Oral Cancer Screening Practices of Canadian Dental Hygienists

Objectives: Oral cancer has a high mortality rate that can often be attributed to delays in diagnosis. Registered dental hygienists (RDHs) can be instrumental in detection, documentation, and referral of suspicious lesions. This study investigates whether RDHs are routinely conducting oral cancer screenings (OCSs). Factors that may mediate provision of OCSs, and ability to discuss sensitive topics with patients, are also examined.
Methods: A web-based survey was developed, pre-tested, and validated prior to dissemination. A link was mailed out nationally through various dental hygiene colleges and associations.
Results: 256 surveys were used for analysis, primarily from Ontario (n = 135), Alberta (n = 44) and Nova Scotia (n = 42). Sixty-four percent of dental hygienists reported conducting OCSs as part of their regular process of care. Except the initial examination, dental hygienists (72%) were more likely to be responsible for the OCS than the dentist (49%). Ninety-six percent of intraoral components are inspected in an OCS compared to 73% of extraoral components. Confidence in OCS technique was high (70%) but those with a bachelor degree were more likely to feel prepared by the education than those with a diploma (p = .002). The average time to conduct an OCS was 4 minutes, with the majority agreeing there is sufficient time to conduct the screening (57%). Only 37% felt their education prepared them to discuss sensitive topics, level of education had no effect (p > .05). Forty-three percent of respondents felt confident in their HPV knowledge and were comfortable discussing HPV risk factors with patients. These last three factors were strongly correlated (p < 0.001).
Conclusions: RDHs are regularly conducting OCSs. However, they lack comfort discussing sensitive topics such as transmission of HPV.