This study reinforces the association of current areca quid chewing without tobacco, cigarette smoking, and alcohol drinking to leukoplakia, OSF, and verrucous lesions in Taiwan.

This research divides oral health status into two parts: clinical disease and patients' subjective perceptions, and then discusses what impact these two items have on the health-related quality of life. A total of 1600 elderly persons, over 65 years old, were sampled as the research target. The overall response rate was 71.62%. SF-36 was used to measure the health-related quality of life, Oral Health Impact Profile (OHIP) was used to measure individuals' subjective perception of their oral health status, and the number of natural teeth was considered as the clinical issue. There are 12 items which affect quality of life in the physical aspect, namely: OHIP score; age; gender; weekly frequency of social activities and interactions; financial status; physician visits per month on a regular basis; hospitalization during the last 6 months; arthritis, rheumatism, cardiovascular disease or diabetes; abnormal IADL patients; and the satisfaction level of current lifestyle. Factors affecting quality of life (i.e. mental aspects), are few, including: OHIP score, gender, education level, weekly frequency of social activities and interactions and satisfaction level of current lifestyle. The results indicate that individuals' subjective perceptions of their oral health status had a greater impact, than did the clinical issue, on their health-related quality of life. The outcomes and findings derived from this research may provide alternative perspectives for professionals, so that they may be more careful concerning individuals' subjective perceptions.

Because the mRNA expression of cyclooxygenase-2 (COX-2) is up-regulated by arecoline in human gingival fibroblasts, as shown in our previous study, we further investigated the mRNA expression level of COX-2 and its upstream effectors in three oral epithelial carcinoma cell lines (KB, SAS, and Ca9-22) by using areca nut extract (ANE) and saliva-reacted ANE (sANE). A case-control study of 377 oral squamous cell carcinoma (OSCC) patients and 442 controls was conducted to evaluate the geneenvironment interaction between COX-2 promoter polymorphisms and substance use of alcohol, betel quid, and cigarettes (ABC) in risk of OSCC. The heterogeneous characteristics of the oral site and the COX-2 À1195G>A polymorphism in these cell lines showed diverse inflammatory response (KBJCa9-22>SAS) after 24-hour ANE/sANE treatments, and the COX-2 up-regulation might be mostly elicited from alternative nuclear factor-KB activation. In the case-control study, betel chewing [adjusted odds ratios (aOR), 42.2] posed a much higher risk of OSCC than alcohol drinking and cigarette smoking (aORs, 2

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