|Year : 2019 | Volume
| Issue : 2 | Page : 66-69
Role of the dentist in early detection of oral cancer
Nasser Alqhtani1, Adel Alenazi1, Fazil Arshad Nasyam1, Sultan A Almalki2, Alshammari Mohammed1
1 Department of Oral and Maxillofacial Surgery and Diagnostics Sciences, College of Dentistry, Prince Sattam Bin Abdul Aziz University, Al-Kharj, Saudi Arabia
2 Department of Dental Public Health, College of Dentistry, Prince Sattam Bin Abdul Aziz University, Al-Kharj, Saudi Arabia
|Date of Web Publication||29-Apr-2019|
Fazil Arshad Nasyam
Department of Oral and Maxillofacial Surgery and Diagnostics Sciences, College of Dentistry, Prince Sattam Bin Abdul Aziz University, Al-Kharj
Source of Support: None, Conflict of Interest: None
Aims: The aim of the study is to appraise the awareness levels among dentists of the Kingdom of Saudi Arabia (KSA) regarding oral cancer. Materials and Methods: A survey based on questionnaire was done to evaluate the acquaintance levels regarding oral cancer among the dentists working in the governmental and private dental clinic, Riyadh city, KSA. Results: Majority of the patients were male (57.9%, n = 117), most were working in private clinics (57.4%, n = 116), graduated within 15 years (2003–2018) (89.1%, n = 180), and general practitioners (78.7%, n = 159). The variation between knowledge and age, gender, year of graduation, and specialty (P > 0.05) among dentists was insignificant. Conclusion: For early detection of oral cancers, dentists have a vital role as they are the persons who see and observe oral cavity during routine dental checkups and can help identify suspicious lesions before having any symptoms.
Keywords: Areca nut dentists, oral cancer, Saudi Arabia, tobacco
|How to cite this article:|
Alqhtani N, Alenazi A, Nasyam FA, Almalki SA, Mohammed A. Role of the dentist in early detection of oral cancer. J Int Oral Health 2019;11:66-9
|How to cite this URL:|
Alqhtani N, Alenazi A, Nasyam FA, Almalki SA, Mohammed A. Role of the dentist in early detection of oral cancer. J Int Oral Health [serial online] 2019 [cited 2019 May 21];11:66-9. Available from: http://www.jioh.org/text.asp?2019/11/2/66/257363
| Introduction|| |
Oral cancer is a grave health problem, globally being the 6th most common cancer. Most of the tumors of head and neck occur in the oral cavity, which accounted for 5% of all tumors., Treating oral cancer lesion in the early stage is the most effectual way to reduce mortality, disfigurement, and complication for the patient. Oral cancer gets less attention than other type of cancer that lead to delaying of diagnosis, and the mistaken diagnosis for other oral lesion which subsequently will worsen the situation.,, As a result of that, several studies state that most of the cases are diagnosed in an advanced stage.
Middle East countries have a somewhat lower incidence rate compared to India and some European countries. More than 80% of oral cancers are linked with risk factors such as smoking, alcohol consumption, and chewing of areca nut., Among the Saudi population, the smokeless tobacco habits appear as significant risk factor correlated with oral cancer. Recently, human papillomavirus is taken into consideration as a risk factor with sufficient evidence base, particularly for the oropharynx. Many studies show a lack of knowledge of dentists and negative approach toward oral cancer investigation and routine oral examination.,,,
The importance of dentist's role in oral cancer prevention is by enhancing the patient education about risk factor, performing oral examination that leads to early intervention if a suspected lesion is detected., Patients expect that all dentists to perform extensive oral mucosal examination through the routine dental examination. Greenwood and Lowry reported that most of the dentists focus their examination on teeth and the procedure-related site rather than high-risk sites such as the floor of the mouth. They found that dentists diagnosed oral cancer cases better than medical practitioners (odds ratios = 2.68, 95% confidence intervals = 1.6, 4.4). Whereas Patton et al. found that dental surgeons in North Carolina needed more knowledge of risk factors and diagnostic concepts, thus aiding in more frequent patient referrals, biopsy procedures or both, thereby resulting in early diagnosis and treatment of oral cancer patients.
