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?

Knowledge and Awareness of Detecting Oral Premalignant Lesions among Dental Students, Interns, and Practitioners in Saudi Arabia

Oral malignant lesions are the most common malignancy of which majority are diagnosed in advanced stages in Saudi Arabia. Patients with oral malignant lesion are first seen by general dental practitioners and dental students. Multiple surveys have been conducted and published to assess the students, interns, and dentists' awareness and attitude toward oral premalignant lesions worldwide. However, little is known about this issue in Saudi Arabia. We aimed to assess knowledge and awareness of detecting oral premalignant lesions among dental students, dental interns, and practitioners in Saudi Arabia. A cross-sectional questionnaire-based survey was conducted and electronically distributed. The questionnaire comprised of three sections including demographic variables, knowledge of risk factors of oral malignancy, and six clinical case scenarios. Descriptive statistics were used, and the results were reported using cross-tabulation and the Chi-square test. A 300 participants answered to the questionnaire, and 83% of respondents strongly agreed that smoking is a risk factor for oral malignancy. However, there was some uncertainty in responses for some more specific oral-related factors, such as a sharp-edged tooth and irritation from dental restoration. Furthermore, the knowledge and awareness of detecting frankly benign and frankly malignant lesions such as fibroma and squamous cell carcinoma are higher comparing to potentially malignant lesion, i.e. lichen planus. Knowledge and awareness of detecting oral premalignant lesions vary based on malignancy factors and by participants academic level. Fibroma and SCC are detected easily among all participants. However, lichen planus was the hardest to diagnose among oral lesions.

Oral Cancer Awareness Among Princess Nourah bint Abdulrahman University Dental Students and Interns

BACKGROUND

Dentists have a very important role in the early diagnosis of oral cancer premalignancy. This aspect of dental practice requires an adequate level of knowledge.

OBJECTIVE

This study aimed to assess the level of knowledge of undergraduate dental students and dental interns about early diagnosis and risk factors of oral cancer.

METHODS

The present cross-sectional study was conducted at the Dental College, Princess Nourah bint Abdulrahman University, Saudi Arabia. Fourth-year and fifth-year students and dental interns were enrolled in the study. The participants were recruited using a convenient, non-probability sampling method. A total of 103 participants filled out a close-ended, online questionnaire. We used descriptive and analytical statistics to analyze the responses to the questionnaire.

RESULTS

The level of general knowledge was moderate (67%). More than half of the participants gave complete responses to questions related to early signs of oral cancer (67%), risk factors (54%), risk sites (75%), treatment plans for leukoplakia (66%), and unhealed ulcer management (58%). We found significant associations between the correct responses and the year of the study regarding early signs of oral cancer (p=0.0001), high malignant potential lesions (p=0.00001), and chronic unhealed ulcer management (p=0.015).  Conclusion: A more satisfactory level of awareness is needed among future dentists, to prevent missing patients undiagnosed with early oral cancerous lesions during routine screening. Consequently, upgrading theoretical curricula, clinical experience, and post-graduate participation in cancer prevention programs is highly recommended.

Knowledge, opinions, and practices related to oral cancer prevention and oral mucosal examination among dentists in Moldova, Belarus and Armenia: a multi-country cross-sectional study

INTRODUCTION

Moldova, Belarus, and Armenia are post-Soviet countries with a high rate of heavy smokers and a relatively high age-standardized incidence of oral cancer. However, to our knowledge, there is lack of available information on dentists' knowledge on prevention of oral cancer in the countries in question. Accordingly, this study aimed to assess the knowledge, opinions, and practices related to oral cancer prevention and oral mucosal examination among dentists in Moldova, Belarus, and Armenia.

METHODS

This was a multi-country, cross-sectional study based on a self-administered questionnaire. A structured questionnaire was distributed to 3534 dentists (797 in Chisinau, Moldova, 1349 in Minsk, Belarus, and 1388 in Yerevan, Armenia). Dentists' knowledge about risk factors for oral cancer development and its clinical picture, current practices and opinions with regard to oral mucosal screening and oral cancer prevention, and their consistency to perform oral mucosal examination were assessed. A knowledge score ranging from 0 to 14 points was generated based on each dentist's answer to the questionnaire.

RESULTS

A total of 1316 dentists responded, achieving an overall response rate of 37.2% (34.5% in Moldova; 52.3% in Belarus; 24.2% in Armenia). Most dentists in the three countries correctly identified tobacco (83.8-98.2%) and prior oral cancer lesions (84.0-96.3%) as risk factors for oral cancer. Most dentists correctly identified leukoplakia as a lesion with malignant potential (68.7% in Moldova; 88.5% in Belarus; 69.9% in Armenia), while erythroplakia was identified by much fewer in all three countries. Less than 52% of dentists identified the tongue, rim of tongue, and floor of mouth as the most common sites for oral cancer. The mean knowledge score for all countries combined was 7.5 ± 2.7. The most commonly reported barriers to perform oral mucosal examination were lack of training, knowledge, and experience.

CONCLUSIONS

This study highlights the need for improved oral cancer-related education and training on oral mucosal examination for dentists in Moldova, Belarus, and Armenia. Such skills are essential to enhance oral cancer prevention and to improve the prognostic outcome by early detection.

RASSF-1A modulates proliferation-mediated oral squamous cell carcinoma progression

Background

To investigate the expression of RASSF-1A in oral squamous cell carcinoma (OSCC) and adjacent tissues, and to explore its mechanism of action in the development of OSCC.

Methods

RASSF-1A and proliferation-related protein expression in clinical and OSCC mouse models were detected by qPCR and western blot. In vitro experiments were used siRNA knockdown of RASSF-1A gene in SCC9 cells to detect cell proliferation, migration and apoptosis. In vivo experiments were performed using adenovirus overexpressing RASSF-1A gene in mice and observing tumor growth.

Results

The results of qPCR and western blot showed that the expression of RASSF-1A gene was decreased in OSCC, and the expression of CyclinD1 protein was increased. The results of co-immunoprecipitation showed that the two proteins were significantly combined in the oral cancer cell line. Knocking down the RASSF-1A gene in SCC9 cells promotes cell migration and proliferation, while reducing apoptosis and increasing CyclinD1 protein expression. Overexpression of RASSF-1A gene in mice reduces tumor volume and inhibits CyclinD1 protein expression.

Conclusions

Low expression of RASSF-1A gene in OSCC promotes the expression of CyclinD1 protein and tumor growth.