Diagnostic Accuracy of Oral Cancer and Suspicious Malignant Mucosal Changes among Future Dentists

Development and Evaluation of an Automated Multimodal Mobile Detection of Oral Cancer Imaging System to Aid in Risk-Based Management of Oral Mucosal Lesions

Oral cancer is a major global health problem. It is commonly diagnosed at an advanced stage, although often preceded by clinically visible oral mucosal lesions, termed oral potentially malignant disorders, which are associated with an increased risk of oral cancer development. There is an unmet clinical need for effective screening tools to assist front-line healthcare providers to determine which patients should be referred to an oral cancer specialist for evaluation. This study reports the development and evaluation of the mobile detection of oral cancer (mDOC) imaging system and an automated algorithm that generates a referral recommendation from mDOC images. mDOC is a smartphone-based autofluorescence and white light imaging tool that captures images of the oral cavity. Data were collected using mDOC from a total of 332 oral sites in a study of 29 healthy volunteers and 120 patients seeking care for an oral mucosal lesion. A multimodal image classification algorithm was developed to generate a recommendation of "refer" or "do not refer" from mDOC images using expert clinical referral decision as the ground truth label. A referral algorithm was developed using cross-validation methods on 80% of the dataset and then retrained and evaluated on a separate holdout test set. Referral decisions generated in the holdout test set had a sensitivity of 93.9% and a specificity of 79.3% with respect to expert clinical referral decisions. The mDOC system has the potential to be utilized in community physicians' and dentists' offices to help identify patients who need further evaluation by an oral cancer specialist. Prevention Relevance: Our research focuses on improving the early detection of oral precancers/cancers in primary dental care settings with a novel mobile platform that can be used by front-line providers to aid in assessing whether a patient has an oral mucosal condition that requires further follow-up with an oral cancer specialist.

Oral Cancer Awareness Among Dental Students and Interns at Khatam Al Nabieen University, Kabul, Afghanistan

Background

Oral cancers, the eighth most common globally and sixth in Afghanistan, pose a major public health challenge due to limited healthcare access. Awareness is vital for prevention, control, and early detection.

Materials and Methods

This cross-sectional study was conducted among university students in Kabul, Afghanistan, from April to November 2022. A revalidated questionnaire containing 14 closed-ended questions was translated into Dari by a specialist and distributed in person to students and dental interns, with an average completion time of approximately 10 min. The collected data were then analyzed using IBM SPSS version 25.

Results

The study included 178 males (39.3%) and 275 females (60.7%). About 74.6% identified smoking and tobacco chewing as causes of oral cancer, and 74.9% knew it is not transmitted through physical contact or speaking. Additionally, 60.9% believed oral cancer is curable. Males had a higher mean knowledge score (62.7%) compared to females (58.4%). More females had heard of oral cancer, but there were no significant gender differences in knowledge about causes, transmission, or the impact of AIDS on oral cancer.

Conclusion

The study revealed insufficient knowledge about oral cancer among participants. While males exhibited slightly better understanding than females, the difference was not significant.

Factors influencing engagement in oral cancer prevention activities among dental students and professionals in Saudi Arabia

BACKGROUND

Oral cancer is a pressing health concern in the Saudi Arabia (SA), with rising incidence and mortality rates. Despite the efforts in raising awareness, gaps persist in knowledge, attitudes, and practices (KAP) related to oral cancer prevention (OCP) among dental health professionals. This study aimed to identify the key factors influencing engagement in oral cancer prevention activities among dental students and professionals in Saudi. It examines the impact of socio-demographic characteristics and assesses their KAP related to oral cancer prevention.

METHOD

A cross-sectional study was conducted between November 2023 and February 2024 using a pre-validated online questionnaire distributed among oral health providers across various regions and sectors in SA. The survey included questions about participants' KAP toward OCP. Descriptive statistics and logistic regression analyses were used to analyze the data.

RESULTS

Out of 400 oral health providers invited, 157 completed the survey. The findings showed a discrepancy between knowledge and practice. While awareness of OC was generally high, this did not consistently lead to favourable attitudes or effective practices. The engagement in OCP activities was significantly associated with good knowledge, practice and favourable attitude scores. Profession significantly influenced participation, with clinicians (P = 0.013, OR = 0.131, 95% CI: 0.026-0.653) and those in administrative roles (P = 0.030, OR = 0.101, 95% CI: 0.013-0.804) both less likely to participate compared to dental students. Knowledge was a significant predictor (P = 0.002), with providers demonstrating poor knowledge being far less likely to participate (OR = 0.053, 95% CI: 0.008-0.339).