As dental surgeons are the ones who routinely perform oral cavity examination, there is a need to educate them not to restrict themselves by observing only the chief complaint but also examine the oral cavity as a whole., They should be made aware about the complaints and appearance of precancerous conditions and oral cancer and also how to examine them. By doing so, cancer-related morbidity and mortality can be reduced.,,
This study was carried to evaluate the awareness level of oral cancer among dentists in public and private clinics in the Kingdom of Saudi Arabia (KSA).
| Materials and Methods|| |
A cross-sectional, questionnaire-based prospective survey was done to appraise the knowledge levels and attitude regarding oral cancer among the dentists working in governmental and private dental clinic, Riyadh city, the KSA. Ethical clearance was acquired from the Institutional Review Board of Prince Sattam Bin Abdulaziz University, Alkarj, Saudi Arabia, and informed consent was obtained from all the patients. Questionnaires were distributed to the dentists in their respective clinics (Reg no. 12/PSBAAU/2018). The study was carried out from April 1, 2018 to October 30, 2018.
The inclusion criteria were as follows:
- Dental Surgeons of Riyadh
- Dental surgeons who agreed to fill in the questionnaire and return back in 2 weeks of time.
The exclusion criteria of the study were as follows:
- Dental surgeons who did not returned questionnaire forms in time
- Partially filled forms.
The study had registered ethical committee clearance. The sample size was calculated using G Power Software (Dusseldorf, Germany) on similar studies. A total sample size obtained was 190 which were rounded to 200. Our study had obtained informed consent from all the patients. The study had included 14 questions divided into sociodemographic data and knowledge and attitude toward oral cancer. Questionnaire was prepared after referring similar studies and was validated by getting approval from senior academics.,,
The data collected were entered into Statistical Package for the Social Sciences, Version 20.0 (IBM Corp, Armonk, NY, USA) for Windows. A descriptive analysis which was followed by inferential statistics was conducted. Mean, standard deviation (SD), frequency, and percentages were calculated for qualitative and quantitative sets of data. The Fisher's exact test and Chi-square test were applied. P ≤ 0.05 was considered as statistically significant. The data were presented in tables and figures generated in Microsoft Excel and Word applications.
| Results|| |
The demographic characteristics of the respondents showed that just under half (48.5%, n = 98) were between 25 and 30 year old. There was a male predominance (57.9%, n = 117), majority were working in private (57.4%, n = 116), graduated within 15 years (2003–2018) (89.1%, n = 180), and general practitioners (78.7%, n = 159) [Table 1].
The percent distribution of exact response to questions on knowledge ranged from 4.0% to 97.5% [Table 2] and [Graph 1]. The mean ± SD correct knowledge score was 5.7 ± 1.4 (range – 2–9) based on ten items.
|Table 2: Percentage of respondents who gave correct responses to knowledge items|
Click here to view
The bivariate relationship between knowledge and background characteristics [Table 3] showed that participants working in public sector had a significantly higher knowledge regarding oral cancer than those working in private sectors (P < 0.05). The mean ± SD correct knowledge score was highest among 31–35-year-old age group, males, those within 15 years (2003–2018) of graduation, and specialist and consultants. Nevertheless, there was insignificant difference between knowledge and age, gender, year of graduation, and specialty (P > 0.05).
|Table 3: Bivariate associations between background characteristics and knowledge|
Click here to view
| Discussion|| |
Oral cancer is one of the most widespread cancers worldwide. Tobacco use and alcohol consumption are considered as the most common risk factors. A complete clinical examination and assessing the risk factors might help in early recognition of oral cancer, thus preventing its associated morbidity and mortality. An oral cancer examination could take as little as 90 s to perform. Early detection of oral cancer is vital in ensuring a good prognosis.,, Gender wise, we found 57.9% males and 42.1% females, our results might be because in the KSA, the dental profession is mainly practiced by males.,, Most of the population were between 25 and 30 years. Our finding that most of the dentists (98%) know that early recognition of oral cancer improves the survival rates, our findings are in accordance with the similar studies done in the USA, Canada, and Kuwait.,, However, only 4% knew about the guidelines for detecting oral cancer.
Our finding was that males had somewhat better knowledge when compared to females, the variation being statistically insignificant. This finding was in agreement with a similar study in India. We also found that the time of graduation and age of the dentists had no significant difference on their knowledge similar to the study in Kuwait. However, dentists working in public dental centers showed a considerably superior awareness than those working in private. This could be because the majority of patients prefer government dental centers, as the services offered are free. Therefore, the dentists in the government centers are more probably to examine a wide range of patients.,,,
Further, such studies with more parameters and on a larger sample size are warranted to actually depict the knowledge and awareness of the dentists toward the dreadful oral cancer that is causing enormous morbidity and mortality worldwide.
