Oral cancer knowledge and practices of dentists along the Texas-Mexico border

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, Opinions, and Practices of Oral Cancer Prevention among Palestinian Practicing Dentists: An Online Cross-Sectional Questionnaire

Oral-health professionals play a critical role in the early recognition and prevention of oral cancer; however, most patients are diagnosed in the advanced stages that demonstrate poor prognosis. Therefore, this study aimed to investigate the knowledge, opinions, and clinical practices of practicing dentists related to oral cancer prevention and oral mucosal screening in Palestine. This research used an online cross-sectional questionnaire design. Practicing dentists in Palestine completed the 44-item questionnaire encompassing the following four sections: (a) personal data (6 items); (b) oral cancer knowledge (21 items); (c) opinions and beliefs related to oral cancer (10 items); and (d) clinical practices related to oral cancer (7 items). The questionnaire was sent to all eligible participants (N = 650) between July and September of 2022. The response rate was 39.1% (N = 254). About 70.1% of the respondents had poor knowledge of oral cancer and its risk factors, and almost 84.3% had positive opinions related to oral cancer prevention and oral mucosal screening. Concerning the clinical practices, only 29.9% routinely examined their patients every time their patients visited. More experienced dentists showed significantly more positive opinions and better clinical practices related to oral cancer prevention and screening; however, they had significantly lower knowledge scores compared with the younger dentists (p < 0.05). Inadequate training was the most reported perceived boundary against routine oral cancer screening. Palestinian dentists appeared to have positive opinions related to oral cancer prevention and oral mucosal screening. However, the assessment of the knowledge and clinical practices revealed deficiencies in this regard.

Association between sociodemographic characteristics and level of knowledge about oral cancer among Mexican dental health professionals: a cross-sectional online survey

BACKGROUND

A good level of knowledge in dentists is crucial for an early diagnosis of oral cancer (OC). In Latin America there are a few studies of OC knowledge among dentist, those has been performed in Brazil, Colombia, and Chile, and their results showed low level of OC knowledge. On the other hand, there is no publication in which the level of knowledge of dentists in Mexico has been addressed. Therefore, this study aimed to assess knowledge of OC and to determine the association of the level of knowledge with sociodemographic characteristics among dentists in Mexico.

METHODS

A cross-sectional online survey was designed to obtain information via questionnaire. The questionnaire was developed in the Spanish language, and the content validity was determined. The study was conducted among Mexican dentists with a 23-item questionnaire that was designed to be anonymous. The sample size was calculated using the finite population formula. Based on the responses, the level of knowledge of OC was categorized as very low, low, regular, good, or excellent. Additionally, the association between sociodemographic characteristics and the level of knowledge about OC was evaluated.

RESULTS

This research was conducted on a sample of 387 dentists. Most of the respondents were general dentists and worked in urban zones. The majority of dentists lacked a specialty (76.7%). Additionally, most of the respondents were students (44.2%). The level of knowledge of the participants was between regular and good (77.8%). On the other hand, concerning self-evaluation, most of the participants considered their knowledge of OC to be regular (50.6%). In addition, there was no association between sociodemographic characteristics and knowledge about OC.

CONCLUSIONS

This research identified some weaknesses in most Mexican dentists' knowledge of OC.

Current Knowledge, Attitudes, and Practice among Health Care Providers in OSCC Awareness: Systematic Review and Meta-Analysis

OSCC remain a global health problem. Lack of awareness leads to inadequate watchfulness regarding early signs/symptoms despite the ease of visual oral inspection. What clinicians know and feel, and how they behave on OSCC is crucial to understand the feasibility and effectiveness of screening programs. The aim of this systematic review was to assess knowledge, attitudes, and practice (KAP) regarding OSCC among health care providers (HCPs). Therefore, a systematic review was conducted with SPIDER and PICO as major tools. A meta-analysis was structured through common items in two comparison groups of medical and dental practitioners. Descriptive statistics and a Mantel–Haenszel test were used to validate data. Sixty-six studies were selected for systematic review, eight of which are useful for meta-analysis. A statistically significant difference was recorded between dentists and medical practitioners for questions regarding: Alcohol (p < 0.001); Elderly (p < 0.012); Sun exposure (p < 0.0001); Erythroplakia (p < 0.019); Red patch (p < 0.010); White patch (p < 0.020); Tobacco consultation (p < 0.0001); Intraoral examination (p < 0.0001) and Up-to-date knowledge (p < 0.002). Overall, the incidence of OSCC screening is low. Most HCPs feel the need to increase KAP. Data confirmed gaps in KAP, highlighting the need for a more efficient pre- and post-graduation training, necessary to increase competence worldwide.

