Risk Factors For Oral Cancer Research Articles

Knowledge, Attitudes and Practices of Dental Surgeon on Oral Cancer in Kinshasa City, Democratic Republic of the Congo

Background and aim: Oral cancer remains a public health problem with a high morbidity and mortality rate. The aim of this study was to determine the level of knowledge, attitude and practice of Kinshasa dentists on oral cancer. Patients and Method: This cross-sectional, descriptive study was conducted in public and private hospitals in the provincial city of Kinshasa between October 2019 and June 2020. A total of 143 dentists responded to the survey. The questionnaires included knowledge of risk factors, attitude and practice of Kinshasa dentists. Results: The average age of the participants was 34.05 ± 7.31 years, the male gender was the most represented (69.2%), and the level of knowledge of the dentists about the risk factors was low despite the fact that the majority of the participants in the study had recognized alcohol (77.5%) and tobacco (77.6%) as the main risk factors for oral cancer. The majority of the participants referred the patient to a specialist upon discovery of a cancerous lesion, only a minority of dentists performed biopsy and counselling. Conclusion: The level of knowledge of Kinshasa’s dentists about oral cancer is low. Refresher training is necessary to enable them to raise their level of knowledge. Thus, the reinforcement of cancer courses in the dental sector is important for a better management of cancer patient.

Knowledge, awareness, and attitude among dental students regarding oral cancer in Saudi Arabia.

Oral cancer awareness among junior and seniors' dental undergraduate students may have an impact on the early detection and prevention of oral cancer. To assess oral cancer awareness, knowledge and attitude among undergraduate dental students in government and private colleges in Saudi Arabia. A cross-sectional survey was undertaken to assess oral cancer knowledge, awareness and attitude among undergraduate dental students in government and private colleges in Saudi Arabia. All junior and senior students enrolled during the 2020- 2021 academic year, were eligible to participate (n=189). The study shows that dental Students at private and government colleges in Saudi Arabia are generally knowledgeable regarding Knowledge, awareness, attitude and management of oral cancer. There was no significant difference between knowledge, awareness, attitude, and management of oral cancer between students in either private and government colleges. Results shows that 99 (88.9%) of dental students in government colleges considered human papilloma virus as a risk factor, higher than dental students in private colleges 48 (73.3%). My results indicated that dental students considered (87%) tobacco, and alcohol (83.6%) as main risk to oral cancer, whereas, 100 (53%) identified limited consumption of fruit and vegetables and 124 (65.6%) considered old age as risk factor for oral cancer. The variation in correct answers indicate to need to reinforce the undergraduate dental curriculum with regards to oral cancer education; particularly in its prevention and early detection. Revision of knowledge senior students in oral cancer is highly recommended.

Clinicopathological\Characteristics and Related Risk Factors of Oral Cancer: A Cross-Sectional Study

Introduction: Oral cancer is the most prevalent and globally fifteenth-most reported cancer worldwide, as per International Agency for Research on Cancer (IARC). Several forms of oral malignancies are recognized clinically and pathologically, although oral squamous cell carcinomas (OSCC) account for 90% of all oral cancers. Aim: To find out whether socioeconomic factors and clinicopathological traits may play a role in the development of oral squamous cell carcimoma (OSCC). Methodology: A total of 197 individuals were incorporated in the study who were diagnosed and treated in the ENT department. A systematic questionnaire was used to collect clinicopathological and socioeconomic data. Descriptive analysis was used for socioeconomic status (SES) and demographics, whereas regression analysis was used to establish a link between SES and tobacco chewing practices, tumor size, and stage. Study design: A cross-sectional study. Place and Duration: This study was conducted at Jhalawan Medical College Khuzdar Pakistan from January 2021 to December 2021. Results: We found a higher prevalence of males, -+++-++-and the average age of patients with OSCC was 43.6 ± 12.2 years. Most of the individuals had a low SES status, and 76.6% chewed tobacco and related substances regularly. Tobacco chewing behaviors or consumption of Smoke Less Tobacco (SLTs) products were substantially connected with gender (male) and SES (p<0.05). The late-stage presentation of OSCC was strongly linked with middle age, tobacco chewing behaviors, and education (=0.05). Conclusion: Most OSCC cases were male patients in their forties from low socioeconomic backgrounds who had a long history of tobacco chewing practices. Tobaccochewers’ most prevalent tumor site was the buccal mucosa, and the majority had advanced malignancies.

