Dentists' Capacity to Mitigate the Burden of Oral Cancers in Ontario, Canada.

Abstract

Background: In Canada, although the incidence of smoking-related oral cavity cancers has decreased, oropharyngeal cancers associated with human papilloma virus (HPV) are on the rise. During their routine interactions with patients, dentists have the opportunity to intervene. This study was conducted to assess dentists' capacity to prevent and detect oral cancers and to identify the barriers and facilitators that affect this capacity.

Methods: A 25-item, self-administered questionnaire was emailed to Ontario dentists through their regulatory body. It aimed to assess their perceptions about various aspects of oral cancer prevention and detection, including their knowledge, attitudes and practices. A binary logistic regression model was constructed for each modifiable risk factor (smoking, alcohol use, HPV) to identify the predictors of dentists' readiness to discuss with patients the connection between risk factors and oral cancers.

Results: Of the 9975 dentists contacted, 932 completed the survey. Most respondents (92.4%) believed that they are adequately trained to recognize the early signs and symptoms of oral cancer. However, only 35.4% of respondents said that they are adequately trained to obtain biopsy samples from suspected lesions. In addition, only a small proportion (< 40%) of the dentists believed that they are adequately trained to address relevant risk factors. Compared with dentists who said that they are adequately trained and currently assess a given risk factor, the odds of discussing the risk factor were consistently and significantly lower among those who said that they are inadequately trained (OR: smoking 0.11, alcohol 0.52, HPV 0.36) and among those who do not currently assess that risk factor (OR: smoking 0.12, alcohol 0.22, HPV 0.23).

Conclusions: This study suggests that the capacity of Ontario dentists to detect and prevent oral cancers is limited by lack of training in using oral cancer screening tools and addressing risk factors. To mitigate this barrier, dentists' capacity could be enhanced by improving their training in detecting oral cancers and their readiness to assess and address the risk factors.