Table 3.
Published data about dental practitioners’KAP on OSCC.
| Knowledge | Attitude | Practice | |||||||
|---|---|---|---|---|---|---|---|---|---|
| References | Participants | Quality Assessment | Risk Factors | Precancerous Lesions | Clinical Picture | Common Sites of Development | Opinion | History Taking | Physical Examination |
| Aldossri et al., 2020 [17] |
932 | >75% | Tobacco 99.5% Alcohol 97.2% Prior OSCC 98.6% HPV 88.2% Elderly 69.6% Diet 31.8% |
N.A. | Ulcer 99.7% Red patch 98.6% White patch 98.6% Dysphagia 93.9% Paraesthesia 96% Airway obstruction 89.3% Oral bleeding 86.6% Pain 85.1% Trismus 65.5% Chronic earache 58.1% |
N.A. | Visual examination is effective in early detection 97.9% Skills in neck examination 96.1% Up-to-date personal knowledge 92.4% Skills in auxiliary devices 83.2% Skills in RX 76.5% Smoking cessation is effective 39.6% Biopsy is mandatory 35.4% Advice HPV vaccine 29.5% Alcohol cessation is effective 22.3% |
N.A. | N.A. |
| da Silva Leonel et al., 2019 [18] |
71 | <75% | Tobacco 100% Alcohol 98.6% Sun exposure 97.2% Family history 95.8% Elderly 93% Ill-fitting prothesis 88.7% Emotional stress 78.9% Poor oral hygiene 78.9% Presence of decay teeth 74.6% Diet 59.2% Oral sex 50.7% Hot food and drink 46.5% Drug abuse 21.1% |
Leukoplakia 85.9% Candidiasis 5.6% Stomatitis 4.2% Blistering 1.4% |
OSCC diagnosis (III/IV stage) 76.1% OSCC 66.2% |
Tongue and floor of the mouth 71.9% Buccal mucosa 11.2% Palate 4.2% Gingival 2.8% |
Key role of dentist 98.6% Need of CE 95.8% Lack of patients’ knowledge 84.5% Adequate knowledge 66.2% Previous CE courses 49.3% Undergraduate training was adequate 43.7% Diagnostic procedure experience 26.8% |
N.A. | Intra- and extraoral 98.6% |
| Jboor et al., 2019 [19] |
177 | >75% | Tobacco 97.4% Prior OSCC 94.3% Alcohol 93.2% HPV 85.3% Betel quid chewing 74.5% Elderly 72.8% Sun exposure 63.3% Gutka use 49.1% Diet 28.2% |
Erythroplakia & Leukoplakia 53.7% | OSCC 84.2% Positive lymph node 75.7% Red patch 66.7% Tongue high-risk area 46.3% OSCC diagnosis (III/IV stage) 39% OSCC time diagnosis > 60 years 31.6% Asymptomatic at early stage 21.5% |
Tongue 77.9% Floor of the mouth 54.2% |
Smoking cessation is effective 90% Up-to-date personal knowledge 66.7% Visual examination is effective in early detection 48.6% |
Tobacco 92.6% Prior OSCC 86.8% Family history 80.6% Tobacco products 80% Alcohol products 46.8% Alcohol 66.3% |
N.A. |
| Nazar et al., 2019 [20] |
289 | >75% | Tobacco 99.7% Alcohol 99.7% |
Erythroplakia and Leukoplakia 97.9% | OSCC 80.6% Positive lymph node 74.3% Asymptomatic at early stage 31.3% |
Tongue and Floor of the mouth 80.3% | Need of CE 92.4% Up-to-date personal knowledge 55% Visual examination is effective in early detection 38% |
Tobacco 62% Alcohol 17% |
Intra- and extraoral 50% |
| Khattab et al., 2018 [21] |
400 | <75% | N.A. | N.A. | N.A. | N.A. | N.A. | N.A. | Intra- and extraoral 37.5% Lymph nodes 26.5% Biopsy 27.5% |
| Pavão Spaulonci et al., 2018 [22] |
Senior GDPs 105; junior GDPs 84 |
>75% | Junior: Tobacco 100%/Alcohol 96.4%/Family history 95.2%/Sun exposure 90.5%/HPV 84.5% Other malignancies 83.3%/Ill-fitting prothesis 60.7%/Emotional stress 56%/Oral sex 51.2%/Presence of decay teeth 44%/Hot food and drink 40.5%/Poor oral hygiene 40.5%/Drug abuse 34.5%/Diet 31%/Spicy food 23.8%/Obesity 16.7% Senior: Tobacco 100%/Alcohol 100%/Family history 95.2%/Ill-fitting prothesis 93.3%/HPV 92.4%/Sun exposure 81.9% Other malignancies 79%/Presence of decay teeth 76.2%/Hot food and drink 74.3%/Emotional stress 67.6%/Poor oral hygiene 64.8%/Oral sex 59%/Diet 47.6%/Spicy food 34.3%/Drug abuse 28.6%/Obesity 16.2% |