CONCLUSION

The study identified a critical need for enhancing OCP education and training among oral health providers in SA. The findings indicate that continuous, targeted, and culturally sensitive training could bridge the existing KAP gap, potentially leading to improved early detection and management of OC, thereby reducing its morbidity and mortality rates in the region.

Assessment of Dental Students' Knowledge and Attitudes About the Epidemiologic and Clinical Characteristics of Oral Cancer: Implications for Other Middle-income Countries

The stage of detection of head and neck cancer and the time between detection and treatment are critical to prognosis. The importance of the dentist in primary diagnosis and treatment planning has been emphasized. The purpose of this study was to evaluate the knowledge of dental students in the prevention and early diagnosis of oral cancer. A descriptive cross-sectional study was conducted on 199 students from different institutions. A self-administered questionnaire with 34 multiple-choice questions on clinical and epidemiologic knowledge and opinions about oral cancer was used. Descriptive analysis to show means and frequencies and the binomial logistic regression test were used to perform the statistical analysis. The confidence level used was 95%. The results showed that all students in the study had heard of the existence of oral cancer, but only 24.6% knew someone with the disease. The majority reported a lack of information in the population about prevention and self-examination, as well as a lack of information campaigns in institutions. Although the majority perform clinical examinations of the oral mucosa (73.4%) and refer patients with suspicious lesions to specialists, there is low confidence in performing biopsies (73.4%) and gaps in training during graduation (84.4%). The majority have never attended continuing education courses on oral cancer but show interest (97.5%). The study identifies deficiencies in the knowledge and practices of dental students and highlights the need for improved teaching and training to promote oral cancer prevention and early detection. Further research in this area and ongoing assessment of students' skills are suggested.

A cytomics-on-a-chip platform and diagnostic model stratifies risk for oral lichenoid conditions

OBJECTIVE

A small fraction of oral lichenoid conditions (OLC) have potential for malignant transformation. Distinguishing OLCs from other oral potentially malignant disorders (OPMDs) can help prevent unnecessary concern or testing, but accurate identification by nonexpert clinicians is challenging due to overlapping clinical features. In this study, the authors developed a 'cytomics-on-a-chip' tool and integrated predictive model for aiding the identification of OLCs.

STUDY DESIGN

All study subjects underwent both scalpel biopsy for histopathology and brush cytology. A predictive model and OLC Index comprising clinical, demographic, and cytologic features was generated to discriminate between subjects with lichenoid (OLC+) (N = 94) and nonlichenoid (OLC-) (N = 237) histologic features in a population with OPMDs.

RESULTS

The OLC Index discriminated OLC+ and OLC- subjects with area under the curve (AUC) of 0.76. Diagnostic accuracy of the OLC Index was not significantly different from expert clinician impressions, with AUC of 0.81 (P = .0704). Percent agreement was comparable across all raters, with 83.4% between expert clinicians and histopathology, 78.3% between OLC Index and expert clinician, and 77.3% between OLC Index and histopathology.

CONCLUSIONS

The cytomics-on-a-chip tool and integrated diagnostic model have the potential to facilitate both the triage and diagnosis of patients presenting with OPMDs and OLCs.

Clinical competency of dental health professionals and students in diagnosing oral mucosal lesions

OBJECTIVE

Proper identification of oral potentially malignant disorders (OPMDs) provides an opportunity for oral cancer prevention. This study aims to assess the competency of dental health professionals in identifying OPMDs and, in turn, reducing the incidence of oral malignancy by early detection.

METHODS

A 26-case online questionnaire of oral mucosal lesions was distributed to cohorts of 363 dental health professionals and dental students in Australia. The participants were asked to provide their provisional diagnosis for each case based on the available information.

RESULTS

The overall accuracy in identifying oral mucosal lesions was 65.9%. There were no significant differences in the overall diagnostic accuracies between dental specialists, general dental practitioners and final-year dental students (p > 0.05). The lowest diagnostic accuracies were associated with normal mucosal variations and OPMDs. The predoctoral dental curriculum showed statistically significant values in terms of improving skills in diagnosing oral mucosal lesions.

