Evaluation the capacity of a sample of dentists in clinical diagnosis of oral cancerous and potentially premalignant lesions

Abstract

Background and aim Early diagnosis is a crucial step for reducing cancer morbidity and mortality. Initial detection of precancerous lesions essentially relies on the vigilance of dentists working in primary healthcare. The aim of this questionnaire-based study was to evaluate the ability of dentists practicing in Damascus to correctly diagnose and mangmemnt of oral potentially malignant lesions. This information serves as a baseline to ascertain educational needs of dentists in the Damascus area.

Subjects and Methods: 93 dentists completed a study questionnaire comprising 9 questions assessing experience and knowledge of diagnostic techniques for oral cancer and precancer and 21 clinical cases including 7 oral cancers, 7 oral precancers, and 7 benign lesions. Dentists were asked to determine the type of each lesion, the need for biopsy, and a management plan for each case. The 21 cases were distributed randomly using compeutrized programme to avoid bias in recognizing studied clinical cases. Data were analysed using SPSS-v 17 programme.

Results: No correlation was found between correct diagnosis of lesions and number of years clinicians had been registered dentists. In total, 37% of participants had performed at least one incisional biopsy during their professional life, 69% of them were unable to carry out a brush biopsy or to apply toluidine blue (84%).  95% respondants had never attended any course concerning oral diagnostic methods, but 77% of dentists had referred patients with potentially malignant oral mucosal lesions. Only 30% of participates perforemed full oral cavity examination regardless patient's complaient.

Only 5% respondants correctly identified 12 clinical cases out of 21 cases. Surprisingly, 9% of respondents failed to identify benign lesions correctly, 18% of precancer lesions, and 29% of cancer lesions. Only 21% of participants were satisfied with oral medicine subject with regard to oral cancer and precancer diagnosis and mangment during their undergraduate study.

CONCLUSIONS: This study emphasizes a need for improving the clinical diagnostic ability of dentists practicing in Damascus in order that patients who might benefit from early precancer intervention are not missed. We believe that reviewing the undergraduate oral medicine curriculum providing oral medicine education opportunities at a postgraduate level will improve the current situation.