants via the University of Malta Mobile Dental Unit (MDU) and the Gozo Teaching Clinic, providing a robust model for accessible community surveillance.
 
Objectives:
The primary objective of this study was to elucidate the epidemiological profile of OMLs within a national cohort. Specifically, the study aimed to systematically assess the correlation between OML incidence and patient pharmacotherapy, alongside the influence of advancing age. A key goal was to investigate significant associations to isolate specific drug classes and demographic factors acting as independent variables in lesion development, thereby establishing an evidence base for targeted screening protocols.
 
Methods:
A cross-sectional analytical study was performed on a representative sample, stratified for age and gender, of the population (n=1,032). Clinical data included demographics, medical history, pharmacotherapy, and lifestyle habits. Demographics were divided into age, gender and nationality. Medical history was coded into medical conditions and medications. Lifestyle habits comprised of smoking and alcohol consumption. Statistical analysis utilized Kruskal-Wallis (KW) for smoking type and demographic variables with OML presence, while Mann-Whitney U (MW) test was carried out to determine associations between these medications, medical conditions, alcohol consumption, smoking status and OML presence. Spearman’s rho (ρ) was carried out to assess the association between the smoking quantity per day with OML prevalence. All tests were performed with statistical significance defined as p < 0.05.
 
Results:
The data revealed a statistically significant positive correlation between advancing age and OML incidence (KW p=0.017), with peak prevalence observed in the 65–74 age bracket. Notably, while underlying medical conditions (e.g., hypertension, diabetes) did not show a significant association with OML prevalence, a statistically significant link was established with specific pharmacological agents. Higher OML incidence was observed in patients prescribed antihypertensives (MW p=0.004), proton-pump inhibitors (MW p=0.003), psychotropics (MW p=0.017), corticosteroids (MW p=0.023), and anticoagulants (MW p=0.032). Significance was not obtained between the other variables and OML prevalence.
 
Conclusions/Implications:
This study highlights a clear area for oncological action: Targeted Medication Review. The results suggest that geriatric patients and those undergoing specific pharmacotherapy require heightened vigilance for soft tissue lesions. This underscores the need for the integration of OML education into established national oral health screening campaigns. The latter represents a cost-effective strategy to increase
cancer awareness without inciting undue public anxiety. Furthermore, the success of the MDU in this study serves as a scalable blueprint for international health authorities; adopting similar mobile outreach programs facilitates opportunistic screening and associated referral services, effectively bridging the gap between the public and early cancer detection.