No abstract

ObjectivesDentists and other members of the dental team could raise awareness by talking about oral cancer during routine dental check‐ups. A communication guide has been developed to facilitate this. However, it has been suggested that discussions about oral cancer may raise patients' anxiety and this has been documented by dentists as a barrier to having these conversations. The current research aimed to investigate implementation of the communication guide and its impact on the dental patient.MethodsA consecutive‐case sample of adult dental patients attending primary dental care for a routine NHS check‐up at one dental practice were invited to take part in the study via letter prior to their appointment. Consultations of participating patients (n = 77) were audio‐recorded. Before and after their appointment, patients were asked to rate their current anxiety via the six‐item version of Spielberger's State‐Trait Anxiety Inventory. Audio recordings of each consultation were reviewed by two raters to determine the extent to which the dentist covered the topics recommended in the communication guide.ResultsThe dentist informed all patients that they were being checked for oral cancer, spoke about signs and symptoms, and discussed risk factors. However, they rarely recommended where help should be sought or addressed barriers to seeking help. Discussions took an average of 95 s. The extent to which oral cancer was discussed did not correlate with patients' post‐appointment anxiety. Patients made positive or neutral responses to the discussions. The few questions that were asked were easily addressed.ConclusionsAs findings are based on one dentist working at one practice, generalization of these results should be cautious. The study indicated that using an evidence‐based guide to talk about oral cancer did not appear to raise patients' anxiety in this practice population. This could help to increase awareness of oral cancer in the endeavour to facilitate early cancer diagnosis.

Diseases of the salivary glands are uncommon and patients present to a number of specialties. The result is that experience is thinly spread across clinical specialities. A dedicated salivary gland clinic was set up at Guy's Hospital London fifteen years ago. The profile of patients referred to the centre over the last ten years was analysed and changes in management mapped over time with respect to methods of investigation and treatment. Gland removal, which was previously the treatment of choice for most benign salivary gland diseases has been replaced by gland sparing procedures which have rendered gland excision to a minor role in management. Salivary gland surgery-related morbidity has been markedly reduced.