Why don't dentists talk to patients about oral cancer?

Oral cancer diagnosis communication: Impact of an educational intervention using the SPIKES protocol

OBJECTIVE

This study evaluated the influence of a single educational intervention on the perception and knowledge of strategies for communicating oral cancer diagnoses.

METHODS

A educational intervention, 72 dentists and 41 dental undergraduates participated in the 'Maio Vermelho Project', a continuing education activity. Participants completed a 14-question online questionnaire concerning their experiences and perceptions of delivering difficult news. The educational intervention featured an interview illustrating the SPIKES protocol, broadcast on YouTube.

RESULTS

Participants had a mean age of 40 years. A minority (21.2%) had encountered or experienced communicating an oral cancer diagnosis. Exposure to lectures on this topic during their education was uncommon (22.1%) but more prevalent among students. After the intervention, confidence in communicating a cancer diagnosis (29.2%) and addressing the patient's family (30.1%) in line with the SPIKES protocol increased.

CONCLUSION

A training deficit persists in delivering cancer diagnoses, highlighting the need for educational interventions to empower students and professionals in this critical procedure. Integration of this topic into the dental undergraduate curriculum is imperative.

CLINICAL RELEVANCE

Effectively communicating a cancer diagnosis poses challenges to healthcare professionals, impacting treatment outcomes. Implementing educational interventions ensures that professionals are well prepared to navigate this complex task, ultimately improving patient care.

Talking about cancer: Patient responses to raising awareness of oral cancer in primary dental care

OBJECTIVES

Dentists and other members of the dental team could raise awareness by talking about oral cancer during routine dental check-ups. A communication guide has been developed to facilitate this. However, it has been suggested that discussions about oral cancer may raise patients' anxiety and this has been documented by dentists as a barrier to having these conversations. The current research aimed to investigate implementation of the communication guide and its impact on the dental patient.

METHODS

A consecutive-case sample of adult dental patients attending primary dental care for a routine NHS check-up at one dental practice were invited to take part in the study via letter prior to their appointment. Consultations of participating patients (n = 77) were audio-recorded. Before and after their appointment, patients were asked to rate their current anxiety via the six-item version of Spielberger's State-Trait Anxiety Inventory. Audio recordings of each consultation were reviewed by two raters to determine the extent to which the dentist covered the topics recommended in the communication guide.

RESULTS

The dentist informed all patients that they were being checked for oral cancer, spoke about signs and symptoms, and discussed risk factors. However, they rarely recommended where help should be sought or addressed barriers to seeking help. Discussions took an average of 95 s. The extent to which oral cancer was discussed did not correlate with patients' post-appointment anxiety. Patients made positive or neutral responses to the discussions. The few questions that were asked were easily addressed.

CONCLUSIONS

As findings are based on one dentist working at one practice, generalization of these results should be cautious. The study indicated that using an evidence-based guide to talk about oral cancer did not appear to raise patients' anxiety in this practice population. This could help to increase awareness of oral cancer in the endeavour to facilitate early cancer diagnosis.

An Exploration of Black Men's Attitudes and Experiences Communicating with Dentists about Oral and Pharyngeal Cancer

BACKGROUND

Poor oral and pharyngeal cancer (OPC) survival among Black men is partially due to their limited knowledge about OPCs, which is exacerbated by dentists' limited training and discomfort in discussing OPC risk factors. The purpose of this study was to assess the attitudes and experiences that Black men have communicating with dentists about OPCs.

METHODS

To qualitatively assess these attitudes and experiences, a focus group guide and recruitment strategy were developed using a community engagement approach. Data were analyzed using grounded theory.

RESULTS

Twenty-three self-identified Black men participated in three focus groups through the Zoom platform (mean age of 46.1 years). Four main themes emerged, which identified that participants: (1) had little knowledge of OPCs; (2) felt that addressing OPC risk among Black men was not a priority for dentists; (3) stressed the importance of dentists acknowledging the complexity of how race and gender affects Black men's healthcare experiences; and (4) expressed a benefit to receiving information from multiple social networks.