Junior: Leukoplakia 73.8% Senior: Leukoplakia 75.2% |
Junior: Ulcer 85.7% Positive lymph node 69% OSCC 67.9% Junior: Ulcer 85.7% Positive lymph node 69.5% OSCC 64.8% |
Junior Tongue 59.5% Senior Tongue 50.5% |
Junior Previous CE courses 48.8% Undergraduate training was adequate 70.2% Up-to-date personal knowledge 54.8% Junior Previous CE courses 31.4% Undergraduate training was adequate 43.8% Up-to-date personal knowledge 51.4% |
N.A. | Junior Intra- and extraoral examination at 1st visit 78.6% Senior Intra- and extraoral examination at 1st visit 85.7% |
| Hashim et al., 2018 [23] |
298 | >75% | Tobacco 99% Prior OSCC 92.3% Alcohol 87.30% HPV 76.6% Sun exposure 73.2% Elderly 60.9% Diet 43.8% |
Leukoplakia 28.4% Candidiasis 19.1% Actinic cheilitis 18.6% Erythroplakia 7.7% OLP 5.7% |
Ulcer 87.6% Positive lymph node 82.9% White patch 79.9% Dysphagia and limited tongue mobility 68.9% Lump 66.9% Red patch 63.2% Non-healing socket 35.1% |
Tongue 30.1% Floor of the mouth 18.7% Palate 7% |
Need of CE 84.9% Previous CE courses 48% Visual examination is effective in early detection 31.14% Biopsy is mandatory 9.9% |
N.A. | Scalpel biopsy 40% Brush biopsy 20.4% Toluidine blue 6% Fluorescent imaging 5.7% Exfoliative cytology 5% |
| Kogi et al., 2018 [24] |
110 | Other malignancies 52.7% Tobacco 41.8% Elderly 21.8% HPV 18.2% Alcohol 13.6% Diet 10.9% |
N.A. | N.A. | N.A. | Need of CE 86.4% Up-to-date personal knowledge 3.6% |
N.A. | Intra- and extraoral examination at 1st visit 43.6%; at recall 32.7% |
|
| Ahmed et al., 2017 [25] |
130 | >75% | Family history 64.6% Comorbidities 60% HPV 60% Elderly 58.4% Ill-fitting prothesis 41.6% Tobacco 38.9% Alcohol 38.9% Diet 29.2% |
N.A. | OSCC 90% Ulcer 83.2% Red patch 80.5% White patch 80.5% Swelling 43.4% Pain 13% |
Lips 22.1% Tongue 20.4% Floor of the mouth 19.5% |
Need of CE 95.6% Need of referral guidelines 88.5% Visual examination is effective in early detection 46% Adequate knowledge 64.7% Undergraduate training was adequate 27.4% Up-to-date personal knowledge 26.7% |
N.A. | Lymph nodes 57% Intraoral 51% Extraoral 40.8% Biopsy 26.5% RX 20.4% |
| Mariño et al., 2017 [26] |
241 | >75% | Tobacco 99.4% Betel quid chewing 98.2% Prior OSCC 97% Alcohol 94.6% |
N.A. | N.A. | N.A. | Visual examination is effective in early detection 95.2% | N.A. | Intraoral 99.7% Oropharynx 92.3% Extraoral 83.8% Lymph nodes 80.7% |
| Kebabcıoğlu et al., 2017 [27] |
170 | >75% | Tobacco 98.8% Prior OSCC 95.3% Alcohol 91.2% HPV 90% Sun exposure 86.5% Betel quid chewing 80.6% Elderly 56.5% Diet 52.4% |
Erythroplakia and leukoplakia 64.1% | OSCC 64.7% White patch 35.9% Red patch 26.5% OSCC time diagnosis >60 yrs 12.9% |
Tongue and floor of the mouth 37.1% Palate and floor of mouth 11.2% Palate 2.4% |
Lack of patients’ knowledge 85.9% Skills in neck examination 70% Visual examination is effective in early detection 53% |
N.A. | N.A. |
| Haresaku et al., 2016 [28] |
Japanese 137; Australian 259 |
>75% | Japanese: Tobacco 90% Family history 74% Alcohol 52% HPV 38% Betel quid chewing 25% Caffeine 15% Australian: Betel quid chewing 98% Tobacco 98% Alcohol 94% HPV 93% Family history 75% Caffeine 5% |
N.A. | N.A. | N.A. | Japanese Need of CE > 90% Visual examination is effective in early detection 76.8 % |
N.A. | Japanese Intraoral 89.3% Extraoral 35.7% Lymph nodes 10.7% Oropharynx 10.7% Australian Intraoral 98.4% Extraoral 80.5% Lymph nodes 50.8% Oropharynx 23.8% |
| Navabi et al., 2016 [29] |