There is a need for still more education of dentists regarding oral cancer etiology, clinical presentation, recent diagnostics, and treatment modalities. We also found that dentists in the government sector had more exposure to oral cancer patients.
Involving dentists of both government and private sector and our questionnaire covered almost all aspects about oral cancer.
Limited sample size and dentists of only Riyadh city were included. Involving dentists of wider areas, especially rural areas would have given us a wider and accurate picture.
| Conclusion|| |
Dentists have a crucial role in early detection of oral cancers as dentists tend to see patients on a regular basis when they are asymptomatic before actual appearance of the lesions. This study revealed that majority of dentists does not know the most common etiologic agents, guidelines for the detection of oral cancer, the most common site, and what to examine during a routine checkup. Hence, there is an acute need to enhance the dentists' knowledge about early detection of potentially malignant and oral cancer lesions by making them participate in regular continuing cancer education and prevention programs.
Written informed consent from all participants were taken prior to involve in the study.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Hashim R, Abo-Fanas A, Al-Tak A, Al-Kadri A, Abu Ebaid Y. Early detection of oral cancer-dentists' knowledge and practices in the United Arab Emirates Asian Pac J Cancer Prev 2018;19:2351-5.
Hamdy B, Almarhoumi A, Arnout EA. Awareness of undergraduate dental students at Taibah University toward early detection of oral cancer. J Dent Health Oral Disord Ther 2016;5:00147.
Gupta N, Gupta R, Acharya AK, Patthi B, Goud V, Reddy S, et al.
Changing trends in oral cancer – A global scenario. Nepal J Epidemiol 2016;6:613-9.
Sarabadani J, Pakfetrat A, Dalirsani Z, Motezarre HR. Oral cancer: Prevention and early detection, dentists' opinions and practices (Mashhad-Iran). Int J High Risk Behav Addict 2016;5:e59762.
Prenit PK, Bandana K. Oral cancer awareness among undergraduate dental students in Nepal. EC Dent Sci 2018;17:2175-8.
Konduru R, Newtonraj A, Arun S, Velavan A, Singh Z. Oral cancer awareness of the general public in coastal village areas of Tamilnadu, India: A population-based cross-sectional study. Int J Community Med Public Health 2016;3:1932-9.
Greenwood M, Lowry RJ. Primary care clinicians' knowledge of oral cancer: A study of dentists and doctors in the North East of England. Br Dent J 2001;191:510-2.
Patton LL, Elter JR, Southerland JH, Strauss RP. Knowledge of oral cancer risk factors and diagnostic concepts among North Carolina dentists. Implications for diagnosis and referral. J Am Dent Assoc 2005;136:602-10.
Clovis JB, Horowitz AM, Poel DH. Oral and pharyngeal cancer: Knowledge and opinions of dentists in British Columbia and Nova Scotia. J Can Dent Assoc 2002;68:415-20.
Roquiadasse M, Daniel MJ, Srinivasan SV, Jimsha VK. Correlation of degree of dysplasia in potentially malignant disorders with tobacco use: A cross-sectional study. Clin Cancer Investig J 2016;5:398-402.
Luo X, Xu H, He M, Han Q, Wang H, Sun C, et al.
Accuracy of autofluorescence in diagnosing oral squamous cell carcinoma and oral potentially malignant disorders: A comparative study with aero-digestive lesions. Sci Rep 2016;6:29943.
Babiker TM, Osman KA, Mohamed SA, Mohamed MA, Almahdi HM. Oral cancer awareness among dental patients in Omdurman, Sudan: A cross-sectional study. BMC Oral Health 2017;17:69.
Jnaneswar A, Goutham BS, Pathi J, Jha K, Suresan V, Kumar G, et al.
A cross-sectional survey assessing knowledge, attitude, and practice regarding oral cancer among private medical and dental practitioners in Bhubaneswar city. Indian J Med Paediatr Oncol 2017;38:133-9.
] [Full text]
Rawal M, Malusare PC, PatilSoman B. Awareness and knowledge of oral cancer among dental practitioners of Bhopal, India – A cross-sectional study. Int J Oral Dent Health 2018;4:056.
[Table 1], [Table 2], [Table 3]