CONCLUSIONS

Lack of adequate knowledge in identifying OPMDs was evident among the participants, highlighting a non-promising figure in reducing the incidence of oral cancers in Australia. Comprehensive modifications of the current continuing professional development system are required to ensure adequate knowledge among dental health providers in Australia.

Comparison of knowledge, awareness, and behaviors toward oral cancer among dental students and dentists: an online cross-sectional questionnaire in Türkiye

OBJECTIVE

This cross-sectional online questionnaire-based study evaluated the knowledge, awareness, and behaviors of dentists and senior dental students regarding oral cancer (OC).

MATERIALS AND METHODS

This study included 168 dentists and senior dental students who had completed all theoretical educations and clinical practices. An online survey was administered to all participants to assess their awareness of the risk factors for OC, clinical knowledge, and behaviors. The participants' demographic characteristics and knowledge of OC were analyzed.

RESULTS

Of the participants, 48.8% were female and 51.2% were male. Their mean age was 27.04 ± 5.56 years (range: 21-51). In addition, 59.5% were dentists, and 40.5% were senior dental students. The dentists' mean time since graduation was 6.38 ± 5.64 years (range: 1-27). Routine oral mucosa examination for OC was significantly more frequent among the dentists than the senior dental students (p < 0.05). Among all participants, 33% of dentists and 51.5% of senior dental students had poor knowledge of OC-related or possibly predisposing factors. Routine evaluation of OC-related and predisposing risk factors, including human papillomavirus infection, smoking, alcohol use, trauma-related non-healing oral lesions caused by long-term incompatible prostheses, and poor oral hygiene, was significantly more frequent among the dentists than the senior dental students (p < 0.05).

CONCLUSION

Educating dental students about a more comprehensive oral examination and early diagnosis of OC would help overcome the current lack of adequate knowledge and attitudes in OC prevention and early detection. A core curriculum compatible with the global standards on OC should be provided to dental students.

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.

Awareness of undergraduate dental students, interns, and freshly graduated dentists about oral manifestation associated with COVID-19

OBJECTIVE

There is growing evidence supporting the presence of oral manifestations associated with COVID-19. The study investigates the knowledge of dental undergraduates and recently graduated dentists concerning oral presentations related to COVID-19.

METHODS

A cross-sectional descriptive study in Saudi Arabia comprised 305 individuals, including undergraduate dental students, interns, and freshly graduated dentists. Data were collected using a questionnaire disseminated to approximately 500 subjects via WhatsApp groups and other applications. The questionnaire was tested in a pilot study for validity, edited, and validated by 2 supervisors at the College of Dentistry, Qassim University, Buraydah, Saudi Arabia. The questionnaire consisted of questions regarding sociodemographic attributes, the level of expertise of dental practitioners, and their knowledge and perspectives regarding COVID-19 and the implementation of oral lesions interrelated to it. The data was subjected to analysis through the utilization of descriptive statistics and chi-square tests, employing the statistical software SPSS (version 24).

RESULTS

About 43.9% of subjects stated that COVID-19 causes oral symptoms. Respondents most frequently reported COVID-19-related dry mouth. Oral ulcers, Candida infection, Hyperpigmentation, tongue coating, atrophy, Petechiae, Herpes, white lesions, Gingivitis, and Periodontitis are further symptoms. COVID-19's oral manifestation was unknown to 41.0% of subjects, and 37.7% of respondents lacked knowledge regarding the most impacted locations of oral manifestations. Oral signs and COVID-19 symptoms are debated and significantly associated with higher educational levels.

CONCLUSION

The dental students and freshly graduated dentists in this study have proper knowledge of COVID-19 and its symptoms. Also, most dental students and newly graduated dentists recognize the potential correlation between COVID-19 and oral manifestations with an average to excellent knowledge of the types and sites commonly affected. The level of awareness was associated with higher educational levels.

How Much Do We Know about Oral Cancer?-An Online Survey

INTRODUCTION

Oral cancer (OC) is a disease with a high mortality rate due to its late recognition. Since the oral cavity is easily accessible for visual inspection, enabling early diagnosis, the education of healthcare workers about preventive oral examinations is critical. This research aimed to assess the level of participants' OC knowledge, as well as to raise awareness about this diagnosis.