313 | >75% | Alcohol 26.3% Tobacco 26.3% |
N.A. | OSCC 66.7% OSCC time diagnosis >60 yrs 66.7% Positive lymph node 48.6% |
Tongue and lips 26.7% | Ease for referral 92.7% Undergraduate training was adequate 41.3% Visual examination is effective in early detection 28% Smoking cessation is effective 27.9% Up-to-date personal knowledge 26.7% Dentist skills in visual inspection 20.2% Physician skills in visual inspection 13.4% |
Tobacco 87.2% Tobacco products 76.5% Alcohol 76.5% Prior OSCC 75.9% Family history 75.2% |
N.A. |
| Akbari et al., 2015 [30] |
GDPs 55; specialists 18 |
<75% | GDPs Tobacco 92.7% Specialists Tobacco 88.9% |
GDPs Leukoplakia 58.2% Specialists Leukoplakia 66.7% |
GDPs Submandibular lymph nodes as first place of metastasis 89.1%/OSCC 87.2%/Lung as first place of distant metastasis 67.3%/Two weeks is minimum time to differentiate cancer from inflammation 63.6%/Lower lip is related with better prognosis of oral cancer 49.1%/Minor salivary tumor commonly placed in lateral posterior palate 47.3% Specialists Submandibular lymph nodes as first place of metastasis 100%/OSCC 100%/Lung as first place of distant metastasis 88.9%/Two weeks is minimum time to differentiate cancer from inflammation 94.4%/Lower lip is related with better prognosis of oral cancer 77.8%/Minor salivary tumor common placed in lateral posterior palate 61.1% |
GDPs Tongue 70.9% Floor of the mouth 56.4% Specialists Tongue 88.9% Floor of the mouth 88.9% |
N.A. | N.A. | N.A. |
| Hassona et al., 2015 [74] |
165 | >75% | Tobacco 97.6% Prior OSCC 75.2% Alcohol 64.2% OPMDs 60.6% Betel quid chewing 53.9% Comorbidities 43% HPV 36.4 % Sun exposure 30.3% Elderly 26.7% Diet 21.8% |
Leukoplakia 71.5% Erythroplakia 53.3% Candidiasis 42.4% OSMF 33.3% OLP 28.5% Actinic cheilitis 21.8% |
OSCC time diagnosis >60 yrs 81.8% Positive lymph node 71.5% Ulcer 68.5% White patches 62.4% Dysphagia and limited tongue mobility 60.6% Red patch 59.4% Lump 58.8% Non-healing socket 38.2% |
N.A. | N.A. | N.A. | Scalpel biopsy 84.8% Fluorescent imaging 68.5% Exfoliative cytology 46.7% Brush biopsy 28.5% Toluidine biopsy 24.2% |
| Allen et al., 2015 [31] |
640 | <75% | N.A. | N.A. | N.A. | N.A. | Visual examination is effective in early detection 98.9% Key role of dentist 90.9% Key role of dental hygienist 69% Key role of physician 48.2% |
N.A. | Intra- and extraoral examination at 1st visit 94.5%; at recall 85.7% |
| Anandani et al., 2015 [32] |
83 | >75% | Betel quid chewing 34.1% Tobacco 27.7% Alcohol 14.1% Chronic disease 14.3% Family history 6.1% |
N.A. | N.A. | Labial mucosa 26.2% Tongue 19.7% Floor of the mouth 8.2% Palate 6.6% |
N.A. | N.A. | N.A. |
| Alaizari et al., 2014 [33] |
800 | >75% | Tobacco 96.4% Shammah usage 91.9% Betel chewing 79.2% Prior OSCC 76.9% Alcohol 73.3% Ill-fitting prothesis 70.1% Comorbidities 65.2% HPV 66.1% Elderly 48% Diet 41.6% Sun exposure 67% Obesity 24% |
N.A. | OSCC 82.81% | Tongue and floor of the mouth 45.7% | Ease for referral 94.1% OSCC early diagnosis improves the survival rate 87.3% Need of CE 86% Biopsy is mandatory 75.1% Visual examination is effective in early detection 72.4% Smoking cessation is effective 72% Skills in neck examination 68.3% Up-to-date personal knowledge 47.1% |
Tobacco 79.6% | Biopsy 75.1% Intra- and extraoral 68.3% Lymph nodes 68.3% |
| Mehdizadeh et al., 2014 [34] |
124 | >75% | N.A. | N.A. | OSCC 81.2% | Tongue 59.6% Floor of the mouth 58.8% |
Need of CE 94% Delay in OSCC diagnosis 74.8% Key role of dentist 60.4% ENT has a key role in OSCC diagnosis 37.2% ENT has a key role in OSCC treatment 27.4% Undergraduate training was adequate 20.4% |