Oral-cancer knowledge, practice, and attitude assessment of dentists in Upper Egypt: A cross-sectional study

The aims of this study were to investigate the knowledge, attitude, and practice of dentists in Upper Egypt with regard to oral cancer (OC). Out of 1,200 licensed dental practitioners list, 424 dentists were randomly selected from three governorates in Upper Egypt (Minia, Assuit, and Sohag). The sample size was calculated using the equation considering the knowledge of dentists about OC, confidence level, and margins of error; then, an additional number of dentists were added to guard against nonresponse. Data were collected by face-to-face interview using 44 items divided into four sections; first part demonstrates sociodemographic. The second part concerned with the knowledge about OC clinical presentation and diagnosis (12 multiple-choice questions) as well as its risk factors (17 close-end questions). The third part consists of six questions focused on the practice of participants, and finally, the last part measures attitude of dentists. The chi-square test was used to compare between the two or more proportions. A correlation was used for describing the relationship or association between two mutually numerical dependent variables. p < 0.05 was considered to indicate significance. Rate of response was 94.3%. The overall knowledge level in the current study was 31.8%. The awareness about OC risk factors was high especially, smoking tobacco and alcohol consumption. Also, over 80% of dentists identified family history and human papillomavirus (HPV) as risk factors. Only 37.5% of participants performed regular screening of oral mucosa, and 26.5% reported lymph-node examination. Regarding attitude, only one quarter of dentists attended continuing educating programs about OC. A statistically significant relation (p < 0.0001) between knowledge level and most demographic variables was detected. There was a fair positive correlation (r = 0.47) between practice and knowledge scores. A predominant trouble among dentists in Upper Egypt was regarding OC knowledge and practice. Continues education and training programs are highly recommended.

Oral cancer knowledge of senior dental students in Zahedan, South-East of Iran

BACKGROUND

Oral carcinoma is one of the common types of cancer and one of the 10 leading causes of death around the world. This study was conducted to evaluate senior dental student knowledge about oral cancerous lesions in Zahedan Dental School.

MATERIALS AND METHODS

In this cross-sectional research, all the students in the last academic year at the School of Dentistry were studied during year of 2013. The study questionnaire covered demographic data as well as 12 questions concerning the knowledge of oral cancer. Data were collected and analyzed with SPSS18 using independent t-test, one way ANOVA. Significance level was considered as p≤0.05.

RESULTS

Of the 104 senior dental students, with an average age of 27.34± 7.79 years, who participated in this study, 32 (30.8%) were female and 72 (69.2%) were male. The mean score of the students regarding the knowledge of oral cancer was 7.24±2.61. 20 students (19.2%) had a weak knowledge, 45 students (43.3%) had a moderate knowledge, and 39 students (37.5%) had a good knowledge.

CONCLUSIONS

The student knowledge of oral cancer is not satisfactory and they need to receive additional information and education.

Dentists' knowledge, attitude, and practice regarding oral cancer in Iran

Dentists are usually the first group who can examine patients for oral cancer and the early diagnosis highly depends on their knowledge. In this study, we aim to survey the Iranian dentists' knowledge, attitude, and behaviors regarding oral cancer. A valid and reliable self-administered questionnaire was designed and sent to 150 dentists. Responses to the questionnaires were analyzed using descriptive and analytical statistics. Just one fifth of the dentists reported to perform oral cancer examination for all of their patients in age of 40 and above and about 34 % of them were knowledgeable. They mostly claimed that the lack of knowledge is the main barriers to the provision of routine oral cancer examinations. The opinion of dentists about the effectiveness of continuing education courses supports the development of these courses on oral cancer. Besides, more emphasis should be placed on oral cancer prevention in dental schools.

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.

Oral cancer awareness among dentists in Kuwait

OBJECTIVES

The aim of this study was to assess oral cancer awareness among dentists in Kuwait.

