Knowledge and clinical expertise regarding oral cancer among Brazilian dentists

A systematic review of dentists' knowledge, perception, practice and confidence in managing patients with cancers

PURPOSE

Little is known about dentists' preparedness in managing oral side effects in patients undergoing cancer therapy (CTx). The purpose of this systematic review is to identify barriers and facilitators of dentists in managing oral health of cancer patients (CPs).

METHODS

The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was Prospero registered (CRD42022333055). CINAHL, Embase, Medline, PsycInfo and Scopus databases were searched using keywords and MeSH terms: dentists, oral health, cancer. The outcomes were analysed descriptively and thematically.

RESULTS

Of the 2303 articles screened 53 met eligibility criteria. Most of articles (n = 50) reported on head and neck cancer (HNC) management. Dentists' oral cancer (OC) knowledge varied across studies (27% to 81%, n = 35). Regardless of their knowledge level, the majority of dentists expressed interest in further cancer education. Across studies, dentists perceived that their role included providing dental treatment for OC patients. However, of the few studies (n = 3) that explored dentists' confidence in managing CPs, less than half of dentists felt confident providing advice to patients with HNC. More barriers than facilitators are identified in providing dental care provision to CPs.

CONCLUSION

This review demonstrates gap in dental care for patients with non-HNCs and highlights a need for methods to involve dentists in managing dental health of CPs.

Knowledge, Attitudes, Practices, and Perceptions of Brazilian Dentists About Oral Cancer

Dentists play a pivotal role in the early detection of oral cancer. Consequently, they are expected to possess the knowledge and the capability to recognize the features of this disease. The objective of the study is to evaluate dentists from different regions of Brazil regarding their level of knowledge and self-confidence regarding oral cancer. An online self-administered questionnaire was completed by dentists across Brazil registered on the TelessaúdeRS-UFRGS platform. This questionnaire encompassed inquiries related to knowledge, attitudes, and practices regarding oral cancer. A total of 1291 dentists from all regions of the country responded to the questionnaire. The majority of participants were females (75.5%), with an average age of 36.3 years, predominantly from the public sector (46.8%). A reasonable level of knowledge regarding oral cancer was observed among dentists, although 48.6% of these professionals felt uncertain about diagnosis procedures. Dentists less than 8 years since graduation perceived themselves as more prepared to perform oral cancer diagnoses than those with more experience. Around 55% of participants had never performed a biopsy. Based on the obtained results, it is concluded that continuous education activities focused on oral cancer and implementing practical training during undergraduate studies are imperative. These strategies can improve professionals' self-confidence and diagnostic accuracy, thereby facilitating early disease diagnosis and, consequently, a more favorable prognosis.

Assessment of the Need for Designing an Interactive Educational Tool on Exophytic Lesions of the Oral Mucosa

Introduction This study sought to evaluate the necessity of creating an interactive educational resource for instructing dental students on oral exophytic lesions. It also aimed to determine the validity and reliability of a questionnaire designed to assess the quality of educational software tailored to these lesions. Materials and methods This descriptive cross-sectional study involved 102 dental students from Mashhad University of Medical Sciences, Iran, who had completed the theoretical course on oral exophytic lesions. A paper questionnaire, including 23 items, assessed their clinical knowledge, the efficacy and limitations of existing educational resources, and the need for interactive electronic courseware (e-courseware). The questionnaire's validity and reliability were evaluated through expert feedback and statistical measures (intraclass correlation coefficient (ICC) and Cronbach's alpha). Results Students' answers to the seven items about evaluating their clinical diagnosis knowledge of oral exophytic lesions were between four and five items correct on average. This finding indicated that students' overall skill in diagnosing exophytic lesions was poor to moderate. The study highlighted a moderate level of self-assessed clinical ability in diagnosing oral exophytic lesions among students (62.7%), with a preference for textbooks and color atlases as primary information sources. The disadvantages of existing electronic resources were noted, alongside a strong student consensus (88.23%) on the need for interactive e-courseware featuring comprehensive, visually engaging content for differential diagnosis education. The reliability and validity analyses of the questionnaire underscored its appropriateness for assessing educational needs. In this regard, ICC for the usability of scientific context, training ability, and interaction was 0.92, 0.73, and 0.82, respectively. Also, Cronbach's alpha score was at 0.90. Conclusion The research underscores a significant gap in dental students' knowledge and diagnostic skills regarding oral exophytic lesions. It emphasizes the critical need for an innovative, interactive educational tool that aligns with contemporary students' digital learning preferences. The envisioned e-courseware would facilitate self-learning and address current resources' limitations, potentially transforming dental education by enhancing clinical diagnostic skills through accessible, effective, and engaging digital content.