Clinical chart 90.4% Recommendations in elderly 70% Addiction 67.6% Family history 52% Biopsy 37% |
Intra- and extraoral 84.8% Lymph nodes 74.2% |
| Saleh et al., 2014 [35] |
362 | <75% | Tobacco 99.4% Betel quid chewing 99.2% Alcohol 88.9% HPV 67.2% |
N.A. | Ulcer 97% White patch 93.1% Red patch 93.1% Gingival bleeding 67.1% |
N.A. | N.A. | N.A. | Intra- and extraoral 84.8% |
| Ramaswamy et al., 2014 [36] |
450 | >75% | Tobacco 94% | N.A. | Ulcer 50% Red patch 50% |
N.A. | N.A. | N.A. | Intra- and extraoral 90% |
| Razavi et al., 2013 [37] |
139 | >75% | Tobacco 97% Alcohol 78% Sun exposure 72% Iron deficiency 62% Ill-fitting prothesis 22% Poor oral hygiene 17% Diet 6% |
Erythroplakia and leukoplakia 50% | Positive lymph node 67% Asymptomatic at early stage 45% Red patch 33% OSCC time diagnosis >60 yrs 33% |
Tongue and floor of the mouth 51% | Key role of dentist 71% Undergraduate training was adequate 36% Adequate post graduate training 16% |
N.A. | Intra- and extraoral 11% Lymph nodes 23% Biopsy 6% |
| Pentenero et al., 2013 [38] |
450 | >75% | Prior OSCC 51.1% | Leukoplakia 79.6% Erythroplakia 57.1% |
N.A. | Tongue 74.4% Floor of the mouth 72.9% Palate 18.7% |
Up-to-date personal knowledge 83.1% Need of CE 31.8% |
N.A. | Intraoral 84% |
| Rocha–Boulevas et al., 2012 [39] |
93 | <75% | Prior OSCC 78.4% Tobacco 78.4% Alcohol 56.9% Elderly 44.1% Diet 17.2% |
Erythroplakia and leukoplakia 51.61% | OSCC 52.6% Red patch 51.6% OSCC time diagnosis >60 yrs 47.3% |
Tongue and floor of the mouth 18.2% | Smoking cessation is effective 74.19% Alcohol cessation is effective 67.74% Skills in neck examination 66.67% Lack of patients’ knowledge 47.3% Visual examination is effective in early detection 39.78% |
Alcohol products 88.1% Alcohol 82.2% Prior OSCC 59.14% Tobacco products 50.54% Tobacco 49.4% Family history 22.58% |
N.A. |
| Joseph et al., 2012 [40] |
153 | >75% | Tobacco 100% Prior OSCC 97.3% Betel quid chewing 89% Alcohol 88.8% Sun exposure 82.7% HPV 71.2% Elderly 60.3% Diet 52.7% |
Erythroplakia and leukoplakia 93.2% | Asymptomatic at early stage 90.7% OSCC diagnosis (III/IV stage) 75% Positive lymph node 70.1% Visual inspection is the most effective screening method 50.4% |
Tongue and floor of the mouth 85% | OSCCC early diagnosis improves survival rate 98% Ease for referral 89.5% Skills in neck examination 72.5% Up-to-date personal knowledge 51.6% Smoking cessation is effective 38.6% Visual examination is effective in early detection 38.6% Previous CE courses 30.1% Alcohol cessation is effective 20.3% |
Tobacco 65% Alcohol 21.6% |
Intraoral 86.3% Biopsy 62.9% |
| Vijay Kumar et al., 2012 [41] |
240 | <75% | Alcohol 99% Tobacco 78.3% Ill-fitting prothesis 53.7% Sun exposure 45% Elderly 31.2% |
Blistering 3% | OSCC 96% White patch 82% OSCC time diagnosis >60 yrs 59% Red erosion 9% |
Buccal mucosa 83% | Ease for referral 98.7% Annual visual inspection for patients over 40 is mandatory 67.9% Visual examination is effective in early detection 68.3% Skills in neck examination 50.4% Up-to-date personal knowledge 39.1% |
Tobacco 68% Alcohol 68% |
Intra- and extraoral 37% Lymph nodes 37% Biopsy 24% |
| Seoane et al., 2012 [42] |
791 | >75% | N.A. | N.A. | N.A. | N.A. | N.A. | N.A. | Intraoral 90.3% Biopsy 28.7% |
| Maybury et al., 2012 [43] |
463 | >75% | Tobacco 98% Prior OSCC 97% Alcohol 95% HPV 88% Elderly 71% Sun exposure 64% Diet 35% |
Erythroplakia and leukoplakia 42% | OSCC 83% Asymptomatic at early stage 80% Red patch 81% Positive lymph node 77% Tongue high-risk area 72% OSCC time diagnosis >60 yrs 30% OSCC diagnosis (III/IV stage) 28% |
