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J Am Dent Assoc, Vol 134, No 3, 307-314. © 2003 American Dental Association

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JADA Continuing Education

Defining the dentist’s role

Background. The authors conducted a study to evaluate the effectiveness of dentists in the early detection, treatment and postoperative care of oral squamous cell carcinoma, or SCC, in a central European population.

Methods. This multicenter retrospective study was conducted under the auspices of DÖSAK (a German, Austrian and Swiss cooperative group on tumors of the maxillofacial region). A questionnaire was used to evaluate the diagnostic, treatment and postoperative processes involved in managing the care of patients with oral SCC. A total of 3,894 questionnaires was sent to patients who had been diagnosed with and operated on for oral SCC at least six months previously; 1,761 questionnaires were returned. Another 1,652 additional questionnaires were sent to their oral surgeons; 1,543 were returned.

Results. The pT staging was pT2 (40.41 percent), pT1 (31.30 percent), pT4 (16.35 percent) and pT3 (11.90 percent). In 61.3 percent of the patients, there was no evidence of metastases. In 40 percent of the patients, the dentist treated the first symptoms, whereas the physician did so in 27 percent of the patients. A total of 72.5 percent of the dentists and 40.11 percent of the physicians identified oral SCC correctly.

Conclusions. Dentists should participate actively in oral cancer patients’ rehabilitation processes through regular clinical follow-up examinations and restoration of intraoral function.

Clinical Implications. Dentists should conduct an oral cancer screening at each patient visit. Patients who are at risk should undergo more intense surveillance. Dentists should advise their patients to stop high-risk habits such as smoking and help them make choices for healthier lifestyles.

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