Evaluación del conocimiento del cáncer oral y manejo odontológico del paciente oncológico en Cali, Colombia

Objetivo: evaluar el conocimiento del cáncer oral y su manejo odontológico, en estudiantes de pregrado de último año de medicina y odontología y odontólogos egresados de diferentes universidades en Cali, Colombia. Métodos: se realizó un estudio descriptivo, cuantitativo de corte transversal. El instrumento de recolección de datos fue una encuesta de 19 preguntas. La muestra incluyó 360 participantes y se realizó un análisis multivariado con pruebas no paramétricas con un grado de confiabilidad del 95%. Resultados: las categorías evaluadas fueron: I) conocimiento del cáncer oral y II) manejo del paciente oncológico. Según la rúbrica empleada, el nivel alcanzado fue “regular” en ambas categorías, con un promedio de 8,7/19 para estudiantes de odontología, 11,29/19 para estudiantes de medicina y 11,33/19 para odontólogos egresados. La media general fue 10,37 respuestas acertadas (a=0,05). Hubo diferencias estadísticamente significativas al evaluar las tres facultades de odontología en ambas categorías y la rúbrica refleja un desempeño “regular” aún para la universidad con el mejor promedio. Conclusión: el nivel de conocimiento sobre cáncer oral y su manejo odontológico en Cali, Colombia, según la rúbrica planteada es insuficiente en la población evaluada y se sugiere un replanteamiento de estrategias de abordaje de estos temas desde la academia.

Knowledge of Oral Precancerous Lesions Considering Years Since Graduation Among Dentists in the Capital City of Iran: a Pathway to Early Oral Cancer Diagnosis and Referral?

Background:

Late diagnosis and improper treatment lead to many avoidable deaths in patients suffering from oral cancer. This study evaluated the knowledge and perceptions of general dentists regarding oral precancerous lesions and oral cancer risk factors with reference to early diagnosis and referral.

Materials and Methods:

In this descriptive study, 200 private general dental practitioners were randomly selected in Tehran, Iran. Demographic information and years since graduation were recorded; knowledge levels were evaluated with a standardized questionnaire consisting of 15 closed-response item questions about precancerous lesions and oral cavity cancer. Each correct answer got one point.

Results:

Out of 200 selected dentists, 153 returned completed questionnaires. The average age of participants was 36 and the average achieved score was 7.96 out of 15 (Min 3, Max 13). Most (64.7%) of participants were in the group that graduated within the previous 10 years, 23.5% between 10 and 20 years since graduation, and 11.8% more than 20 years previously. There was a statistically significant difference between the most recently graduated group (< 10 years) and the other two groups. The dentists’ awareness was also significantly dependent on age. There was no statistically significant difference in awareness between male and female dentists.

Conclusion:

As professional oral health care providers, dentists should be aware of all aspects regarding precancerous lesions in order to optimize early diagnosis and referral of oral cancer patients. Training courses and continuing education seem to be an essential strategy to increase and maintain knowledge of this group.

Oral Cancer Knowledge Assessment: Newly Graduated versus Senior Dental Clinicians

The present study assessed the level of dentists' knowledge regarding oral cancer in the city of São Paulo, Brazil. A questionnaire was used to compare the level of knowledge among newly graduated and senior clinicians. A total of 20,154 e-mails were correctly delivered to the dentists registered in the database of the Regional Dentistry Council of São Paulo, and 477 (2.36%) responses were received. This sample consisted of 84 newly graduated clinicians and 105 senior clinicians. For the statistical analysis, the chi-square test and the logistic regression analysis were performed with α = 0.05, and the results were described herein. According to their knowledge level, the results were statistically different between the groups, since 19% of the newly graduated clinicians were evaluated with knowledge grade A (excellent) in comparison to 6.7% of the senior clinicians. In spite of the results indicated that newly graduated clinicians' knowledge regarding oral cancer was 2.1 times higher, 34.5% of the professionals in this group had regular or poor knowledge on the subject, and several questions relating to clinical characteristics and risk factors indicated that there still exist some knowledge gaps, demonstrating that there is a need for further studies and information activities addressing oral cancer.

Impact of academic and continuing education on oral cancer knowledge, attitude and practice among dentists in north-western Italy

The present study aims to assess the knowledge, attitude and practice of dentists practicing in the Turin Province (north-western Italy) regarding oral cancer prevention and early detection, to weigh the impact of academic and continuing education and to compare actual and perceived knowledge/practice. A survey was prospectively carried out using an anonymous 23-item questionnaire. Bivariate analyses, multivariate logistic regression analyses and Spearman's correlation analyses examined the overall effect of demographic/background characteristics of responders, with particular emphasis on academic and continuing education. The responder group was formed by 450 dentists representative of the Turin Province Council of Dentists. Both academic and continuing education have a significant impact on knowledge, with a significant association between the time elapsed from continuing education and the degree of knowledge. Knowledge acquired during graduation is seen to significantly weaken in the absence of continuing education. The present study highlights the need of both thorough academic curricula and compulsory current continuing education.