Impact of demographic factors on delayed presentation of oral cancers

Background: Oral cancer is a major health issue in India. The majority of patients with oral cancer present at an advanced stage. Objectives: We aimed to understand the factors responsible for delay in presentation of patients with oral cancer in rural areas. Materials and Methods: This questionnaire-based, cross-sectional study on patients with oral cancer was conducted in the head and neck surgical outpatient department of our tertiary care center at Homi Bhabha Cancer Hospital, Sangrur, between June and September 2021. A questionnaire consisting of 31 multiple choice questions was administered to consenting patients. The demographic and socio-economic profile of the patients, their knowledge of risk factors, and their symptomatology, attitude towards cancer management, access to cancer care, and knowledge about cancer treatment and its outcomes were assessed. Results: A total of 200 patients were included; 70% were men. About 60% of the participants had to travel more than 100 km to reach our center. About 50% of the patients were addicted to tobacco in some form. Only 30% of the participants were aware of the risk factors for oral cancer. The median time between symptom onset and seeking any medical consultation was 120 days, whereas the median time between symptom onset and cancer diagnosis was 165 days. About 75% of patients initially consulted an alternative medicine practitioner, and 90% took some form of alternative treatment before consulting a cancer specialist. Around 80% considered alternative medicines to be an effective form of cancer treatment. Conclusion: Our study shows a gross lack of awareness and multiple misconceptions that prevail in the rural population. Increasing public awareness, training primary healthcare workers to pick up on early signs of oral cancer, promoting tobacco cessation activities, and teaching oral self-examination and its importance to people can help tackle the problem of delayed presentation of oral cancers.

The association between sociodemographic characteristics and knowledge about oral cancer among Jazan Population, Saudi Arabia.

Oral cancer (OC) is a cancer of the mucosal lip, oral cavity, and tongue and is linked to drinking, smoking, or both. After lymphoma and leukemia, oral cancer is the third most common malignancy in Saudi Arabia. A cross-sectional, descriptive, analytical study was conducted in the Jazan province. We used an online qustionnare and the sample was selected in a random, multistage manner, with a total of 400 members from both genders. A representative subregion was randomly selected from each sector, including Baish, Samtah, Faifa, Sabya, Abu Arish, and Jizan. Almost all of the participants in the study appeared to be aware of oral cancer. Oral cancer is not a contagious disease, according to 65% of respondents. Sniffing is a risk factor for oral cancer, according to 85% of respondents; yet, 61.7% believed that it can be healed. Majority of the study participants believed that sun exposure and alcohol consumption are both risk factors for mouth cancer. Chemotherapy, radiation surgery, and mouth augmentation surgery are all options for treating oral cancer. Seventy percent felt that oral self-examination can help detect oral cancer, and that early discovery can speed up treatment. We conclude that the research participants lacked sufficient understanding of early clinical signs and treatment options for oral cancer. A community-wide educational initiative might help to increase awareness and knowledge about oral cancer. Furthermore, additional research should be undertaken to determine the efficacy of the intervention.

Role of nano curcumin on superoxide dismutase levels in leukoplakia.