Tongue 59% | Up-to-date personal knowledge 81% Visual examination is effective in early detection 94% Skills in neck examination 79% Smoking cessation is effective 32% Alcohol cessation is effective 15% |
N.A. | N.A. |
| Alami et al., 2012 [75] |
55 | >75% | Tobacco 92% Alcohol 83% Sun exposure 67% Elderly 62% HPV 47% Diet 33% |
Erythroplakia 47.3% Leukoplakia 40% OLP 14.5% Nicotinic stomatitis 14.5% |
OSCC 98.2% Red or white patch 94.5% Asymptomatic at early stage 90.9% Positive lymph node 80% OSCC diagnosis (III/IV stage) 75.9% |
Floor of the mouth 45.5% Tongue 29.1% Lips 29.1% |
N.A. | N.A. | N.A. |
| Borhan–Mojabi et al., 2011 [76] |
86 | >75% | Tobacco 78.3% Alcohol 34.9% |
N.A. | N.A. | Tongue 80.9% Lips 28.3% Floor of the mouth 25.7% |
Lack of patients’ knowledge 40.7% | N.A. | Intraoral 79.15% |
| Hertrampf et al., 2011 [44] |
306 | >75% | Tobacco 99% Prior OSCC 95.1% Alcohol 92.8% Sun exposure 68% Elderly 60.5% HPV 57.8% Diet 19% |
Erythroplakia and leukoplakia 67.6% | OSCC 86.9% Need of three negative follow-ups 84.6% OSCC diagnosis (III/IV stage) 81% Tongue high-risk area 67.6% Red patch 59.5% OSCC time diagnosis >60 yrs 47.7% Asymptomatic in the early stages 47.1% |
Floor of the mouth 76.1% Tongue 70.3% |
OSCC early diagnosis improves the survival rate 98.4% | N.A. | Intraoral 84.3% |
| Decuseara et al., 2011 [45] |
254 | >75% | Alcohol 98% Tobacco 98% Prior OSCC 83% Sun exposure 79% HPV 60% Elderly 53% Radiotherapy 39% Spicy food 33% Diet 28% Hot food and drink 9% |
Leukoplakia 87% Erythroplakia 82% Erythroplakia and leukoplakia 80% |
Asymptomatic at early stage 95% Tongue high-risk area 87% OSCC diagnosis (III/IV stage) 86% OSCC time diagnosis >60 yrs 42% |
Floor of the mouth 86% Tongue 70% |
OSCC early diagnosis improves the survival rate 95% Visual examination is effective in early detection 73% Skills in neck examination 55% Smoking cessation is effective 33% Alcohol cessation is effective 13% |
Tobacco 75% Prior OSCC 70% Alcohol 45% |
Intra- and extraoral 97% |
| Hertrampf et al., 2010 [46] |
306 | >75% | Tobacco 99% Alcohol 93% Prior OSCC 95% Sun exposure 68% Elderly 61% HPV infection 58% Diet 19% |
Erythroplakia and leukoplakia 67% | OSCC 87% Need of three negative follow-ups 85% OSCC diagnosis (III/IV stage) 81% Positive lymph node 71% Tongue high-risk area 68% Red patch 60% Asymptomatic at early stage 47% OSCC time diagnosis >60 yrs 46% |
Floor of the mouth 76% Tongue 70% |
OSCC early diagnosis improves the survival rate 90% | N.A. | Intraoral 70% |
| Reed et al., 2010 [77] |
288 | <75% | Tobacco 90% Betel quid chewing 88% Alcohol 45% HPV 26% Diet 6% |
N.A. | N.A. | N.A. | N.A. | Tobacco 70% | Intraoral 81% |
| Klosa et al., 2010 [47] |
306 | >75% | N.A. | N.A. | N.A. | N.A. | Annual visual inspection for patients over 40 is mandatory 84% Dentists are qualified to perform OSCC examination 71% Visual examination is effective in early detection 63% |
Tobacco 65% Prior OSCC 65% Tobacco products 45 Family history 40% Alcohol 35% Alcohol products 25% |
Intra- and extraoral 28% |
| López–Jornet et al., 2010 [48] |
340 | >75% | Tobacco 100% Alcohol 96.4% Prior OSCC 95.5% Ill-fitting prothesis 95.5% Family history 87.1% Poor oral hygiene 77.6% Elderly 69.4% Diet 52.6% Spicy foods 40.8% Obesity 14.4% |
Erythroplakia and leukoplakia 95% | Tongue high-risk area 96.8% Asymptomatic at early stage 95.6% OSCC diagnosis (III/IV stage) 94.7% OSCC 90.6% Positive lymph node 86.2% Red/white patch 89.7% OSCC time diagnosis >60 yrs 72.6% |
