Importance of imparting adequate training to general dentists regarding oral cancer

Sir,

Oral cancer accounts for 30% of all cancers in India. 60–80% of patients in India present with an advanced stage of oral cancer when detected.^[1] Tobacco, alcohol, human papillomavirus, and Epstein-Barr virus are implicated in the etiology of oral cancer.^[2] Two important routes to effectively manage and control oral cancer lies in its prevention and early diagnosis.^[2] The prognosis of oral cancer depends upon the stage of its detection. The earlier the detection better is the prognosis.

General dentists are often consulted by a significant amount of the Indian population for oral complaints. It is of utmost importance to give proper basic awareness and education about various aspects of oral cancer to the budding undergraduate dentists. Dental surgeons should be thoroughly trained to identify persons with a significant risk of oral cancer. They should be able to recognize the earliest clinical manifestations of oral cancer including those of the preceding precancerous lesions and conditions of the oral cavity. They should promptly be able to differentiate the clinical appearance of common lesions such as aphthous ulcers, traumatic ulcers, and denture sores from that of oral cancers. They should also be aware of common sites of occurrence of oral cancer such as tongue, floor of the mouth, buccal mucosa, and gingiva.^[3]

Oral cancer is more fatal when compared to the cancers of the cervix, breast, and prostrate. A simple method for early detection is the 90 s visual and tactile examination.^[4] Dentists should be trained to detect oral precancerous lesions and conditions such as leukoplakia, erythroplakia, and oral submucous fibrosis. Complete case history including habits should be documented in dental records with frequent oral examinations in a high-risk group. Lesions that exhibit altered surface texture, color, and contour; loss of surface integrity; changes in size; and mobility of oral and extraoral structures should be identified during the visual clinical examination.^[4]

A recent study undertook a simple, low-cost method of screening oral cancer and found it to be considerably effective. It utilized magnivisualizer. Magnivisualizer uses white light instead of the yellow light spectrum of torch light used in screening by a general dentist. Furthermore, it provides magnification from 1 to 5 diopter. It is not only superior in detecting oral cancer lesions, but also in differentiating those lesions.^[5]

General dentists play an important role in the early detection and prevention of oral cancer. Workshops and continuing dental education programs on oral cancer should be conducted regularly to educate and update the knowledge of existing general dental practitioners.^[6,7] Dental schools should devote sufficient time to train undergraduates about the etiologies, detection, and prevention of oral cancer.^[8] A well trained and educated dentist not only plays an important role in arresting the mortality rate due to oral cancer, but also prevents the occurring of oral cancer by educating his patients about various aspects of oral cancer.