Sir, St George et al. (BDJ 2005; 198: 341) and Brown (BDJ 2005; 198: 731) described two cases of missed diagnosis of malignancies by a dental technician and a dental practitioner, respectively, and stated that general medical practitioners have been shown to be better at diagnosis and prompt referral of oral malignancies than their dental colleagues.
This may be the truth according to one report.1 However, other large-scale research has revealed no significant difference in professional delay of oral malignancies between dentists and physicians,2,3,4,5,6 whereas other publications conclude that dentists refer patients at earlier stages than physicians do.7,8,9,10–11 According to Holmes et al.,11 oral- or oropharyngeal-squamous cell carcinoma (SCC) patients referred from dental offices were of significantly lower stage (TMN 1.94) than those referred from medical offices (TMN 3.00). As many as 72% of patients referred by physicians and ENT specialists were of advanced stages and only 21% of the patients referred by dentist and dental hygienists.11 Recently, Gordon et al.13 reported a case of misdiagnosis of tongue SCC as an apthous ulcer and later as an oral candidiasis by a dermatologist.
Although more attention and education among dentists is needed, still the dental profession is the only profession capable and dedicated to the diagnosis and treatment of diseases of the oral cavity.
References
Schnetler JF . Oral cancer diagnosis and delays in referral. Br J Oral Maxillofac Surg 1992; 30: 210–213.
Scully C, Malamos D, Levers BG, Porter SR, Prime SS . Sources and patterns of referrals of oral cancer: role of general practitioners. Br Med J 1986; 293: 599–601.
Dimitroulis G, Reade P, Wiesenfeld D . Referral patterns of patients with oral squamous cell carcinoma, Australia. Eur J Cancer B Oral Oncol 1992; 28B: 23–27.
Jovanovic A, Kostense PJ, Schulten EA, Snow GB, van der Waal I . Delay in diagnosis of oral squamous cell carcinoma; a report from The Netherlands. Eur J Cancer B Oral Oncol 1992; 28B: 37–38.
Kerdpon D, Sriplung H . Factors related to delay in diagnosis of oral squamous cell carcinoma in southern Thailand. Oral Oncol 2001; 37: 127–131.
Onizawa K, Nishihara K, Yamagata K, Yusa H, Yanagawa T, Yoshida H . Factors associated with diagnostic delay of oral squamous cell carcinoma. Oral Oncol 2003; 39: 781–788.
Cooke BE, Tapper-Jones L . Recognition of oral cancer. Causes of delay. Br Dent J 1977; 142: 96–98.
Amsel Z, Strawitz JG, Engstrom PF . The dentist as a referral source of first episode head and neck cancer patients. J Am Dent Assoc 1983; 106: 195–197.
Kowalski LP, Franco EL, Torloni H, Fava AS, de Andrade Sobrinho J, Ramos G, Oliveira BV, Curado MP . Lateness of diagnosis of oral and oropharyngeal carcinoma: factors related to the tumour, the patient and health professionals. Eur J Cancer B Oral Oncol 1994; 30B: 167–173.
Gorsky M, Dayan D . Referral delay in diagnosis of oro/oropharyngeal cancer in Israel. Eur J Cancer B Oral Oncol 1995; 31B: 166–168.
Holmes JD, Dierks EJ, Homer LD, Potter BE . Is detection of oral and oropharyngeal squamous cancer by a dental health care provider associated with a lower stage at diagnosis? J Oral Maxillofac Surg 2003; 61: 285–291.
Gordon M, Rishpon S, Gorski M . Delayed diagnosis of carcinoma of the oral cavity. J Isr Med Assoc 2005; 144: 243–245.(Hebrew.)
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Zadik, Y. Dentist versus doctor. Br Dent J 199, 355 (2005). https://doi.org/10.1038/sj.bdj.4812753
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DOI: https://doi.org/10.1038/sj.bdj.4812753