CONCLUSION

The focus groups provided context for how dentists might engage with Black men in discussions about OPC prevention and treatment.

A community-based participatory protocol to improving communication with Black men about oral and pharyngeal cancers: Research protocol

Black men are disproportionately impacted by oral and pharyngeal cancer (OPC) mortality. This is in part due to a lack of information received about OPCs and their associated risk factors during health encounters. Discussions between dentists and Black men may improve Black men's knowledge, screening, and treatment uptake. Yet, dentists do not commonly communicate with Black men about OPCs due to their own discomfort. This paper describes the protocol for our research project, which proposes an initiative, grounded in community-based participatory research, to adapt a culturally-specific OPC communication tool. This tool will be adapted using a mixed-methods approach to assess the knowledge, attitudes, and experiences of Black men discussing OPCs and associated risk factors with dental providers. The tool will then be assessed for feasibility and acceptability among Black men, as well as dental students and dental providers in community-based clinical settings.

Continuing education activities improve dentists' self-efficacy to manage oral mucosal lesions and oral cancer

OBJECTIVES

This cross-sectional study aims to evaluate whether Continuing Education Activities (CEA) influence dentists' behaviour in relation to oral lesions. The secondary aim is to assess the association between dentists' perception of learning adequacy and self-efficacy for oral mucosal lesion management.

METHODS

A self-administered online questionnaire was conducted on dentists working at the public health system of Rio Grande do Sul State, Brazil. The questionnaire included questions pertaining to perception of adequacy for oral diagnosis classes upon graduation, participation in oral cancer CEA and self-efficacy in managing oral mucosal lesions.

RESULTS

221 dentists from 91 municipalities answered the questionnaire. Most participants were female (71.5%) with a mean age of 38.3 years. Perception of learning as adequate during undergraduate coursework was associated with self-efficacy to diagnose, biopsy, and treat oral mucosal lesions (P < .05, Chi-squared test). However, 83.3% of dentists considered the time devoted to these topics prior to graduation insufficient. The frequency of oral lesion detection was related to self-efficacy to treat oral lesions and detecting oral cancer (P < .05, Chi-squared test). Among dentists who detected oral lesions frequently, 88.9% had attended CEA, whereas 11.1% of them had never attended these activities.

CONCLUSIONS

CEA may improve awareness and efficacy of primary healthcare professional's detection of oral cancer.

A qualitative study of attitudes to and perceptions of betel quid consumption and its oral health implications in Taiwan

OBJECTIVES

Betel quid (BQ) chewing is extremely prominent in South and Southeast Asia because it considered by users to be of social, cultural and religious importance. BQ chewing has been recognized as a risk factor for oral premalignant lesions and oral cancer. Because BQ chewing has become a severe health risk in Taiwan, the development of prevention and cessation programmes is essential. The purpose of this study was to explore the attitudes and perceptions associated with BQ consumption and its oral health implications in an attempt to inform the development of health promotion initiatives and BQ cessation efforts in Taiwan, where the dental profession could have a pivotal role in preventing and controlling BQ use among persons at risk.

METHODS

This qualitative study used data gathered from focus groups and individual interviews. A convenience sample of 41 adults from Jhushan and Lugu Townships (Nantou County) and Taichung City, Taiwan, participated in this study (27 men, 14 women; 31 Han, 10 aboriginals from the Paiwan tribe; mean age 40.3, SD 9.2 years).

RESULTS

Among the seven themes that emerged from the original study, five (Initiation, Health Risk Perception, Health Consequences, Withdrawal Symptoms and Help from Healthcare Providers) had oral/dental implications.

CONCLUSIONS

Our study highlights research areas relevant to further investigation, such as incorporating brief BQ prevention and cessation counselling when early oral and dental signs associated with BQ consumption are detected. Undertaking behavioural interventions in dental settings might help to reduce the prevalence of BQ chewing in Taiwan.

