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Aly NM, El Kashlan MK, Giraudeau N, El Tantawi M. A Tele-detection and referral pAthways model for early childhood cariEs control- a protocol for a randomized factorial study: the TRACE study. BMC Oral Health 2024; 24:934. [PMID: 39129017 PMCID: PMC11318187 DOI: 10.1186/s12903-024-04706-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 08/05/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Early childhood caries (ECC) is one of the most common childhood diseases affecting the primary teeth of children younger than 6 years of age. ECC progression can be reversed in the early stages although these lesions often go undetected. New approaches are needed to detect oral diseases at an early stage when they can be better controlled. The aim of the study is to assess the effectiveness of ECC tele-detection methods combined with referral pathways with and without user fee removal in controlling ECC. METHODS A randomized factorial trial will be used to compare two tele-dentistry detection methods for ECC (intraoral camera and smartphone camera) and two referral pathways (user fee removal versus conventional care). The study will recruit children younger than 6 years of age in marginalized communities in Alexandria, Egypt. The primary outcome is the percentage of teeth receiving indicated care, while the secondary outcomes are the oral health-related quality of life, acceptance of teledentistry by dentists, procedure time, and child cooperation. Two-way analysis of variance will be used to assess the effect of the two factors as between group variables on the outcomes after 6 and 12 months. The interaction between detection methods and referral pathways will also be assessed, and the effect of confounders will be controlled in a multivariable linear regression model. DISCUSSION The findings of this study have the potential to inform clinical practice and oral healthcare policies for ECC management. Successful tele-detection and referral pathways could be integrated into oral healthcare systems, leading to improved oral health outcomes for children. TRIAL REGISTRATION The trial has been registered on ClinicalTrials.gov in August 2023 (initial release) ID: NCT06019884.
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Affiliation(s)
- Nourhan M Aly
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria University, Champollion St., Azarita, Alexandria, 21527, Egypt.
| | - Mona K El Kashlan
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria University, Champollion St., Azarita, Alexandria, 21527, Egypt
| | | | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria University, Champollion St., Azarita, Alexandria, 21527, Egypt
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Martínez-Ramírez J, Saldivia-Siracusa C, González-Pérez LV, Cuadra Zelaya FJM, Gerber-Mora R, Cabrera OFG, Bologna-Molina R, Gilligan G, Delgado-Azañero W, Rajendra Santosh AB, González-Arriagada WA, Villarroel-Dorrego M, Rojas BV, Gallagher KPD, Tager EMJR, Aranda-Romo S, García-Heredia GL, Garcia EC, Hurtado I, Turcios CA, Espinal LPS, González RAM, Prado Ribeiro AC, Ribeiro-Rotta RF, Kowalski LP, Curado MP, Toporcov TN, Sollecito TP, Carvalho AL, Lopes MA, Warnakulasuriya S, Santos-Silva AR. Barriers to early diagnosis and management of oral cancer in Latin America and the Caribbean. Oral Dis 2024. [PMID: 38380784 DOI: 10.1111/odi.14903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE This study aimed to explore perceived barriers to early diagnosis and management of oral cancer, as well as potential pathways for improvement in Latin America and the Caribbean (LAC). METHODS This cross-sectional study used a self-administered online questionnaire created via the Research Electronic Data Capture platform. The survey was distributed to health professionals trained in Oral Medicine, Oral Pathology, Oral and Maxillofacial Surgery, and Dentists with clinical and academic expertise in oral potentially malignant disorder (OPMD) and oral cancer. Data obtained were systematically organized and analyzed descriptively using Microsoft Excel. RESULTS Twenty-three professionals from 21 LAC countries participated. Major barriers included the limited implementation of OPMD and oral cancer control plans (17.4%), low compulsory reporting for OPMD (8.7%) and oral cancer (34.8%), unclear referral pathways for OPMD (34.8%) and oral cancer (43.5%), and a shortage of trained professionals (8.7%). Participants endorsed the utility of online education (100%) and telemedicine (91.3%). CONCLUSION The survey highlights major perceived barriers to early diagnosis and management of OPMD and oral cancer in LAC, as well as potential avenues for improvement.
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Affiliation(s)
- Josefina Martínez-Ramírez
- Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
- Faculty of Dentistry, University of El Salvador, San Salvador, El Salvador
| | | | - Leonor-Victoria González-Pérez
- Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
- Laboratory of Immunodetection and Bioanalysis, Investigation Group POPCAD, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | | | - Roberto Gerber-Mora
- Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Ronell Bologna-Molina
- Research Department, School of Dentistry, Universidad Juárez del Estado de Durango, Durango, Mexico
- Molecular Pathology Area, School of Dentistry, Universidad de la República, Montevideo, Uruguay
| | - Gerardo Gilligan
- Oral Medicine Department, School of Dentistry, Universidad Nacional de Córdoba, Haya de la Torre SN, Córdoba, Argentina
| | - Wilson Delgado-Azañero
- Department of Oral Pathology, Oral Medicine and Oral Surgery, School of Dentistry, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Arvind Babu Rajendra Santosh
- School of Dentistry, Faculty of Medical Sciences, The University of the West Indies, Kingston, Jamaica
- Department of Oral Medicine, Faculty of Dentistry, Universitas Airlangga, Surabaya, Indonesia
| | - Wilfredo Alejandro González-Arriagada
- Universidad de los Andes, Facultad de Odontología, Santiago, Chile
- Centro de Investigación e Innovación em Biomedicina, Universidad de los Andes, Las Condes, Chile
| | | | - Bernardo Venegas Rojas
- Department of Stomatology, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Karen Patricia Domínguez Gallagher
- Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
- Oral Pathology, School of Dentistry, National University of Asunción, Asunción, Paraguay
| | - Elena María José Román Tager
- Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
- Pathology Section, Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala
| | - Saray Aranda-Romo
- Diagnostic clinic, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | | | | | - Ileana Hurtado
- School of Dentistry, University of San Carlos, Guatemala City, Guatemala
| | | | | | | | - Ana Carolina Prado Ribeiro
- Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
- Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Oral Medicine Service, Sírio Libanês Hospital, São Paulo, Brazil
| | | | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil
- Head and Neck Surgery Department and LIM 28, University of São Paulo Medical School, São Paulo, Brazil
| | - Maria Paula Curado
- Group of Epidemiology and Statistics on Cancer, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Tatiana Natasha Toporcov
- Epidemiology Department, Faculdade de Saude Pública da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Saman Warnakulasuriya
- The WHO Collaborating Centre for Oral Cancer, London, UK
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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