MATERIALS AND METHODS

The research was conducted as an online survey among students of dental medicine, students of medicine, doctors of dental medicine and doctors of medicine. The questionnaire was designed solely for the purpose of this study and consisted of 29 questions. The first part of the questionnaire consisted of general questions about the participants, whereas the questions in the second part addressed their knowledge and attitudes towards OC.

RESULTS

The surveyed population comprised of 140 dental students, 105 medical students, 159 doctors of dental medicine and 100 medical doctors. The level of knowledge about OC among the participants is not yet satisfactory. The group of dental medicine students scored highest, while medical doctors showed the weakest knowledge.

CONCLUSION

Additional education about OC for doctors of dental medicine and medical doctors is needed. This step will improve prevention and increase chances for early detection.

Evaluation of the diagnostic ability of oral lesions on clinical images among undergraduate dental students

INTRODUCTION

The dentist should be able to carry out systematic oral examinations of the mucosa of patients in order to diagnose any alterations at an early stage.

MATERIALS AND METHODS

An observational, analytical, prospective, and longitudinal study was carried out. 161 students were evaluated at the beginning of their clinical practice in their 4th year of dental school (September 2019), at the beginning and at the end of their 5th year of dental school (June 2021). Thirty oral lesions were projected, and the students were asked to provide an answer; if the lesions were benign, malignant, or potentially malignant, whether they should be biopsied and/or treated and a presumptive diagnosis.

RESULTS

Significant improvement (p < .001) was obtained between the 2019 and 2021 results, in relation to the classification, need for biopsy and treatment of lesions. For differential diagnosis, no significant difference (p = .985) was obtained between the 2019 and 2021 responses. Malignant lesions and PMD obtained mixed results, with the best results corresponding to OSCC.

DISCUSSION

In this study, a correct lesion classification by the students was over 50%. As for the OSCC, the results were superior to the rest of the images, reaching more than 95% correct.

CONCLUSION

Theoretical-practical training from universities and continuing education for graduates in relation to oral mucosal pathologies should be further promoted.

Head and neck exam practices of dental professionals

OBJECTIVE

Periodic examination of the head and neck includes screening for oral cancer, which is largely performed in dental offices by vigilant oral healthcare providers. The aim of this study was to assess practice patterns among Virginia dentists in performing head and neck exams and the referral rates of biopsies after completion of head and neck exams. We hypothesized that not all dentists perform head and neck exams and there is a difference between dentists who refer patients for a biopsy and those that perform biopsies.

METHODS

General dentists and dental specialists who are members of the Virginia Dental Association were invited to participate in a cross-sectional survey study through REDCap to self-report their head and neck exam protocols.

RESULTS

A total of 224 providers completed the survey. The majority of respondents were general dentists with more than 20 years in practice, who practice in a private setting, and see more than 10 patients in a day. All respondents stated they perform intraoral examinations, but 10 respondents stated they do not perform extraoral examinations. Nearly a third of respondents reported doing their own biopsies.

CONCLUSIONS

Although only 8.5% of oral healthcare providers in Virginia responded to our survey, respondents are following the 2017 ADA good practice statement by providing their patients with head and neck exams to screen for oral cancer. Additional education pertaining to extraoral anatomy, malignant transformation of oral potentially malignant disorders, and pathology procedures may be helpful to clinicians.

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.

A Retrospect of the Special Issue "Second Edition of Innovative Solutions for Oral Healthcare"

Medicine and oral health are constantly progressing through a series of small advancements that, together, lead to significant discoveries and breakthroughs [...].

Oral cancer screening knowledge and practices among dental professionals at the University of Toronto

INTRODUCTION

Opportunistic oral cancer screening during visits to the dentist is a non-invasive and accessible option for detection of pre-malignant lesions and early-stage malignancies. The objective of this study was to investigate the knowledge, practices, and attitudes towards oral cancer screening among dentists.

METHODS

A 42-item survey was sent to 650 dental professionals affiliated with the University of Toronto. Data regarding training/practice characteristics, knowledge of oral cavity cancer, current screening practices, attitudes towards screening, and remuneration were collected.