Introduction:Oral leukoplakia has an estimated prevalence of 2% of the oral cavity, one of the risk factors for oral cancers. The most commonly linked etiology being tobacco smoking causing reactive oxygen species (ROS) induced DNA damage. Curcumin, a polyphenol derivative from herbal remedy, possesses diverse properties ranging from centuries old documented anti-inflammatory properties to recently documented anticancer properties.Aims:Role of nano curcumin on superoxide dismutase (SOD) levels in leukoplakia patients’ pre- and post-treatmentMaterials and Methods:The study group comprised thirty test subjects. Single capsule of 250 mg (Brecan Plus) was given to the test group for 30 days with weekly follow-up. Blood samples were taken from the test group and were evaluated for SOD levels before and after the completion of the trial.Results:In the study, there was a decrease in size of the lesion, number of lesions, down staging of the disease, and increase in serum SOD levels after the therapy. Binary logistic retrogression analysis was done to assess the predictive ability of serum SOD-dependent variable, and a positive association was noted between increase in serum SOD level and down staging of the disease.Conclusion:Nano curcumin is an excellent medical nutrition intervention derived from traditional natural products. The study has demonstrated the clinical efficacy of these new classes of therapeutic nutraceuticals such as nanocurcumin in treating oral leukoplakia, which are suitable for long-term use.

Cancer awareness & its association with demographic variables & mobile phone usage among the rural population of a district in north India.

Lack of awareness is one of the major reasons for the high morbidity and mortality associated with cancers. The present study was aimed to evaluate the awareness of prevalent cancers among the rural population in a district of north India and its association specifically with mobile phone usage. Using a stratified random sampling technique, households in three villages of Gautam Buddh Nagar district of India were selected. A house-to-house survey on cancer awareness was conducted among adults in selected households and data were analyzed to check for the association of such an awareness with sociodemographic factors and internet usage. The study included 59 males and 145 females, with majority (115) being in the age group of 18-30 yr. Although most (96.5%) of the participants were aware of cancer, the common risk factors and warning signs of cancer were known to only a few. Specific risk factors for cervical and breast cancers were, however, not known to a majority (79.9% and 72.2%). A significant association between the awareness of general risk factors and warning signs as well as specific aspects including risk factors for breast, cervical and oral cancer, HPV vaccine and the education level of the participants (P<0.05 for all). Knowledge of risk factors, warning signs and cancer prevention modalities was higher among mobile phone users who accessed internet for health information. There was no significant association between age group and cancer risk factor awareness, though females were more aware of the risk factors for breast cancer (P=0.002). The findings of this study highlight the existing low level of awareness of cervical and breast cancers among the rural population. The association of cancer awareness with education level and mobile phone-based internet usage suggests the potential utility of internet-based platforms such as m-health programmes for cancer prevention activities.

Awareness and Knowledge of Dental Hygienists Assessment of Oral Cancer Risk Factors

Awareness and Knowledge of Dental Hygienists Assessment of Oral Cancer Risk Factors

Association study of NAT2 gene polymorphism and risk of oral cancer in Southern Punjab, Pakistan.

To investigate the single nucleotide polymorphic variations of N-acetyltransferase 2, phase-II metabolising enzyme, and associated risk factors for oral cancer. The case-control study was conducted from November 2017 to April 2018 after approval from the Institute of Molecular Biology and Biotechnology, Bahauddin Zakariya University, Multan, Pakistan, and comprised oral cancer patients and healthy controls. Single nucleotide polymorphism of the N-acetyltransferase 2 gene associated with oral cancer was analysed. Factors assessed using tetra-primer amplification refractory mutation system polymerase chain reaction included age, smoking, naswar, betel leaves and nuts. Of the 201 subjects, 94(47%) were patients and 107(53%) were controls, while 108(54%) were aged 10-30 years. Single nucleotide polymorphism rs1208 of N-acetyltransferase 2 gene was primarily A803G and Lys268Arg, with allelic frequency of G/A. Age range 51-70 was significantly (p=0.00001) associated with the prevalence of oral cancer in terms of genotypic relationship with A803G. Substantial allelic association was found between the gene and oral cancer (p=0.006895). Smoking increased the cacner risk 7-fold (odds ratio: 7.0). The genetic variant of N-acetyltransferase 2 rs1208 was found to be significantly associated with oral cancer progression and development of associated risk factors.

