Early detection of oral cancer: a key role for dentists?

Abstract

Purpose The majority of suspected malignant changes in the oral mucosa are detected by dentists in private practice. Statements regarding the effectiveness of visual examination of the oral cavity for early detection are not necessarily transferable between different health care systems. Our clinical-epidemiological and methodological aim was thus to conduct a prospective regional study in dental practices under everyday conditions, assess the frequency and type of oral mucosal changes, and evaluate the dental examination methodology. Methods A prospective observational study was conducted, combining a feasibility study of early detection of oral cancer and its documentation with phase I ‘modelling’ to conceptualize complex interventions in health services research. Dentists in private practice continuously recruited patients over 6 months and used two different sheets for the documentation of suspicious lesions. Statistical analysis involved descriptive statistics and tests for differences (Welch test) or association (Chi-squared test). Results Twenty-five dentists (mean age: 50 years, 24% females) participated in this study. Eleven dentists achieved the overall aim of recruiting 200 patients. Around 4200 patients (mean age: 52 years, 57.5% females) participated. The prevalence of suspicious lesions was 8.5%. Conclusion It became apparent that a study in cooperation with dentists in private practice to generate clinical-epidemiological data on the early detection of oral mucosal lesions under everyday conditions can be carried out successfully. Further studies with a corresponding level of evidence should be carried out to be able to draw conclusions about the effectiveness of the early detection measure under everyday practice conditions.

Best practices and future challenges in the treatment of oral cancer

“…As a result, patients are often confronted with limited therapeutic options. Late diagnosis thus not only reduces the chance of survival, but also limits the preservation of important everyday functions such as swallowing, speaking and eating [ 2 ].…”

“…The presumed diagnosis and localization are recorded. It should be noted that the visual examination of the oral mucosa, for the general early detection of malignant disease sites, is easy to perform, non-invasive, inexpensive and therefore uncomplicated for the patient [ 2 ].…”

“…Unlike breast, prostate and colorectal cancers, the detection of tumours in the oral and pharyngeal regions does not require extensive screening tests and can therefore be effectively mapped by the dentist during regular consultations [ 2 ]. Whether this will be effective in limiting the global problem is unclear at this time and will need to be investigated in further studies.…”

“…The incidence of the number of cases has increased significantly in recent years. Men are affected more than twice as often as women [ 1 , 2 ]. More than 90 % of all malignancies of the oral cavity are squamous cell carcinomas.…”

A Systematic Review and Meta-Analysis Assessing the Role of Oral Health as a Risk Factor in Oral Cancer

“…Oral cancer must be detected early to be successfully treated; hence routine dental exams should include oral cancer screenings. The stage of diagnosis affects the five-year survival rate for oral cancer, with early-stage tumors having a substantially greater survival rate than advanced-stage cancers [3,4].…”