RESULTS

Ninety-one dentists responded. Most obtained their dental degree from Canada (71.4%) and were practicing in large urban centers (87.9%). Most dentists correctly identified the oral tongue (87.8%) and floor of mouth (80%) as the two of most common sites of oral cavity cancer but only 56% correctly identified the most common presentation. 91% performed intra/extra oral examinations at every patient visit. Only 9.9% of dentists discussed the risk factors of oral cancer and 33% were not familiar with resources for smoking cessation and alcohol abuse. International medical graduates were more likely to discuss risk factor management than Canadian medical graduates (p < 0.01). Over 80% of dentists referred to a specialist when a suspected lesion was found. The greatest barrier for oral cancer screening was lack of time. Almost all dentists (98.8%) reported that their screening practices do not differ depending on the patient's insurance status and 63.8% reported compensation would not influence their decision to perform oral examinations.

CONCLUSION

Most dentists have a good knowledge of the presentation and risk factors associated with oral cavity cancer. Most dentists perform screening with every patient, with no influence from compensation and insurance status. Dentists are therefore an excellent first contact for oral cavity cancer screening for the general public and for high-risk populations.

Knowledge of Oral Cancer Risk Factors among International Medical and Dental Students at the Lithuanian University of Health Sciences: A Cross-Sectional Study

The aim of this study was to evaluate knowledge of oral cancer risk factors among international dental and medical students at the Lithuanian University of Health Sciences (LSMU). A cross-sectional study was conducted among international medical and dental students at the LSMU in 2018−2019. In total, 253 students participated, for a response rate of 76.2%. An anonymous self-administered English questionnaire, consisting of 18 items, covered background information (gender, faculty and academic study year), and statements about risk factors for oral cancer and attitudes towards the prevention and treatment of oral cancer. The fifteen statements had the following answer options: yes, no and I don’t know. The statistical data analysis was performed using SPSS version 22. Overall, a good, fair and poor knowledge of oral risk factors was reported by 15.02%, 56.92% and 28.06% of the participants, respectively. The mean score for knowledge of oral cancer risk factors was 10.01 (SD = 2.56), which was defined as fair knowledge. Cronbach’s alpha was found to be 0.78 (a good value). Bartlett’s sphericity test and the KMO index were adequate (χ2 = 677.563, p < 0.001; KMO = 0.788). This study demonstrates a lack of knowledge of oral cancer risk factors among international medical and dental students.

Multimodal optical imaging with real-time projection of cancer risk and biopsy guidance maps for early oral cancer diagnosis and treatment

SIGNIFICANCE

Despite recent advances in multimodal optical imaging, oral imaging systems often do not provide real-time actionable guidance to the clinician who is making biopsy and treatment decisions.

AIM

We demonstrate a low-cost, portable active biopsy guidance system (ABGS) that uses multimodal optical imaging with deep learning to directly project cancer risk and biopsy guidance maps onto oral mucosa in real time.

APPROACH

Cancer risk maps are generated based on widefield autofluorescence images and projected onto the at-risk tissue using a digital light projector. Microendoscopy images are obtained from at-risk areas, and multimodal image data are used to calculate a biopsy guidance map, which is projected onto tissue.

RESULTS

Representative patient examples highlight clinically actionable visualizations provided in real time during an imaging procedure. Results show multimodal imaging with cancer risk and biopsy guidance map projection offers a versatile, quantitative, and precise tool to guide biopsy site selection and improve early detection of oral cancers.

CONCLUSIONS

The ABGS provides direct visible guidance to identify early lesions and locate appropriate sites to biopsy within those lesions. This represents an opportunity to translate multimodal imaging into real-time clinically actionable visualizations to help improve patient outcomes.

The Impact of Educational Intervention on Junior Dentists' Capacity to Detect Oral Mucosal Lesions and Suspect Malignant Potential

OBJECTIVES

This study aimed to assess the impact of Continuing Education (CE) activity on junior dentists' competency to identify oral mucosal abnormalities those suggestive of oral cancer or potentially malignant disorders.