Determining the Risk Factor of Oral Cancer on Chewing Smokeless Tobacco Kharra: A Case–control Study

Background: Oral cancer is the sixth most common cancer globally; however, the incidence is much higher in the developing countries, including Pakistan, India, Sri Lanka. The etiology of oral cancer is multifactorial with majority of the cases attributable to separate and combined use of tobacco (smoked and smokeless), excessive alcohol consumption, betel quid, and betel quid substitutes. Among this, Kharra chewing (areca nut and tobacco) is the most prevalent addiction and the most common risk factors of oral cancer in central India.&#x0D; Objectives: To evaluate the risk of oral cancer associated with kharra users and non-tobacco user. To evaluate the association for the risk factors of oral cancer with kharra and non-tobacco user.&#x0D; Methodology: A hospital based case control study will be carry out in the study, the study will be conducted among the patient who had confirmed diagnosis of oral cancer and visited the hospital in AVBRH and SPDC Sawangi (Meghe) Wardha. Non- probability convenient sampling technique will be used for selecting the sample. The structured questionnaire will be used for collection of the data.&#x0D; Expected Results: This study is mainly planned to evaluate the effects of Kharra chewing on oral cancer risk with the help of structured questionnaire. Hence, it is expected to identify the effects of Kharra chewing on the risk of oral cancer.

Oral Cancer Knowledge and Awareness among Patients Referred to a University Dental Hospital in North Cyprus

Public knowledge about oral cancer may help to prevent and detect the disease at an early stage. This study aimed to evaluate the awareness and knowledge levels on oral cancer symptoms and risk factors among patients attending a faculty of dentistry in North Cyprus. A total of 250 adult dental patients participated voluntarily in a self-administered questionnaire. The questionnaire included questions on sociodemographic profile, oral cancer awareness, and knowledge. A total of 54.8% of the participants were male and 91.2% of the participants had a high school diploma and above education. Most participants were knowledgeable about oral cancer symptoms and a majority of them identified oral ulceration (64%). Tobacco cessation was the most selected option for protecting from oral cancer (79.6%). Significant differences were found between genders in current smokers, past tobacco users, alcohol users, and HPV awareness questions (p &lt; 0.05). Furthermore, awareness and knowledge questions were compared between smoker and non-smoker participants and significant differences were found in the answers of ‘alcohol may cause mouth cancer’ and ‘quit tobacco use to prevent oral cancer’ (p &lt; 0.05). This study showed that most of the participants were aware that tobacco cessation reduces the risk of oral cancer. The survey results showed that patients in North Cyprus are generally aware of the risk of tobacco-related oral cancer, but they demonstrate lower knowledge about other risk factors.

Oral lesions associated with smokeless tobacco users in Saudi Arabia: Single center cross-sectional study

IntroductionSmokeless tobacco (SLT) causes significant harm to the oral cavity and is considered a risk factor for oral cancer. Various forms, products, and patterns of SLT are used across different populations. Many products, such as nicotine and betel nut, have addictive and carcinogenic properties. SLT use is associated with benign, premalignant, or malignant lesions. This study aimed to identify the characteristics of these oral lesions and their association with SLT exposure. Materials and methodsThis cross-sectional study, performed at our institution’s Faculty of Dentistry, included all the patients with a history of using SLT within a 5-year period at the oral medicine clinic. The patients’ demographic details were collected, and information regarding habit, duration, frequency, site of placement, and history of habit discontinuity were recorded. If a biopsy was performed, the diagnoses were also reported. ResultsOf the 59 patients included, 89.8% were male and 10.2% were female. SLT lesions in the oral cavity were usually focal lesions (76.3%). The most preferred placement site by SLT users was the mandibular posterior vestibule. Follow-up of SLT patients after quitting or clinical changes in the placement site showed a 92.8% regression or complete healing of the lesions. Of the 59 patients who underwent SLT, 18.6% were diagnosed with oral squamous cell carcinoma. ConclusionThis study demonstrated a high percentage of remarkable regression or complete healing of SLT lesions related to early diagnosis and habit change. In contrast, 18.6% of the lesions progressed to SCC.

