Diagnostic approach used by US general dental practitioners following discovery of oral lesions suspicious for malignancy/premalignancy: findings from the National Dental Practice-Based Research Network.

Oral cancer examinations seek to clinically identify early oral cancers and discover premalignancies prior to their progression to invasive cancer. A cross-sectional study was conducted between April and August 2017 to explore and quantify the diagnostic approach used by United States (U.S.) general dentists (GDs) following discovery of an oral lesion suspicious for malignancy/premalignancy. U.S. licensed GDs who were clinically-active members of the U.S. National Dental Practice-Based Research Network were eligible to participate. Data for analysis were obtained via two questionnaires. The majority of participants were males, practiced full-time, had a suburban primary practice, were born during the 1950s, and graduated dental school in the 1980s or 2000s. After identifying an oral lesion suspicious for premalignancy/malignancy, the next action of most GD respondents (65.4%) was to refer the patient for consultation/biopsy. Most GDs (87.2%) referred to an oral and maxillofacial surgeon; 22% of GDs reported personally biopsying suspicious lesions. There was a relatively weak association between completing an AEGD or GPR residency and subsequently personally performing biopsies on patients with oral lesions suspicious for malignancy/premalignancy (OR 1.33, p=0.06). Most written referrals take place electronically and often include information, including lesion location (87.0%), lesion sign/symptoms (85.3%), lesion history (83.9%), radiographs (59.3%), medical history (50.6%), dental history (48.8%), and photographs (42.4%). When a referral biopsy was performed, referring clinicians were most frequently informed of the findings via a written report (96.7%,when positive for malignancy/premalignancy and 95.4% when negative). We present a snapshot of current actions taken by U.S. GDs following the discovery of oral abnormalities suspicious for premalignancy/malignancy.