Tongue and floor of the mouth 89.1% | Dentists are qualified to perform OSCC examination 94.7% Ease for referral 90.9% Annual visual inspection for patients over 40 is mandatory 89.7% Skills in neck examination 52.6% Up-to-date personal knowledge 49.7% Physicians are qualified to perform OC examination 41.8% Smoking cessation is effective 41.5% Alcohol cessation is effective 27.6% Dental hygienists are qualified to perform OC examination 13.8% |
N.A. | N.A. |
| Seoane–Leston et al., 2010 [49] |
440 | >75% | Diet 18.6% | Leukoplakia 78% OLP 72% |
N.A. | N.A. | N.A. | N.A. | N.A. |
| Applebaum et al., 2009 [78] |
274 | >75% | N.A. | Erythroplakia and leukoplakia 34% | N.A. | N.A. | Dentists are qualified to perform OSCC examination 96% Visual examination is effective in early detection 85% Lack of patients’ knowledge 79.5% Skills in neck examination 66.67% Up-to-date personal knowledge 50% Physicians are qualified to perform OC examination 45% Smoking cessation is effective 24% Alcohol cessation is effective 12% |
Tobacco 85.5% Prior OSCC 85% Family history 56% Alcohol 51% Tobacco products 34% Alcohol products 34% |
N.A. |
| Mahalaha et al., 2009 [50] |
34 | >75% | N.A. | N.A. | OSCC 79.4% Red patch 76.5% Tongue high-risk area 70% Asymptomatic at early stage 67.6% Positive lymph node 56.3% OSCC time diagnosis >60 yrs 30.3% Persistent ulcer 26.5% Need of three negative follow-ups 6.2% Bleeding area 2.9% Pain 2.9% Swelling 2.9% |
Tongue and floor of the mouth 62% | Annual visual inspection for patients over 40 is mandatory 100% Ease for referral 96.9% Dentists are qualified to perform OSCC examination 96.9% Visual examination is effective in early detection 84.4% Skills in neck examination 71.9% Up-to-date personal knowledge 70% Undergraduate training was adequate 65.7% |
N.A. | Intra- and extraoral examination at 1st visit 83% at recall 73% Lymph nodes 57% |
| Colella et al., 2007 [12] |
457 | >75% | Tobacco 94.1% Prior OSCC 89.5% Alcohol 79.2% Elderly 47.9% Diet 25.8% |
Erythroplakia and leukoplakia 53.8% | N.A. | Tongue and floor of the mouth 32% | Smoking cessation is effective 80.9% Alcohol cessation is effective 76.5% Visual examination 53.8% Skills in neck examination 66.8% Lack of patients’ knowledge 39.6% |
Tobacco 81.8% Prior OSCC 78.6% Alcohol 71.9% Alcohol products 59.9% Tobacco products 55.6% Family history 47.9% |
Intra- and extraoral examination at 1st visit 52.3% |
| LeHew et al., 2007 [51] |
518 | >75% | Elderly 47.9% Family history 31.3% Alcohol 8.1% Tobacco 1.2% |
Leukoplakia 83.6% Erythroplakia 72% |
OSCC 74.7% Positive lymph node 64.3% White patch 53.9% OSCC time diagnosis >60 yrs 20.1% Red patch 31.5% |
Tongue 77.4% Floor of the mouth 72% Buccal mucosa 26.3% |
Need of CE 74.5% | Tobacco 76.1% Tobacco products 63.5% Alcohol 47.4% Alcohol products 28.8% |
Intra- and extraoral 92.3% Lymph nodes 71.5% |
| Gajendra et al., 2006 [52] |
499 | >75% | Tobacco 90% Alcohol 80% Sun exposure 60% Elderly 55% Betel quid chewing 52% Diet 25% Gutka consumption 16% |
N.A. | OSCC time diagnosis >60 yrs 33% | N.A. | Visual examination is effective in early detection 82% Previous CE courses 80% Skills in neck examination 75% Up-to-date personal knowledge 72% Lack of patient’s knowledge 65% Dentist skills in visual inspection 53% Dental hygienist skills in visual inspection 38% Smoking cessation is effective 20% Alcohol cessation is effective 15% |
Prior OSCC 79% Tobacco 70% Tobacco products 58% Family history 57% Alcohol 45% Alcohol products 31% |