Knowledge, opinions, and practices related to oral cancer prevention and oral mucosal examination among dentists in Moldova, Belarus and Armenia: a multi-country cross-sectional study

IntroductionMoldova, Belarus, and Armenia are post-Soviet countries with a high rate of heavy smokers and a relatively high age-standardized incidence of oral cancer. However, to our knowledge, there is lack of available information on dentists’ knowledge on prevention of oral cancer in the countries in question. Accordingly, this study aimed to assess the knowledge, opinions, and practices related to oral cancer prevention and oral mucosal examination among dentists in Moldova, Belarus, and Armenia.MethodsThis was a multi-country, cross-sectional study based on a self-administered questionnaire. A structured questionnaire was distributed to 3534 dentists (797 in Chisinau, Moldova, 1349 in Minsk, Belarus, and 1388 in Yerevan, Armenia). Dentists' knowledge about risk factors for oral cancer development and its clinical picture, current practices and opinions with regard to oral mucosal screening and oral cancer prevention, and their consistency to perform oral mucosal examination were assessed. A knowledge score ranging from 0 to 14 points was generated based on each dentist’s answer to the questionnaire.ResultsA total of 1316 dentists responded, achieving an overall response rate of 37.2% (34.5% in Moldova; 52.3% in Belarus; 24.2% in Armenia). Most dentists in the three countries correctly identified tobacco (83.8–98.2%) and prior oral cancer lesions (84.0–96.3%) as risk factors for oral cancer. Most dentists correctly identified leukoplakia as a lesion with malignant potential (68.7% in Moldova; 88.5% in Belarus; 69.9% in Armenia), while erythroplakia was identified by much fewer in all three countries. Less than 52% of dentists identified the tongue, rim of tongue, and floor of mouth as the most common sites for oral cancer. The mean knowledge score for all countries combined was 7.5 ± 2.7. The most commonly reported barriers to perform oral mucosal examination were lack of training, knowledge, and experience.ConclusionsThis study highlights the need for improved oral cancer-related education and training on oral mucosal examination for dentists in Moldova, Belarus, and Armenia. Such skills are essential to enhance oral cancer prevention and to improve the prognostic outcome by early detection.

The Development of Dental Informatics of Oral Cancer Screening for Prevention in Community Level: A Prototype Study in Thailand.

Objective:The purpose of this study is to identify general dentists’ information needs for oral cancer screening in community and the information sources they use to meet those needs in clinical settings so as to inform the design of dental information systems. Methods:A semi-structured interview was conducted with a convenience sample of 8 general dentists and 5 dental assistant in the Public Health Region 9 area during clinical hours. One hundred and five patient cases were reported by these dentists. Interview transcripts were coded and analyzed using thematic analysis with a constant comparative method to identify categories and themes regarding information needs and information source use patterns. Results:Two top-level categories of information needs were identified: foreground and background information needs. To meet these needs, dentists used four types of information sources: clinical information/tasks, risk factor of oral cancer in general people, surveillance in community and referral to oral cancer treatment. Major themes of dentists’ unmet information needs include: (1) timely access to information on various subjects; (2) better visual representations of dental problems; (3) access to patient-specific evidence-based information; and (4) accurate, complete and consistent documentation of patient records. Resource use patterns include: (1) dentists information needs matched information source use; (2) little use of electronic sources took place during treatment; (3) source use depended on the nature and complexity of the dental problems; and (4) dentists and dental nurse routinely practiced cross-referencing to verify patient information. Conclusions:Dentists have various information needs of oral cancer at the point of care. For future development of dental information or clinical decision support systems, developers should consider integrating high-quality, up-to-date clinical evidence into comprehensive and easily accessible EDRs as well as supporting dentists’ resource use patterns as identified in the study.

Role of Nurses in the Prevention and Early Detection of Oral Cavity and Pharynx Cancers