MATERIALS AND METHODS

This multiphase study administered a pre-validated quiz to dental interns and junior dentists. The quiz was designed to assess the respondent's competency to recognize different oral lesions and stratify their potential for malignancy. Invited candidates attempted the quiz and then attended an informative half-day workshop focused on identifying oral mucosal changes, diagnosing various oral lesions, and recognizing the risk factors and features that suggest the malignant potential of oral lesions. The post-intervention survey was sent to the workshop attendees by 7 months.

RESULTS

67 out of 110 invitees attended the workshop, with an overall response rate of 60.1%. In the initial quiz, the overall accuracy of diagnosis was 55.1±9.04%. The participants correctly identified most normal variations (80.60±5.05), but less than half of the benign lesions (40.96±8.30) and potentially malignant lesions (43.62±6.02). The malignant lesions were correctly diagnosed by 55.22±3.98% of the participants. The CE intervention has improved the overall diagnostic accuracy (74.81±5.84% (p,0.015); benign to 70.18±6.68% (p,0.02), the potentially malignant lesions to 62.99±4.63% (p,0.01).

CONCLUSIONS

This study highlights the importance of CE activity in improving the role of dentists in the detection of oral cancer. CE activity has remarkably enhanced the junior dentists' ability to accurately diagnose various oral lesions and effectively stratify their malignant potential.

Knowledge and Awareness of Oral Mucosal Diseases Among Saudi Dentists

Background:

Oral mucocutaneous lesions have a significant impact on patient care. Late diagnosis of oral lesions may affect patients' quality of life and prognosis. Dentists are usually the first to encounter such lesions, and many studies have explored the knowledge and management related to oral cancer. However, not many studies have examined a more comprehensive understanding and management of oral lesions, including infectious and autoimmune/immune-mediated diseases.

Aims:

This study aimed at evaluating dentists’ knowledge and referral patterns regarding oral mucocutaneous diseases.

Methods:

A questionnaire-based cross-sectional study was conducted to evaluate dentists’ knowledge about oral mucocutaneous diseases and referral patterns among Saudi dentists. A total of 301 participants were included in the study. It was voluntary and written informed consent was obtained from the participants. A Chi-square test was used to compare the categorical variables. A p-value of less than 0.05 was considered statistically significant.

Results:

A total of 301 participants responded. Significant differences were observed between genders when asked about being comfortable with treating oral mucosal lesions in their practice (p-value: .019), and males were more convenient than females. A significant difference (p-value: .011) was observed between different educational levels when the participants were asked about the management of patients with oral mucosal lesions. Overall, the majority of participants rarely or never managed oral lesions. When comparing the different groups of participants, postgraduate residents responded more accurately (p-value: 007). Approximately 60% of all participants did not or rarely managed oral lesions in their practice.

Conclusion:

It was found that there was a lack of knowledge among dentists regarding the detection and treatment of oral mucosal lesions. This lack of knowledge can lead to unfavorable patient care and prognosis outcomes.

Knowledge, attitudes, and practices of oral cancer prevention among dental students and interns: an online cross‑sectional questionnaire in Palestine

Background

Oral cancer is frequently characterized with an aggressive behavior and an unfavorable prognosis; however, it is generally associated with promising prognosis if detected early. Therefore, this study aimed to assess knowledge, practices, and attitudes toward oral cancer prevention among dental students and interns; and to investigate the factors that influence their practices of oral cancer screening or prevention.

Material and methods

A cross-sectional questionnaire-based survey was conducted between March and April of 2022 on the fourth- and fifth-year undergraduate dental students and interns in the College of Dentistry at Arab American University in Palestine. A 48-item questionnaire which has 4 sections: demographics, knowledge, practices, and attitudes toward oral cancer prevention and early detection was sent to all eligible participants (N = 570).

Results

The response rate was 68.7% (N = 351). About 66.8% of the respondents had poor knowledge about oral cancer and its risk factors, and 85.5% had a poor practice of oral cancer early detection and prevention; however, the majority of the respondents (81.1%) had shown favorable attitudes toward oral cancer prevention. Interns had significantly better knowledge and attitude scores compared to the undergraduate dental students (P < 0.05). Lack of training, time, confidence, and effectiveness were stated among the barriers to oral cancer screening.

Conclusions

Most of the participants surveyed in this study appeared to lack adequate knowledge and skills in oral cancer prevention and early detection; however, they seemed to have good motivation and a good attitude toward oral cancer prevention training.

