Adjunctive screening devices for oral lesions: their use by Canadian Dental Hygienists and the need for knowledge translation

• Published in: International journal of dental hygiene Vol. 15; no. 3; pp. 187 - 194
• Main Authors: Laronde, DM, Corbett, KK
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.08.2017
• Subjects: Adult; Biopsy; brush biopsy; Canada; Cancer screening; Chemiluminescence; Clinical Competence; Coloring Agents; decision‐making; Dental Hygienists - psychology; Dentistry; Early Detection of Cancer - methods; Education, Dental, Continuing; Female; fluorescence visualization; Humans; knowledge translation; Localization; Luminescent Measurements; Male; Mass Screening - methods; Medical screening; Microscopy, Fluorescence; Mouth Neoplasms - diagnosis; Mucosa; Oral cancer; oral cancer screening; Oral cavity; oral premalignant lesions; Practice Patterns, Dentists; Tolonium Chloride; Toluidine; toluidine blue; Translational Medical Research; fluorescence visualization; decision-making; oral cancer screening; brush biopsy; oral premalignant lesions; toluidine blue; knowledge translation
• DOI: 10.1111/idh.12190
• ISSN: 1601-5029

Screening for oral cancer and other mucosal conditions is a knowledge‐to‐action objective that should be easy: there is supportive evidence, it is fast and non‐invasive, and the oral cavity is easy to visualize. However, over 60% of oral cancers are diagnosed late, when treatment is complex and prognosis poor. Adjunctive screening devices (ASDs), e.g. toluidine blue (TB), fluorescence visualization (FV), chemiluminescence (CL) and brush biopsies, were designed to assess risk of oral lesions or aid in identification and localization of oral premalignant and malignant lesions. Little is known on how clinicians feel about using ASDs. Objectives To evaluate use and level of comfort in using ASDs for oral cancer screening among dental hygienists. Methods Online email survey of a stratified random sample of nearly 3000 dental hygienists from four Canadian provinces. Results A total of 369 hygienists responded about ASDs. Ninety‐three (25%) had used an ASD. Use was associated with six or more continuing education (CE) courses per year (P = 0.030), having a CE course in oral pathology within the last 3 years (P = 0.003) and having a screening protocol (P = 0.008). The most commonly used ASD is FV, which was the tool hygienists felt most comfortable using. Few used brush biopsies. Older graduates were more comfortable using TB (P = 0.014) and CL (0.033). Conclusion Current evidence and education through CE appears to bolster knowledge translation efforts for hygienists to become more comfortable in the use of ASDs. ASDs with minimal supporting evidence and not specifically targeted to hygienists, such as the brush biopsies, are not well utilized.