Purpose: The incidence of oral cavity and pharynx cancer is rising in the United States and South Dakota (SD) (2009-2018). In 2018, it was estimated that 396,937 of Americans were living with oral cavity and pharynx cancer. The 5-year relative survival rate for oral cancer is 66.2%, which is less than the survival rates for breast, colorectum, and prostate cancers. Tobacco and alcohol use and human papillomavirus (HPV16) exposure are some of the risk factors for oral cancer. Overall rural populations have higher cancer mortality than no rural population due to higher poverty, lower access to health services, and cigarette use. The purpose of this study is to investigate the prevalence of the oral cancer risk factors (e.g., cigarette smoking), HPV vaccination rates, and to identify the spatial distribution of social and environmental factors (e.g., social vulnerability, dental care access) in SD. Finally, this article discusses how nurses can contribute to oral cancer prevention and early detection. Methods: This descriptive study used data from multiple data sources (e.g., SD Department of Health, HRSA, County Health Rankings). Maps were created using ArcGIS. Findings: From the 66 SD counties, nearly 17% presented high-level shortage scores and were also highly socially vulnerable. HPV vaccination among youth was higher than the national average. Studies showed that improving nurse’s knowledge by training on oral cancer is needed and this may increase nurses’ practice in oral cancer prevention and control. Conclusions: Primary care professionals like nurse practitioners can assist in early detection of oral cancer and promote awareness of signs and main risk factors in rural areas. As part of the total patient care, nurses hold a vital role in prevention and early detection of oral cancer. These efforts with referral to oral cancer screening are vital for decreasing oral cancers morbidity and mortality rates primarily. Keywords: Rural health, Nurses, oral cancer, dentalcare access, Geographic Information Systems DOI: https://doi.org/10.14574/ojrnhc.v21i2.692

Liquid Chromatography-Nanoelectrospray Ionization-High-Resolution Tandem Mass Spectrometry Analysis of Apurinic/Apyrimidinic Sites in Oral Cell DNA of Cigarette Smokers, e-Cigarette Users, and Nonsmokers.

Cigarette smoking is an established risk factor for oral cancer. The health effects of e-cigarettes are still under investigation but may disturb oral cavity homeostasis and cause lung and cardiovascular diseases. Carcinogens and toxicants in tobacco products and e-cigarettes may damage DNA, resulting in the formation of apurinic/apyrimidinic (AP) sites and initiation of the carcinogenic process. In this study, we optimized a liquid chromatography-nanoelectrospray ionization-high-resolution tandem mass spectrometry method to analyze AP sites in buccal cell DNA of 35 nonsmokers, 30 smokers, and 30 e-cigarette users. AP sites in e-cigarette users (median 3.3 per 107 nts) were significantly lower than in smokers (median 5.7 per 107 nts) and nonsmokers (median 6.0 per 107 nts). AP sites in smokers were not significantly different from nonsmokers (p > 0.05). The e-cigarette vaporizing solvents propylene glycol and glycerin were tested and did not protect against AP site formation in in vitro control and carcinogen exposed rat liver homogenates. However, propylene glycol may inhibit bacteria in oral cells, resulting in reduced inflammation and related effects, and reduced AP site levels in e-cigarette user DNA. This is the first study to examine AP site formation in e-cigarette users and to evaluate AP sites in human oral cell DNA.

ORAL CANCER AWARENESS AMONG NON-MEDICAL PROFESSIONALS - A CROSS SECTIONAL STUDY IN LADAKH

Introduction:Oral Cancer is the fifth‑most common cancer and is the cause of 130,000 deaths worldwide annually. It is a global health problem with an increasing incidence and mortality rate and also has one of the lowest survival rates.Therefore, the aim of this study is to assess the awareness about Oral Cancer among non-medicalprofessionals in Ladakh. Methodology:A questionnaire-based survey was conducted over a period ofsixmonth among the different areas of Ladakh to assess the knowledge and awareness about Oral Cancer among non-medical professionals in Ladakh. A questionnaire containing 20 questions pertaining to awareness, signs, symptoms and risk factors of Oral Cancer was submitted to the participants. Results:Participants who completed the questionnaire had a poor understanding of Oral Cancer, particularly with regard to etiology, signs, symptoms &amp; risk factors. Conclusion:Overall, the awareness about Oral Cancer among the non-medical professionalsin Ladakh was not satisfactory pointing to the need of mass awareness and dissemination of information about Oral Cancer and its risk factors.