Expertise regarding dental management of oral cancer patients receiving radiation therapy among Western Australian dentists

OBJECTIVES

Dental care forms an important part of the multidisciplinary management of oral cancer patients. The aim of this study was to examine actual and self-perceived knowledge and clinical expertise regarding dental management of oral cancer patients receiving radiation therapy among Western Australian general dentists.

MATERIALS AND METHODS

An invitation to participate in a web-based questionnaire was emailed to 1095 dentists registered with the Australian Dental Association (ADA), WA branch. To assess dentists' knowledge and expertise, actual and perceived knowledge was investigated. Information regarding type of practice, practice location, year of graduation and number of oral cancer patients treated in the preceding 12 months was also obtained.

RESULTS

One hundred and ninety one dentists responded to the survey. General dentists who took part in the study appeared to possess some knowledge regarding dental management of oral cancer patients treated with radiation therapy. The majority of responders however identified deficiencies in their knowledge and willingness to participate in continuing education programs.

CONCLUSION

In view of the rising incidence of oral cancer in Western Australia, efforts should be made to provide more clinically relevant training to dentists in this area.

A comparison of screening methods in two early phase oral leukoplakia clinical trials

OBJECTIVES/INTRODUCTION

Clinical trial accrual for oral dysplasia is difficult in the United States and elsewhere. Patients with dysplastic oral leukoplakia progress to frank invasive carcinoma at a rate of 5-37% over 5 years. We compared two clinical trial screening efforts to hopefully devise better accrual strategies to these types of clinical trials.

METHODS

For the first trial, we identified 244 patients with dysplastic oral leukoplakia in our university database and a media campaign. Patients were notified and screened by examination and biopsy. For the second clinical trial, we established a preneoplastic lesions clinic and teaching and communications network with regional oral healthcare professionals.

RESULTS

Only one of 244 patients accrued to the first clinical trial through an organized screening effort based on database/medical records review. The second clinical trial accrued 16/30 screened patients through redirected efforts in teaching, communications, and a preneoplastic lesions clinic.

CONCLUSION

We conclude that significant difficulties resulted from medical record/database review of leukoplakia patients as a screening method for leukoplakia clinical trial entry. We feel that persistent direct contact and education of healthcare professionals who are likely to examine leukoplakia patients improved accrual to the second clinical trial.

Knowledge and attitudes about oral cancer among dentists in Spain

OBJECTIVES

Detecting oral cancer (OC) at an early stage is the most effective means of improving survival and reducing morbility from disease. The objective was to study the knowledge, opinions and attitudes held by general dentists in Spain regarding aspects of OC in general clinic practice.

METHODS

A 44-item questionnaire relating to OC was randomly distributed by email to 1000 dentists in the different autonomous communities in Spain.

RESULTS

The response rate was 42.7%. Only 49.7% of the dentists who replied considered themselves to have up-to-date knowledge on OC. A total of 94.7% of those interviewed hold the opinion that it is the dentists who are qualified to carry out the oral examination. In addition, 41.8% felt that family doctors and 13.8% that dental hygienists were also capable of making this examination. We should highlight that dentists who rated their undergraduate OC training favourably were more likely to agree that their OC knowledge was current than those who rated their undergraduate training unfavourably [odds ratio (OR) = 4.1, 95% confidence interval (CI) = 1.1-4.2, P = 0.019). Respondents who performed oral cancer examinations on all patients 40 years of age or older were 1.8 times more likely to agree that their OC knowledge was current; however, the differences were not significant (OR = 1.3, 95% CI = 0.6-2.7, P = 0.392).

CONCLUSIONS

Gaps in knowledge exist, strongly suggesting the need for continued courses of education detection and prevention of OC.

Knowledge and attitude towards risk factors in oral cancer held by dental hygienists in the Autonomous Community of Murcia (Spain): A pilot study

The objective was to study the knowledge and attitude on risk factors in oral cancer held by dental hygienists working in private dental practices in the Autonomous Community of Murcia, Spain. An anonymous phone survey was made after obtaining consent from the interviewee. A simple randomized study was carried out and 240 dental hygienists were selected. The questionnaire was divided into three different parts: (1) professional data and years of practice; (2) knowledge of the risk factors in oral cancer and (3) education and training needs on oral cancer. The response rate was 58.3%. Regarding knowledge of the risk factors in oral cancer, 100% correctly identified tobacco and 90% alcohol, while only 50.7% identified sun exposure with labial cancer. Only 51.4% of the dental hygienists routinely gave advice to their patients on prevention of oral cancer. Furthermore, 57.1% did not consider themselves sufficiently well trained to discover suspected oral cancer lesions, and 84.3% recognized that their academic training on the early diagnosis and prevention of oral cancer was insufficient for their professional activity. To reduce morbidity and mortality of oral cancer it is necessary to implement training programs on oral cancer for dental hygienists, so they may acquire the necessary skills for its detection and prevention.