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Dyskeratosis congenita is an inherited disorder that usually presents in males, consisting of a triad of leukoplakia of the mucous membranes, nail dystrophy and skin pigmentation. Whilst most cases are X-linked, autosomal dominant and recessive forms have also been reported. The significance of the condition lies in premature mortality arising from either bone marrow failure or malignant change within the areas of mucosal leukoplakia. We present a case (X-linked recessive form) where the classic triad of signs were present, along with the development of lichenoid reaction in the buccal and labial mucosa. This is believed to be the first case in which such a reaction has been noted together with the oral hyperkeratosis. The identification of a white patch within the mouth of a child, in the absence of any other obvious cause must arouse suspicion of this rare condition. All clinicians should be aware of this rare genetic disorder so that early referral can be made and appropriate management instigated. [ABSTRACT FROM AUTHOR]

Competence in undergraduate oral surgery involves assessment of the students' knowledge, practical skill and attitude. The assessment of practical skills can be achieved using a formative assessment method such as the structured clinical operative test (SCOT) which uses a checklist for the assessment of a clinical task. The aim of this study was primarily to determine whether SCOTs could be integrated into the oral surgery undergraduate course, and secondarily to collect feedback from both the students and the staff on this assessment. A validated checklist was used by trained examiners to assess the performance of 49 students in their second clinical year undertaking simple exodontia. Feedback was collected from the students by questionnaire and from the staff by interview. The SCOT was well received by both students and staff. The main problem highlighted by the students was the perceived inter-examiner variability and by the staff, the disruptive effect on the clinics. The checklist must be objective enough to prevent misinterpretation. Despite these limitations, the SCOT provides a more objective assessment and serves to highlight weaker students, allowing them to be targeted for closer supervision and instruction as well as providing the students with a tool to measure their progress in oral surgery. The use of peer assessment by students may alleviate the burden on the staff. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess whether vascular endothelial growth factor (VEGF) expression in oral tissues is associated with angiogenesis, disease progression or field cancerisation. Vascularity and VEGF immunoreactivity were quantified in 68 archival specimens including normal oral mucosa (NOM), dysplasia (DYS) and squamous cell carcinoma (SCC). Vascularity increased significantly with disease progression; it was also higher in NOM adjacent to SCC than in NOM from healthy tissue, suggesting an association with field cancerisation. VEGF expression in epithelial cells was evaluated using two antibodies and three indices. VEGF indices and vascularity were not directly correlated. The expression of VEGF was similar in all DYS and NOM specimens, whether or not adjacent to a concurrent lesion. A comparison of SCC with NOM or DYS led to opposite results, depending on the VEGF antibody and index used. We conclude that VEGF expression in the oral mucosa may play a physiological role, but does not appear to be associated with angiogenesis, field cancerisation or transition to dysplasia. Further studies concerned with tumour development require examining specific VEGF isoforms and standardisation of the methodology. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess whether vascular endothelial growth factor (VEGF) expression in oral tissues is associated with angiogenesis, disease progression or field cancerisation. Vascularity and VEGI immunoreactivity were quantified in 68 archival specimens including normal oral mucosa (NOM), dysplasia (DYS) and squamous cell carcinoma (SCC). Vascularity increased significantly with disease progression; it was also higher in NOM adjacent to SCC than in NOM from healthy tissue, suggesting an association with field cancerisation. VEGF expression in epithelial cells was evaluated using two antibodies and three indices. VEGF indices and vascularity were not directly correlated. The expression of VEGF was similar in all DYS and NOM specimens, whether or not adjacent to a concurrent lesion. A comparison of SCC with NOM or DYS led to opposite results, depending on the VEGF antibody and index used. We conclude that VEGF expression in the oral mucosa may play a physiological role, but does not appear to be associated with angiogenesis, field cancerisation or transition to dysplasia. Further studies concerned with tumour development require examining specific VEGF isoforms and standardisation of the methodology.e [ABSTRACT FROM AUTHOR]

