Effectiveness of Continuing Education Interventions in Improving Dentists' Proficiency in Oral Cancer Screening: A Systematic Review and Quality Appraisal.

Abstract

Background: Early detection of oral cancer (OC) is critical for improving survival outcomes; however, delayed diagnosis remains common worldwide. By performing routine OC screenings, dentists play a central role in its early detection yet persistent gaps in knowledge, confidence and clinical skills remain. While previous reviews have focused on diagnostic adjuncts and technologies for OC detection, the effectiveness of continuing educational interventions targeting dentists' screening proficiency has not been systematically appraised.

Objective: To systematically review and qualitatively appraise the effectiveness of continuing educational interventions in improving dentists' proficiency in performing OC screenings.

Method: A systematic review and quality appraisal was conducted in accordance with PRISMA 2020 guidelines. Searches were undertaken in MEDLINE, PubMed and CINAHL, supplemented by Google Scholar and citation tracking from inception to January 2026. Eligible studies were English-language primary research evaluating OC educational interventions for dentists with pre and postintervention outcome assessment. Owing to substantial heterogeneity in study design, intervention characteristics and outcome measures, meta-analysis was not feasible. A qualitative synthesis was undertaken, and the certainty of evidence was assessed using the GRADE approach. This study has been registered in PROSPERO (REF: CRD420250591937).

Results: Nine studies involving sample sizes ranging from 47 to 442 participants were included, encompassing online, face-to-face, blended and campaign-based educational interventions. All nine studies reported improvements in dentists' knowledge and awareness following the interventions. Five studies reported improvements in diagnostic accuracy and lesion recognition, five reported increased confidence or self-efficacy, and three reported improvements in OC screening or referral practices. Most interventions were of short duration and relied predominantly on self-reported outcomes. Limited undergraduate training, unclear referral pathways and inadequate infrastructure were commonly reported barriers to the implementation of OC screening. The certainty of evidence, assessed using the GRADE approach, ranged from very low to low across the evaluated outcomes.

Conclusion: Continuing educational interventions may enhance dentists' proficiency in OC screening, particularly when interactive and practice-oriented methods are used. Nevertheless, integrated approaches combining standardised curricula, longitudinal training and system-level support are required to translate educational gains into sustained practice change, earlier OC detection and improved outcomes.