Abstract
PurposeThe 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.MethodsA 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).ResultsTwenty-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%.ConclusionIt 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.
Highlights
The tumour of the oral cavity and pharyngeal region remains an underestimated public health problem
Out of a total of 53 participants, 25 dentists, one of them an oral and maxillofacial surgeon, working in 18 different private practices located in Schleswig–Holstein were recruited via quality circles and personal contacts of the principal investigator (KH) (Fig. 3)
The oral cavity is accessible and the investigation should be routinely performed by practicing dentists
Summary
The tumour of the oral cavity and pharyngeal region remains an underestimated public health problem. More than 529,000 affected individuals received this diagnosis (oral cavity including lips, pharyngeal region; ICD-10 C00C14) in 2012, accounting for approximately 3.8% of all cancers (Shield et al 2017). In Germany, the incidence of oral (including lips) and pharyngeal cancer has been on an upward trend in recent years, from about 10,000 previously to nearly 14,000 incidences (9720 men and 4180 women). The five-year relative survival rate was only 47% in men and 63% in women (Robert Koch Institut 2019). One reason for this is that the majority of affected individuals do
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