Oral potentially malignant disorders - An assessment of knowledge and attitude to future education in undergraduate dental students

INTRODUCTION

The aim of this study was to assess the knowledge and clinical experience of oral potentially malignant disorders (OPMDs) in undergraduate dental students in six European countries (Croatia, France, Italy, Portugal, Spain and United Kingdom) and assess student's attitude and preference to future education on the topic. A secondary aim was to identify gaps in student's knowledge and clinical practice. The study was a part of the Erasmus+ project "Oral Potentially Malignant Disorders: Healthcare Professionals Training" (Grant No: 2020-1-UK01-KA202-078917).

MATERIALS AND METHODS

An online questionnaire was distributed to all final-year students in six partner universities. This consisted of four parts assessing: (1) knowledge on OPMDs, (2) clinical experience with this group of patients, (3) self-rated competence in the management of OPMDs and (4) preferences with regard to future education.

RESULTS

Two hundred and sixty final-year dental students from six partner universities responded to the questionnaire. Response rates varied from 12% to 92% between partner universities. Significant differences in clinical experience and knowledge were found between students. Students with more clinical exposure to OPMDs rated their knowledge and competence in the management of OPMDs higher than students with less clinical experience. The majority of students were interested in future education on OPMDs, preferably via short educational videos.

CONCLUSION

The majority of students have received theoretical knowledge of OPMDs during their undergraduate studies, however, not all had clinical exposure to this group of patients. Students were open to further education on OPMDs. Important deficiencies in knowledge were identified that need to be addressed and it is anticipated that the e-learning platform and e-book that are in development by partner institutions will help to improve overall knowledge of OPMDs.

A Prospective Comparative Analysis Regarding the Assessment of Oral Mucosal Disease Using a Validated Questionnaire to Improve the Teaching of Dental Students

Structured examination and treatment are essential in medicine. For dental students, a structured approach to the assessment of oral mucosal lesions is missing thus far. To validate an approach, a structured questionnaire was compared with the habitually used free description of oral lesions (white lesions, ulcers, hyperplasia). Thirty-three dental students were divided into two groups (Group 1 (n = 17) used the free description; Group 2 (n = 16) used a guided questionnaire) to characterize mucosal lesions in patients and make a tentative diagnosis. Although no difference was found between the groups regarding the suspected diagnosis or the histopathological findings, there was a significant advantage of the structured questionnaire in all aspects of the description compared to the free description (p = 0.000018). Thus, a structured description is an important aspect in the evaluation of oral mucosal changes, and a guided questionnaire should be implemented in the study of dentistry.

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.

The readiness of dentists to use the autofluorescence method

Background. Head and neck squamous cell carcinoma are the sixth most common cancer in prevalence rate. Early diagnosis significantly reduces morbidity and mortality. Autofluorescence facilitates diagnosis the disease at the early stages, but it depends on the doctor’s skill in interpreting images. The aim of the study: to analyze the results of reading autofluorescence images of the oral mucosa by dentists.Materials and methods. The results of reading 10 autofluorescence images of potentially malignant diseases of the oral mucosa and 10 images of benign lesions and conditions were evaluated. The study involved 308 dentists. The assessment of the ability to recognize autofluorescence images was carried out with respect to gender, age, length of service, qualification category, academic degree, position of the head of the department.Results. On the average, dentists correctly differentiated the results of visualization of potentially malignant diseases of the oral mucosa in 3.85 ± 2.47 cases, benign lesions together with other benign conditions – in 4.56 ± 2.47 cases. Images of benign lesions and conditions were identified by dentists better than images of potentially malignant diseases of the oral mucosa (t = –17.0; p < 0.001). There is a direct correlation between the correct differentiation of visualization of potentially malignant diseases of the oral mucosa with the correct interpretation of benign lesions and conditions (r = 0.956; p < 0.001). The interpretation of potentially malignant diseases of the oral mucosa is not related to gender (t = –1.62; p = 0.306), work experience (r = –0.002; p = 0.977), department head (t = –0.11; p = 0.910), qualification category (t = –0.50; p = 0.574), academic degree (t = –0.34; p = 0.731).Conclusion. Dentists cannot recognize diseases of the oral mucosa well in autofluorescence images. The recognition skill is not related to general professional development.