Knowledge and Attitudes About Oral Cancer Among Dental Students After Bologna Plan Implementation

Oral cancer is the most common of head and neck tumours. Dentists have an important role in the most effective prevention measures: controlling aetiological factors and early detection. Dental curriculum has suffered changes in their structures and contents during Bologna process. The aim of this study is to explore oral cancer knowledge and attitudes among dental students of Granada after the implementation of the Bologna plan. A cross-sectional study was carried out in the School of Dentistry of the University of Granada. A questionnaire was delivered to dental students in the fourth and fifth years (of study) to assess knowledge and attitudes about oral cancer area. 79.3 % related that they examined the oral mucosa from their patients regularly. Almost the whole sample (95.9 %) said that they would advise their patients about risk factors for oral cancer when they graduated. Tobacco followed by alcohol was the main oral cancer risk factor identified (94.2 and 72.7 %, respectively). 96.7 % of the sample would like to receive more information about this subject. Fourth year students had taught self-examination for early detection of oral cancer more frequently than fifth year students (42.5 versus 22.9 %, respectively). The results of this study revealed that dental students had good attitudes in the area of oral cancer. On the other hand, it highlights the need for an improvement of the teaching program regarding risk factors for oral cancer and performing routine oral examination.

Educational intervention about oral piercing knowledge among dental students and adolescents at schools

INTRODUCTION

Oral piercing can lead to complications and dentists are in a unique position to detect such complications. The purpose of this study was: (i) to assess the immediate and the long-term effects, on dental students, of a training programme about oral piercing knowledge; and (ii) to assess the immediate effect, on adolescents, of a single educational intervention session about oral piercing.

METHODS

A training programme for dental students (n = 66) was carried out in three phases. The last phase consisted of preparing and giving talks about oral piercing at schools, which was delivered by a random selection of dental students involved in the training programme. Dental students answered a questionnaire about oral piercing knowledge, before, immediately after (only the dental students included in the last phase) and 12 months after the training programme. Adolescents (n = 347) answered a survey about oral piercing knowledge before and after the talks.

RESULTS

There were statistically significant differences in all comparison groups, except for the results in the 'before intervention' and in the '12 months after intervention' groups among dental students who had not prepared and given the talks to adolescents. Knowledge about oral piercing significantly improved among adolescents when comparing results before (mean questionnaire score = 3.0) and after (mean questionnaire score = 6.2) the talks.

CONCLUSIONS

Oral piercing educational intervention had a favourable impact on adolescents and dental students, particularly among those who were more involved in the learning process.

A New Practice Approach for Oral Health Professionals

The oral health care paradigm presented here would broaden oral health services to include primary health care activities focusing on risk reduction and chronic disease screening.

BACKGROUND AND PURPOSE

Changes in our nation's health care delivery system, shifting patient demographics, and availability of new health insurance programs have resulted in exploration of new practice models of health care delivery. Chronic diseases require coordinated care efforts over decades of a patient's life. Oral health professionals will be part of that care.

METHODS

The practice model for this article was developed in the context of an academic medical center that promotes oral health care professionals as health care providers through interprofessional education. The combined experiences of the authors, including a diabetes predictive model for oral health settings, the efficacy and effectiveness of human immunodeficiency virus screening in a dental setting, the feasibility of using a decision support tool for tobacco cessation, and the effectiveness of integrating oral health education with comprehensive health services for people living with human immunodeficiency virus, have contributed to this concept.

CONCLUSIONS

Prevention is increasingly recognized as a cost-effective means of reducing chronic disease burdens. To be effective, health promotion activities that encourage healthy living and early detection need to occur in a variety of health care settings. Oral health professionals represent an underutilized group of health care providers that can contribute to improved health of populations living with chronic diseases by broadening their scope of practice to include primary health screenings and tailored health promotion activities.