Heavy usage of tobacco and alcohol may greatly increase the risk of OPC. This study investigates the feasibility and acceptability of targeted oral screening for addiction centre residents, and assesses potential benefits of national targeted screening.
METHODS:
Four addiction treatment centres were visited periodically over 12-month period. Data was collected on alcohol, tobacco and drug habits (type, quantity, duration) and attitudes to dental care. Participants underwent comprehensive oral examination; all soft tissue pathology/abnormalities were recorded; potentially sinister lesions/symptoms were referred for further investigation. Data analysis utilised SPSS-14. Funded by Irish Cancer Society (No:06-090307).
RESULTS:
220 residents (78%, 220/283) underwent screening (148 males; 61 females); 7% refused; 15% were unavailable. 53% reported dual addiction, 44% Alcohol only, 3% Drug only. While subject age ranged from 18-73 years, 60% participants were <40years; only 21% were over 50yrs. Extremely high rates of tobacco (87.6%) and alcohol usage recorded (91.5% alcoholics, 5.3% ex-alcoholics), reported intake ranging from 0-784units/wk. Last Dental Visit (LDV) ranged from 3 days to 30+ years; none of the edentulous participants reported LDV <15years. 82% participants required urgent dental care, 23% needed extraction(s), <50% had ~full dentition, 12.5% had significant pain. 84 mucosal abnormalities were detected in 61 subjects (29%). Subjects with mucosal abnormalities were significantly older (41.8 yr versus 35.9, P<0.05). 21 residents were referred for further investigation; seven (33%) attended. Despite poor compliance rate, two premalignant lesions and one carcinoma were detected – yield 1.3% (3/220).
CONCLUSIONS:
Study addresses the paucity of data on the prevalence of mucosal abnormalities in high-risk individuals. The high incidence of dental disease and LDV confirm a lack of engagement with GDP services among high-risk individuals, highlighting need for alternative screening mechanisms. Targeted oral screening was acceptable, feasible and achieved a high rate of detection of mucosal abnormalities. Plans for national targeted screening formulated.