SUBJECTS AND METHODS

A cross-sectional survey was conducted among 200 dentists working at the Ministry of Health Dental Centers and Kuwait University Dental Center using a structured questionnaire. Dentists' knowledge about risk factors of oral cancer and about diagnostic concepts, current practices and opinions, preferred point of referral as well as interest in continuing education were assessed and the responses were analyzed.

RESULTS

Of the 200 dentists surveyed, 153 responded (76.5% response rate). The mean knowledge score of the respondents was 20.6 ± 4.0 out of a total score of 30. Thirty-five (22.9%) dentists had consistently high knowledge scores for both risk factors and diagnostic concepts. Of the 153 dentists, 132 (86.3%) were interested in obtaining further information about oral cancer.

CONCLUSION

This study highlighted the need for improved knowledge and education of dental practitioners on oral cancer.

Perspectives of San Juan healthcare practitioners on the detection deficit in oral premalignant and early cancers in Puerto Rico: a qualitative research study

Background

In Puerto Rico, relative to the United States, a disparity exists in detecting oral precancers and early cancers. To identify factors leading to the deficit in early detection, we obtained the perspectives of San Juan healthcare practitioners whose practice could be involved in the detection of such oral lesions.

Methods

Key informant (KI) interviews were conducted with ten clinicians practicing in or around San Juan, Puerto Rico. We then triangulated our KI interview findings with other data sources, including recent literature on oral cancer detection from various geographic areas, current curricula at the University of Puerto Rico Schools of Medicine and Dental Medicine, as well as local health insurance regulations.

Results

Key informant-identified factors that likely contribute to the detection deficit include: many practitioners are deficient in knowledge regarding oral cancer and precancer; oral cancer screening examinations are limited regarding which patients receive them and the elements included. In Puerto Rico, specialists generally perform oral biopsies, and patient referral can be delayed by various factors, including government-subsidized health insurance, often referred to as Reforma. Reforma-based issues include often inadequate clinician knowledge regarding Reforma requirements/provisions, diagnostic delays related to Reforma bureaucracy, and among primary physicians, a perceived financial disincentive in referring Reforma patients.

Conclusions

Addressing these issues may be useful in reducing the deficit in detecting oral precancers and early oral cancer in Puerto Rico.

Comparing dentists' and the public's awareness about oral cancer in a community-based study in Northern Germany

INTRODUCTION

The purpose of the study was to compare the knowledge about oral cancer of dentists and the public using a standardised, internationally accepted questionnaire in Schleswig-Holstein, Germany.

MATERIAL AND METHODS

In November 2007, a standardised questionnaire about knowledge on oral cancer was mailed to all dentists within the state (n=2233). Simultaneously, a polling firm conducted a representative survey with a shortened version of the questionnaire, via computer-aided telephone interview, among the public (n=1000).

RESULTS

The results are based on 306 usable dental questionnaires (n=14%) and 1000 interviews of the population. Most of the diagnostic factors were correctly identified by the dentists, whereas less than 30% of the public knew these factors. Only 47% of the dentists and 27% of the public were aware that the patient is asymptomatic in the early stage of oral cancer. The knowledge about risk factors was inconsistent and showed deficits by the dentists as well as by the public.

CONCLUSIONS

The survey revealed a few gaps in dentists' knowledge compared to large deficits in the public's knowledge about oral cancer. Based on these results, a continuing educational programme for the dentists as well as an educational campaign for the public should be pursued.

Oral cancer preventive practices of South Carolina dentists and physicians

The purpose of this study was to assess the South Carolina (SC) dentists' and physicians' oral cancer knowledge and practices and interest in training in oral cancer screening and tobacco cessation counseling. Method used was a cross-sectional survey of SC dentists and selected physician specialties with responses to mailed questionnaires summarized by descriptive statistics and chi-square tests for comparisons. Overall response rates were 58%for dentists and 44% for physicians. Dentists (81%) and 13% of the physicians reported conduct of oral cancer examinations at least half of the time over the past 12 months. Dentists (41%) and 83% of physicians assisted patients to quit smoking. Few dentists (19%) and 53% of physicians were aware of SC tobacco cessation resources. Dentists (40%) and physicians (37%) were interested in receiving training in oral cancer screening, and 36% and 49%, respectively, in training in tobacco cessation counseling. Results support the development of tailored education for SC dentists and physicians to achieve Healthy People 2010 Oral Health Objectives for Oral Cancer.

