ABSTRACT
BACKGROUND: Knowledge of oral mucosal lesions (OMLs) among dentists is relevant in diagnosing potentially malignant diseases and oral cancer at an early stage. The aim of this survey was to explore dentists' knowledge about OMLs. MATERIAL AND METHODS: Respondents to a web-based questionnaire, containing 11 clinical vignettes representing patients with various OMLs, provided a (differential) diagnosis and management for each. Information about demographics and clinical experience of the participants was acquired as well. Descriptive statistics were performed and T-tests were used to test for significant (p<0.05) differences in mean scores for correct diagnosis and management between subgroups based on demographic variables. RESULTS: Forty-four of 500 invited dentists completed the questionnaire. For (potentially) malignant OMLs, the number of correct diagnoses ranged from 14 to 93%, whilst the number of correct management decisions ranged from 43 to 86%. For benign OMLs, the number of correct diagnoses and management decisions ranged from 32 to 100% and 9 to 48%, respectively. For 11 clinical vignettes, mean scores for correct diagnosis, correct management and correct diagnosis and management were respectively 7.2 (±1.8), 5.7 (±1.5), and 3.8 (±1.7). CONCLUSIONS: The results show that dentists in the Netherlands do not have sufficient knowledge to accurately diagnose some OMLs and to select a correct management. This may result in over-referral of benign OMLs and under-referral for (potentially) malignant OMLs. Clinical guidelines, that include standardized criteria for referral, and continuing education, may improve dentists' ability to correctly diagnose and accurately manage OMLs.
Subject(s)
Mouth Neoplasms , Humans , Netherlands , Mouth Neoplasms/diagnosis , Mouth Neoplasms/therapy , Referral and Consultation , Diagnosis, Differential , Dentists , Surveys and QuestionnairesABSTRACT
Recently, the Dutch National Immunization Programme has started to offer the human papillomavirus (HPV) vaccination to boys as well as girls from the age of 10. The vaccine protects against long-term HPV infection, which can lead to cervical, anogenital and oropharyngeal cancer. Besides malignant disorders, a HPV infection can also lead to certain disorders of the skin and oral cavity. Since the national HPV vaccination campaign has probably resulted in more awareness among patients about the relation between HPV and oropharyngeal cancer, patients may consult oral healthcare professionals with questions about HPV infection. Oral healthcare professionals are thus able to play a role in preventing HPV related disorders by counseling their patients on HPV. They can also contribute to early diagnosis of HPV related oral and oropharyngeal disorder, although the possibility of detecting oropharyngeal cancer during routine dental examination is limited.
Subject(s)
Alphapapillomavirus , Oropharyngeal Neoplasms , Papillomavirus Infections , Papillomavirus Vaccines , Female , Health Personnel , Humans , Male , Oropharyngeal Neoplasms/prevention & control , Papillomavirus Infections/prevention & control , Vaccination/methodsABSTRACT
Worldwide and also in the Netherlands there is an increasing human papillomavirus (HPV)-attributable oropharyngeal cancer incidence. This type of cancer is more common at a younger age than the classical oropharyngeal cancer, which is usually caused by smoking and excessive drinking. Most often, the tumor occurs in the tonsils and at the base of the tongue. This study explored the level of knowledge of dentists about oropharyngeal cancer, its association with the human papillomavirus and their willingness to play a role in prevention. 7.364 digital questionnaires were sent to oral health-care providers and data from 607 dentists was analyzed. 48% of knowledge questions were answered correctly by more than half of the respondents. Significantly more female caregivers were aware of the relationship between HPV and oropharyngeal cancer and the availability of an HPV vaccine. Respondents considered it important that the relationship between HPV and oropharyngeal cancer is discussed with patients and that a protocol is developed that is useful in screening for mouth and throat cancer.
