Epstein Joel B, Villines Dana, Drahos Gary, Kaufman Eliezer, Gorsky Meir
Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, Interdisciplinary Program in Oral Cancer, College of Medicine, University of Illinois at Chicago, Chicago, Ill. 60612-7213, USA.
J Am Dent Assoc. 2008 Oct;139(10):1338-44. doi: 10.14219/jada.archive.2008.0045.
Dental education must emphasize early diagnosis and management of oral mucosal disease, including early detection of oral premalignant lesions and cancer. The authors evaluated clinical findings of oral screening examinations of dental patients during a one-week period in an urban dental school clinic.
Third- and fourth-year dental students conducted clinical screening examinations for all dental patients of record seen during the Yul Brynner Foundation's Oral, Head and Neck Cancer Awareness Week in April 2006.
Of 262 patients, 100 (38.2 percent) reported that they had used tobacco for a mean of 8.1 years. Most patients reported having denture or tooth and gingival problems. The dental students reported abnormal findings in 55 patients (21 percent). Two patients had suspected premalignant lesions that were diagnosed as lichen planus and traumatic keratosis.
The one-week screening provided an educational opportunity for the dental students, and the results demonstrate the value of having a focused week to reinforce the importance of head and neck and oral soft-tissue examination. The finding of mucosal lesions in 21 percent of patients of record reflects the fact that lesions were present but undetected. In addition, there are important implications for teaching and patient care. The screening week provided an opportunity for students to be active in a national campaign for cancer detection, and it represents an opportunity for visible community participation in the recognition of oral mucosal diseases in dental training programs and broadly for the profession.
牙科教育必须强调口腔黏膜疾病的早期诊断和管理,包括口腔癌前病变和癌症的早期检测。作者评估了一所城市牙科学校诊所一周内牙科患者口腔筛查检查的临床结果。
三年级和四年级牙科学生在2006年4月尤尔·伯连纳基金会口腔、头颈癌宣传周期间,对所有有记录的牙科患者进行了临床筛查检查。
在262名患者中,100名(38.2%)报告称他们使用烟草平均达8.1年。大多数患者报告有假牙或牙齿及牙龈问题。牙科学生报告了55名患者(21%)有异常发现。两名患者有疑似癌前病变,被诊断为扁平苔藓和创伤性角化病。
为期一周的筛查为牙科学生提供了一个教育机会,结果表明设定一个重点周以强化头颈及口腔软组织检查的重要性具有价值。在21%的有记录患者中发现黏膜病变,这反映出病变确实存在但未被检测到这一事实。此外,这对教学和患者护理也有重要意义。筛查周为学生提供了一个积极参与全国癌症检测活动的机会,并且代表了社区在牙科培训项目中以及更广泛地在整个行业中参与口腔黏膜疾病识别的一个可见机会。