Intra- and extraoral 85% |
| Kujan et al., 2006 [53] |
143 | <75% | N.A. | N.A. | N.A. | N.A. | Undergraduate training was adequate 51% | Prior OSCC 74.2% Tobacco 67.1% Tobacco products 55.2% Alcohol 41.3% Betel quid chewing 39.8% Alcohol products 32.8% Family history 21% Diet 25.3% Sun exposure 10.5% |
Intra- and extraoral 92% |
| Seoane et al., 2006 [54] |
32 | <75% | N.A. | N.A. | N.A. | N.A. | N.A. | N.A. | Scalpel biopsy 96.9% Intraoral examination 87.5% Toluidine blue 9.4% |
| Patton et al., 2005 [55] |
584 | >75% | Tobacco 100% Prior OSCC 99% Alcohol 95% Elderly 76% Sun exposure 74% HPV 60% Diet 39% |
Erythroplakia and leukoplakia 73% | Need of three negative follow-ups 98% OSCC 84% Red patch 82% Asymptomatic at early stage 79% Positive lymph node 70% Tongue high-risk area 77% OSCC diagnosis (III/IV stage) 53% OSCC time diagnosis >60 yrs 29% |
Floor of the mouth 79% Tongue 78% |
OSCC early diagnosis improves survival rate 99% | N.A. | Intraoral 83% |
| Cruz et al., 2005 [56] |
904 | <75% | N.A. | N.A. | N.A. | N.A. | N.A. | Tobacco 77% Tobacco products 66% Alcohol 54.5% Alcohol products 36% |
Intra- and extraoral examination at 1st visit 86%; at recall 80% |
| Alonge et al., 2004 [57] |
158 | >75% | Tobacco 98% Alcohol 98% Prior OSCC 93% Hot food and drink 75% Elderly 74% Spicy food 73% Family history of cancer 70% Obesity 63% Poor oral hygiene 42% Diet 37% Ill-fitting prothesis 33% |
Erythroplakia and leukoplakia 31% | OSCC 84% Positive lymph node 79% Red patch 76% Asymptomatic at early stage 76% Tongue high-risk area 68% Lip cancer related to the sun 76% OSCC diagnosis (III/IV stage) 53% OSCC time diagnosis >60 yrs 39% |
Tongue and floor of the mouth 51% | Need of CE 81% Undergraduate training was adequate 75% Previous CE courses 64% |
N.A. | Intra- and extraoral examination at 1st visit 67% Recall visit 54% Lymph nodes 36% |
| Macpherson et al., 2003 [79] |
225 | >75% | Tobacco 94% Alcohol 90% HPV 35% Fungal infections 33% |
Leukoplakia 79% Erythroplakia 67% |
N.A. | N.A. | N.A. | N.A. | N.A. |
| Clovis et al., 2002 [58] |
British Columbia 401 Nova Scotia 269 |
<75% | Tobacco 99.4% Prior OSCC 96.6% Alcohol 90.4% Elderly 78.7% Sun exposure 70.1% HPV 53.1% Diet 34% |
Erythroplakia and leukoplakia 76% | Need of three negative follow-ups 92.4% OSCC 83.4% Asymptomatic at early stage 78.4% Red patch 77.3% Tongue high-risk area 75.7% Positive lymph node 68.1% OSCC diagnosis (III/IV stage) 54.4% OSCC time diagnosis >60 yrs 45.7% |
Tongue 78.7% Floor of the mouth 66.6% |
OSCC early diagnosis improves the survival rate 97.8% Up-to-date personal knowledge 56.8% |
N.A. | Intraoral 80.6% |
| Clovis et al., 2002 [59] |
British Columbia 401; Nova Scotia 269 |
<75% | N.A. | N.A. | N.A. | N.A. | British Columbia Visual examination is effective in early detection 83.1% Skills in neck examination 74.8% Undergraduate training was adequate 68.5% Smoking cessation is effective 11.4% Alcohol cessation is effective 5.3% Nova Scotia Visual examination is effective in early detection 79.5% Skills in neck examination 69.4% Undergraduate training was adequate 68.3% Smoking cessation is effective 7.8% Alcohol cessation is effective 5.3% |
British Columbia Prior OSCC 93.1% Tobacco 76.8% Family history 69.6% Tobacco products 62.4% Alcohol 35.65 Alcohol products 17.7% Nova Scotia Tobacco 82% Prior OSCC 87.4% Family history 64.5% Tobacco products 60.1% Alcohol 39.3% Alcohol products 23.4% |
British Columbia Intra- and extraoral examination at 1st visit 71.2%; at recall 54.5% Lymph nodes 27.4% Nova Scotia Intra- and extraoral examination at 1st visit 69.9%; at recall 45.7% Lymph nodes 26.2% |