Dentists' perspectives on oral cancer: a survey in Northern Germany and a comparison with international data

The objective of this study was to assess the knowledge on diagnostic procedures and risk factors for oral cancer among dentists in Northern Germany by means of a standardized questionnaire. A self-administered questionnaire was mailed to all dentists in Schleswig-Holstein, Germany, which was composed of 41 items focusing on knowledge about diagnostic procedures for oral cancer and its main risk factors. Three hundred and six of 2,233 questionnaires were returned and analysed. Most dentists correctly agreed that early detection of oral cancer improves 5-year survival. Knowledge of the facts that oral cancer is mostly diagnosed at an advanced stage and that the floor of the mouth is a common site to be affected was higher compared with international data. In contrast, knowledge was lower on the appearance of oral cancer and its symptoms in the early stages. Dentists were less certain about the role of nonrisk factors (e.g. family history) than that of risk factors. Continuous education on oral cancer within the past year was the only background factor that significantly contributed to a better knowledge onrisk-related and diagnostic factors. Profound knowledge about diagnostic procedures and risk factors for oral cancer is essential for dentists. This survey was informative with regard to areas of high versus low knowledge and will help design appropriate continuing education programmes.

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.

Training in the Primary Prevention and Early Detection of Oral Cancer: Pilot Study of its Impact on Clinicians’ Perceptions and Intentions

In this pilot study, we tested a new program for training medical care providers in the primary prevention and early detection of oral cancer. The training program consisted of two modules: (1) oral cancer epidemiology and head and neck examinations for the early detection of oral cancer and (2) assessment and counseling of patients in tobacco cessation. On a pretraining questionnaire, the 8 participating clinicians (3 primary care physicians, 4ENT nurses, and 1 physician assistant) indicated that they had only a limited awareness of oral cancer, that they generally did not routinely examine asymptomatic patients for oral cancer, and that they engaged in only a limited amount of risk assessment/counseling with their patients. On a post-training questionnaire, they indicated that their training had been well received and would prompt them to increase their efforts to examine their patients for early signs of oral cancer and to counsel them about its risks.

Oral Cancer Prevention and Early Detection Knowledge and Practices of Illinois Dentists ? A Brief Communication

OBJECTIVES

The purpose of the study was to assess Illinois dentists' self-reported knowledge and practices concerning oral cancer prevention, early detection, and management as a baseline prior to conducting interventions designed to increase dentists' capacity to detect and manage oral cancers and counsel their patients about risk reduction.

METHODS

A weighted sample to represent licensed dentists in 19 counties yielded 518 dentists who responded to a 38-item mailed survey in 2004.

RESULTS

Over 92 percent of the dentists reported providing oral cancer exams. However, many are not doing them properly or at frequent intervals. Over two-thirds had oral cancer continuing education, but 40 percent had it more than 2 years prior to the survey. Training in risk counseling was rare.

CONCLUSIONS

Interventions are needed to assure appropriate skill and knowledge levels for oral cancer early detection, management, and risk counseling by Illinois dentists.

Adequacy of training in oral cancer prevention and screening as self-assessed by physicians, nurse practitioners, and dental health professionals

OBJECTIVE

To assess the educational preparedness of medical and dental professionals to reduce the burden of OPC through planning effective cancer control strategies such as reducing tobacco consumption, suggesting healthy lifestyle and diet, and performing early detection through screening examinations and appropriate follow-up.

METHODS

Self-reported adequacy of training in oral and pharyngeal cancer (OPC) early intervention activities was compared among 4 health care provider groups in North Carolina. Pretested surveys were mailed to random samples of licensed professionals.

RESULTS

Nearly all providers agreed that early detection improves 5-year survival rates from OPC. Compared with 567 medical providers (273 family physicians and 294 nurse practitioners), 1235 dental providers (584 dentists and 651 hygienists) were significantly less likely to feel adequately trained in tobacco and alcohol cessation and to palpate neck nodes, but were significantly more likely to feel adequately trained to perform oral cancer examinations. Among dental providers, those who felt they had adequate training in tobacco and alcohol cessation were significantly more likely to assess these risk factors on patient medical histories.

CONCLUSIONS

Education is needed to prepare dental providers to undertake OPC prevention activities, whereas medical providers would benefit from enhanced oral examination skills to improve their performance in early detection.