Prevalence of Tobacco and Areca-nut Use and Awareness of Its Harmful Effects among Non-academic Staff at Faculty of Dental Sciences, University of Peradeniya

Background: Tobacco and areca nut (AN) are well known risk factors for oral cancer and awareness of these harmful risk habits will reduce the incidence of oral cancer in Sri Lanka. Faculty of Dental Sciences, University of Peradeniya plays a major role in this fight against oral cancer. Hence this study is aimed to evaluate the prevalence of these risk habits among its non-academic staff and their awareness of its harmful effects as they are also responsible stakeholders of the faculty. Method: An institutional based cross sectional study was conducted among 108 non-academic staff members of the faculty using a self-administered questionnaire on risk habit details and their awareness on its harmful effects. Results: Analyzed results revealed that only 4.6% of the sample had tobacco and AN use; betel quid chewing (2.7%) and tobacco smoking (1.8%). However, the awareness on the harmful effects of these products were not very satisfactory as only 48% were overall aware while the unhealthy effects of AN use were known only by 27% of the sample. Contradictorily, 70% of them informed that they have received information regarding the harmful risk habits. Conclusion: It is important to increase awareness among the non-academic staff of the faculty as they become important stakeholders of one of the leading centres in the fight against oral cancer.

What should the role of the dentist be in managing patients with eating disorders?

Back in 2016 I returned to my old university to interview then Executive Dean of the College of Clinical and Biomedical Sciences at the University of Central Lancashire, StJohn Crean. During the interview he spoke about the future, which for him included creating a college of 'One Health' - people working together who emerge with different skills but with one focus - the patient. Perhaps there's another application of the vision that applies to the role of the dental professional. After all, there's encouragement to ask patients about their diet, alcohol intake and smoking status, specifically with oral cancer in mind. These are easy discussions to have. There's a different group of conversations that the dental professional could/should have (delete as appropriate according to your own thoughts) that are far more difficult to broach, and they're surrounding the wider welfare of the patient. When we talk about safeguarding, our brains almost always think about children. It's the parental instinct to protect that kicks in - quite right too. We do so because they're vulnerable and yet we don't always immediately think of those who are vulnerable when it comes to safeguarding. In this very issue there's an article about dentists and gender based violence,1 which firmly falls into the category of difficult conversations. Dental professionals are also encouraged to discuss that other oral cancer risk factor - HPV - which means talking to patients about oral sex. In conversation with some friends in the profession, their reaction to this has very much been along the lines of 'critical high yikes' - no way, even though they know they should. Others simply aren't sure where or how to begin, which is a very different starting point. For me, there's one more addition to the 'difficult conversation' column that also directly affects the oral health of a patient; eating disorders. Open in a separate window

Oral Cancer Awareness among Dental Patients

Introduction: The incidence of oral cancer in South Asian countries, including Nepal is increasing despite the fact that all of its risk factors are modifiable. This can be attributed to lack of awareness regarding oral cancer and its risk factors among general public. This study was conducted among subjects attending Dental OPD of a tertiary hospital to assess the knowledge and attitude regarding oral cancer and also practices of risk factors associated with it. Methods: This is a questionnaire based cross-sectional study conducted from July 2020 to October 2020. Subjects attending Dental OPD of a tertiary hospital in Kathmandu were asked to fill a structured close-ended Questionnaire. Section one of the questionnaire focused on the demographic data of the subjects, second part elicited information pertaining to knowledge of oral cancer, third part focused on attitude and fourth part on practices of participants towards risk factors of oral cancer. Result: Out of 300 subjects, 65% were males. Most were in the age group 41 - 50 years and 75.6% were literate. Majority mentioned smokeless tobacco as the risk factor, followed by smoking and alcohol. Regarding signs and symptoms, most of the participants mentioned non-healing ulcer, followed by lump and pain. Most of the participants responded tongue as the most common site of oral cancer. Majority answered that oral cancer can be prevented by not chewing tobacco. Among the total, 55.3% said oral cancer is non-contagious. Only 25% had undergone oral examination in the last one year. 31.7% had habit of tobacco and / or alcohol. Conclusions: The awareness level and knowledge about risk factors and early signs of oral cancer in this cross-section of dental patients were satisfactory. Key words: awareness; oral cancer; risk factors; tobacco