Dentists and oral cancer prevention in the UK: opinions, attitudes and practices to screening for mucosal lesions and to counselling patients on tobacco and alcohol use: baseline data from 1991

Abstract

OBJECTIVE: To investigate the opinions, attitudes and practices towards oral cancer prevention among UK dentists as a baseline from which to measure the need for continuing education efforts in this area. DESIGN AND METHOD: Postal questionnaire survey carried out in August 1991.A questionnaire with 13 test items was piloted at continuing education courses then distributed to all subscribers of the British Dental Journal with a postage paid return envelope. The aspects inquired into were recent attempts by dentists at updating their knowledge on oral cancer, their practical approaches to screening for oral mucosal diseases and follow‐up actions after oral screening, their questions to patients regarding the major risk factors for oral cancer, their efforts towards behavioural counselling for patients and any constraints felt or experienced in this regard. RESULTS: The questionnaire was circulated to 15 836 dentists. The response rate of 16% was poor but due to the many dentists circulated, 2519 responses were available for analysis. This large sample, though presumptively biased towards those interested in professional matters, showed an encouraging 84% claiming to perform screening of the oral mucosa routinely. Among these, 74% reported referral of screen detected cases to a hospital for further attention and only 4% would adopt a wait and see policy. Disturbingly, half of the respondents did not enquire about risk habits related to oral cancer and, among the other half who claimed to make such enquiries, only 30% routinely provided brief health education advice concerning these. Seventy‐one percent agreed that giving advice against tobacco use is desirable but major constraints were identified, notably a lack of training, and frustration regarding patient compliance. There was even greater reluctance on the part of the respondents to enquire into the alcohol use of their patients and to provide advice on alcohol moderation. CONCLUSIONS: Most of this large but unrepresentative sample of UK dentists were carrying out screening of the oral mucosa as a part of their prevention activities in 1991.However, the survey indicated a considerable need for improvement in the manner and extent of provision of health advice in respect of the major risk factors for oral cancer: such a substantial need amongst the presumptively better motivated implies that the need amongst the practitioner population at large is even greater.

Oral Cancer Knowledge, Attitudes, and Practices among Dentists in Khartoum State, Sudan

“…An 86.92% response rate of the present study is high compared with previous studies from UK (Warnakulasuriya et al, 1999;, Italy (Colella and Gaeta, 2008) and Spain (López-Jornet et al, 2010).…”

“…Moreover, 84% of dentists in the UK said that they performed a systematic examination of the oral mucosa irrespective of the patient's presenting symptom and 91% of the dentists spent less than 3 minutes for an oral mucosal examination (Warnakulasuriya and Johnson, 1999).…”

“…Studies have shown that a 10 minute quit-smoking consultation by a health professional will assist 3% more smokers to abstain from smoking for six months or longer compared to those who receive no advice (Parrott et al, 1998 Most dentists in the UK disagreed that they were adequately trained to provide alcohol or tobacco cessation education and were not very well disposed to providing health education to their patients on alcohol cessation (Warnakulasuriya and Johnson, 1999). These results are consistent with findings of low rates of tobacco-and alcoholuse cessation counseling among dentists in other studies (Clovis et al, 2002;Kujan and Duxbury, 2006;Cruz et al, 2005) In Ireland when asked about dentists' training needs most of dentists expressed an interest in furthering their education regarding oral cancer and the vast majority identified the "recognition of suspicious lesions" and on "suspicious lesions referral guidelines" alcohol (74%) and tobacco (79%) cessation counseling and education were the least selected options (Decuseara et al, 2011).…”

“…In comparison, Warnakulasuriya et al (1999) reported that most of dentists in UK spent less than 3 min for an oral mucosal examination (Warnakulasuriya and Johnson, 1999). Most important reasons given by respondents for not providing oral cancer examinations were "I am not trained enough" and "It's not necessary for all patients".…”

Curriculum survey on tobacco education in European dental schools

“…Repeated surveys in the UK since the 1990s have highlighted a considerable need for improvement in the manner and extent of provision of health advice on smoking cessation. 13,14 By 2006, only 10% of UK dentists reported they had received any formal training in tobacco cessation intervention strategies. 15 The lack of confidence and deficiency of knowledge can be tracked to lack of adequate training in tobacco cessation as a component of the dental undergraduate curriculum.…”