| Canto et al., 2001 [60] |
508 | >75% | Tobacco 100% Prior OSCC 97% Alcohol 95% Elderly 68% Sun exposure 62% Diet 30% |
Erythroplakia and leukoplakia 32% | OSCC 82% Red patch 81% Asymptomatic at early stage 76% Positive lymph node 76% Tongue high-risk area 71% OSCC diagnosis (III/IV stage) 50% OSCC time diagnosis >60 yrs 35% |
Tongue and floor of the mouth 62% | N.A. | N.A. | N.A. |
| Greenwood et al., 2001 [80] |
143 | >75% | Tobacco 90.7% Betel quid chewing 60.8% Alcohol 45.7% |
N.A. | N.A. | N.A. | N.A. | N.A. | Intra- and extraoral 68.2% |
| Yellowitz et al., 2000 [61] |
3200 | >75% | Tobacco 99.7% Alcohol 92.7% Prior OSCC 96.4% Elderly 70% Sun exposure 64% Diet 33% |
Erythroplakia and leukoplakia 37% | OSCC 83% Red patch 80% Asymptomatic at early stage 76% Tongue high-risk area 71% Positive lymph node 69% OC diagnosis (III/IV stage) 51% OSCC time diagnosis >60 yrs 33% |
Tongue and floor of the mouth 54% | Need of CE 84% Up-to-date personal knowledge 68% |
N.A. | Intraoral 81% |
| Horowitz et al., 2000 [62] |
3200 | >75% | N.A. | N.A. | N.A. | N.A. | Visual examination is effective in early detection 88% Undergraduate training was adequate 78% Skills in neck examination 72% Smoking cessation is effective 28% Alcohol cessation is effective 11% |
Prior OSCC 91% Tobacco 83.5% Tobacco products 72% Family history 65% Alcohol 55% Alcohol products 33% |
Intra- and extraoral examination at 1st visit 81% at recall 68% Lymph nodes 30% |
| Horowitz et al., 2000 [63] |
243 | >75% | N.A. | N.A. | N.A. | N.A. | Visual examination is effective in early detection 92.6% Skills in neck examination 76.5% Undergraduate training was adequate 74% Smoking cessation is effective 25% Alcohol cessation is effective 11.5% |
Prior OSCC 92.1% Tobacco 84.2% Tobacco products 70.2% Family history 69.2% Alcohol 60.9% Alcohol products 35.8% |
Intra- and extraoral examination at 1st visit 83.7% at recall 78.3% Lymph nodes 34.3% |
| Warnakulasuriya et al., 1999 [64] |
2519 | <75% | N.A. | N.A. | N.A. | N.A. | N.A. | Tobacco 50.2% Alcohol 19.3% |
Intra- and extraoral 84% Biopsy 21% |
| Yellowitz et al., 1998 [65] |
243 | <75% | Tobacco 99.6% Sun exposure 97.9% Prior OSCC 95.7% Alcohol 90.8% Elderly 68.9% Ill-fitting prothesis 64.6% Poor oral hygiene 47.2% Diet 33.6% |
Erythroplakia and leukoplakia 36% | OSCC 83% OSCC time diagnosis >60 yrs 30% Asymptomatic at early stage 27% |
Tongue 74% Floor of the mouth 68% Tongue and floor of the mouth 46% Buccal mucosa 30% Palate 14% |
Annual visual inspection for patients over 40 is mandatory 97.6% OSCC early diagnosis improves survival rate 96.4% Visual examination is effective in early detection 88% Up-to-date personal knowledge 83.7% Skills in neck examination 77.2% Lack of patients’ knowledge 67% |
Tobacco 78.5% Tobacco products 65% Alcohol 40.5% Alcohol products 20% |
Intra- and extraoral examination at 1st visit 33% Lymph nodes 33% |
| Yellowitz et al., 1995 [81] |
57 | >75% | N.A. | N.A. | OSCC time diagnosis >60 yrs 89% Pain 37.5% |
N.A. | Annual visual inspection for patients over 40 is mandatory 92.5% Ease to referral 88.2% Up-to-date personal knowledge 73.1% OSCC early diagnosis improves the survival rate 65.5% |
N.A. | N.A. |
Abbreviations: OSCC: Oral squamous cell carcinoma; GDPs: General dental practitioners; OLP: Oral lichen planus; OSMF: Oral sub-mucous fibrosis; Max-fac surgeon: Oral and maxillofacial surgeon; ENT: Otolaryngologist; OM: Oral medicine; CE: Continuing education; RX: Radio diagnostics.