Knowledge and Attitudes Around Oral Cancer Screening in Dental Practice

Objective: To compare knowledge and attitudes about oral cancer screening (OCS) and lesion identification before and after a continuing education (CE) course on oral pathology for dental providers. Methods: 27 dentists and 26 dental hygienists from 24 offices in the Ohio Dental Practice Research Network participated in a study on the frequency and type of oral lesions presenting in the general dental office. Providers attended a 3-hour CE course reviewing oral pathology. Before and 6 weeks after the course, providers completed an attitude, behavior and 30-item knowledge questionnaire about OCS. Knowledge and barrier scores were calculated and compared using paired analysis. Results: Providers had a mean of 21.5 years (±11.5) in practice. At baseline, the strongest perceived barriers to OCS were reluctance to perform lymph node palpation (LNP) (26%), lack of time (24%) and inadequate training (22%). Most providers (90.7%) reported screening their at-risk patients at least yearly, but fewer reported they performed a LNP at each screening (64.8%) or instructed their patients to perform an oral self-exam (63%). After the CE course, providers increased their knowledge scores (mean 4.2, s.d. 5.3, p<.001), reported greater confidence in their ability to perform an oral cancer exam (p<.001) and were less likely to cite inadequate training as a barrier to OCS (p=.013). There was no change in their perception of time constraints or reluctance to perform LNP as barriers. Conclusions: Enhanced educational strategies to improve knowledge of oral cancer risk factors and oral lesions are needed to enhance the dental provider's willingness and ability to perform effective OCS. Such strategies should be developed for current practitioners as well as become integrated into the education of future dentists. Supported by the American Cancer Society, Cuyahoga County Unit.