Intra-oral examination that includes mucosal screening to detect oral malignant or premalignant lesions is of critical importance in the prevention and early detection of oral cancer . The risk of oral cancer increases with age; the average age at diagnosis is 62, and two-thirds of oral cancer patients are over 55 years old, although the disease may occur in younger people as well. According to records of the United Nations, about 600 million (10%) of the world’s population were aged 60 years and over in 2000. This figure is projected to reach 1.2 billion by 2025 . Age is a well-known risk for tooth loss and complete edentulism ; the prevalence rate of edentulousness (complete tooth loss) is 6% − 78% among individuals aged 60 years or over . Consequently, prosthodontists (specialists in providing artificial teeth) are expected to be the most frequently visited by older adults out of all oral health care providers. Therefore, prosthodontists can play a crucial role in the early detection and referral of oral cancer cases, thus reducing morbidity and mortality rates.
The present study, the first of its kind in the region, aimed to assess the beliefs, experiences and practices surrounding oral cancer screeningamong prosthodontists practicing in Saudi Arabia. Overall, the findings of this study revealed that prosthodontists in Saudi Arabia are motivated to conduct screenings and make referrals of suspicious oral mucosa pathologies. However, they lack the adequate training and confidence. The results also showed that recent graduates had better confidence and more positive attitudes towards oral cancer screening.
The main finding in the current study was that most of the surveyed prosthodontists claimed to screen their new patients for oral pathologies and refer them for treatment when necessary. These results are comparable with the findings reported among Australian prosthodontics . Unfortuanately, a large proportion of the participants admitted that they do not examine their patients at recall visits. This finding differsfrom the aforementioned study, in which most prosthodontists reported screening both new and recall patients . Lack of training and confidence were among the identified barriers for routine oral cancer screening - findings which are consistent with previous studies [15, 20]. Therefore, more work is needed to motivate prosthodontitsts to routinize oral cancer screening and referral.
Concerningly, a considerable proportion of the prosthodontists surveyed were not aware of mucosal screening and diagnostic aids. The majority felt unconfident in their ability to detect suspicious mucosal lesions, suggesting a deficit in professional training. These results highlight the urgent need for continued educational courses on mucosal screening, such as hands-on workshops and regular scientific meetings.
Tobacco is renowned for being a major risk factor for oral cancer and precancerous lesions. Dentists including prosthodontists and other dental health providers are in an ideal position to provide tobacco cessation advice, and thus help reduce the incidence of oral mucosal pathologies. It is disheartening to know that only 61% of the participants in the present study always give tobacco cessation advice, and less than half (43%) believe that they can influence their patients to quit this deleterious habit. These findings are in line with other previous studies elsewhere [15, 20–23]. Such unsatisfactory results can be attributed to the lack of confidence and indequate training on tobacco cessation counseling, and emphasize the urgent need to launch a training program on tobacco tobacco cessation counseling, targeting all prosthodontists and other oral health care providers.
Interestingly, recent graduates revealed better attitudes and more confidence in performing mucosal screening and providing tobacco cessation advice,. These findings which corroborate those of previous studies [15, 20, 24]. This can be explained by the fact that recent graduates are still fresh out of their studies, and so tend to be more knowledgeable and motivated compared to those who graduated years before them. This again underscore the importance of continuous professional courses for all prosthodontists and other dental health care personnel.
This is the first survey that assessed oral mucosal screening practices and beliefs among prosthodontics in Saudi Arabia. Howevere, the results of the present study should be interpreted with caution considering due to some potential methodological limitations. The main limitation of the survey was the relatively low response rate (57.5%). Although this rate is reasonable and comparable to other questionnaire-based surveys among prosthodontists and dentists, this could have introduced a non-response bias into the results that subsequently limits the generalizability of our findings. Thus, it is difficult to generalize the findings to all prosthodontists practising in Saudi Arabia. Additionally, the responses were subjective as a result of the survey being questionnaire-based (self-reported data). As a result, the responses may not accurately reflect actual levels of knowledge and methods of practice. Despite these shortcomings, this study sheds some light on the beliefs and practices of prosthodontists around mucosal screening. It has also highlighted the importance of continuous educational courses for all prosthodontists.
In conclusion, this study has demonstrated that prosthodontists in Saudi Arabia appear to have good motivation and practices regarding oral cancer screening. However, they lack the adequate training and confidence. Periodic, continuous educational courses should be organized to address this deficit in training and to help improve prosthodontists’ motivation, confidence and skills in identifying and referring suspicious mucosal lesions.