Objective: To assess whether final year dental students could act as reliable examiners within an Objective Structured Clinical Examination (OSCE) by comparison with results obtained by an experienced member of staff.Design: A station testing examination of the mouth was included in the second year medical undergraduate summative OSCE examination.Setting: Concurrently run in three different examination venues on the Ninewells Hospital campus.Subjects: 147 medical students and 3 pairs (A, B, C) of examiners. Each examining pairing consisted of one member of staff and one dental student (blind to each other's marking).Method: A checklist of 13 tasks to be performed was provided to the examiners. One mark awarded for a completed task, no mark for no attempt at the task, and half a mark for attempt at task.Results: Paired results were available for 125 medical students. Using Mann-Witney analysis, the non-parametric 95% confidence intervals for the difference in scores between the 3 paired teams were group A (-0.5, 0), group B (-0.5, 0.5), group C (-0.5, 0). In only 4 students (out of 125) did the difference between the individual pair differ by 2 or more marks.Conclusion: On the basis of this pilot study final year dental students may be used as examiners in OSCEs where basic technical skills are to be evaluated. This development from peer group teaching provides further evidence supportive of interprofessional education. [ABSTRACT FROM AUTHOR]

The structure of the oral mucosa has been extensively studied but its cell physiology has been less well characterised. This study aimed to show the range in variation in fluid phase endocytic capability in biopsies from different oral sites. Oral epithelial cells were obtained from both biopsies and single-cell suspensions obtained by brushing the oral cavity. Biopsies in organ culture and single cells in suspension were incubated with fluorescent microspheres of 0.02, 0.1 or 1.0 μm diameter. Endocytosis of fluorescent microspheres was quantitated by flow cytometry and visualised by confocal microscopy. Epithelial cells from all oral sites that were sampled internalised 0.02 μm and 0.1 μm but not 1.0 μm microspheres, with no significant differences observed between oral regions. Single cells from non-cancer patients endocytosed significantly more 0.02 μm microspheres than cells removed from patients with oral cancer. This model may be used to study integrated oral cell function both in health and disease. [ABSTRACT FROM AUTHOR]

The effect of alcohol on the oral mucosa was assessed using quantitative cytomorphology applied to smears taken from clinically normal oral mucosa of patients attending an alcohol problem unit and results were compared to a control group (consisting of social and non-drinkers) attending a hospital for routine dental care. Smears were stained using the Papanicolaou method and the nuclear and cell boundaries of 50 randomly selected cells traced and mean areas (NA and CA, respectively) calculated. The average number of units of alcohol consumed were recorded for each group together with relevant blood tests. The alcohol group was further subdivided into "binge" and "regular" drinkers. No significant differences were found between mean NA and mean CA values for these two types of alcohol drinkers, despite a marked difference in weekly units consumed. However, a statistically significant reduction in mean cytoplasmic area (P < 0.001) and mean nuclear area (P < 0.01) was found for the alcohol group when compared to controls. In conclusion, excess alcohol intake may influence results for quantitative oral cytomorphology. Further research is indicated on the relative effects of alcohol (both topical and systemic). [ABSTRACT FROM AUTHOR]

The use of oral exfoliative cytology in clinical practice declined due to the subjective nature of its interpretation and because there may be only a small number of abnormal cells identifiable in a smear. The more recent application of quantitative techniques, together with advances in immunocytochemistry, have refined the potential role of cytology, stimulating a reappraisal of its value in the diagnosis of oral cancer. This review considers the influence of the quantitative analysis of cytomorphology, DNA analysis and other tumour markers applied to oral exfoliative cytological samples. These studies indicate that oral cytology may provide an important adjunct in the assessment of the patient with a potentially cancerous oral lesion. [ABSTRACT FROM AUTHOR]

The tumour suppressor gene p53 is frequently mutated in neoplasia. Since mutant p53 protein is often over-expressed, mutation can be indirectly detected by immunocytochemical techniques. As microwave antigen retrieval is becoming a widespread method for increasing the antigenicity of paraffin sections, we investigated the application of this technique to p53 immunohistochemical staining of oral mucosa specimens. Paraffin sections of 22 squamous cell carcinomas (SCC) and 36 benign lesions were immunohistochemically stained with and without antigen retrieval. Without antigen retrieval p53 over-expression was observed in 6/22 SCC and 1/36 benign lesions. Following antigen retrieval positive staining was observed in 15/22 SCC and 35/36 benign lesions. Staining in benign lesions was confined to basal and parabasal cells and could reflect normal functioning of wild-type p53. We conclude that antigen retrieval increases the sensitivity of p53 immunoreactivity, but such staining is not specific for malignancy and should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Although cytokeratin expression is said to alter with the state of tumor differentiation, few studies appear to have confirmed this in fresh tissue biopsies from oral squamous cell carcinomas. Previous studies have been limited by the number of antibodies utilized, small sample size, or lack of information regarding tumor differentiation. A panel of 8 antikeratin antibodies (of which five recognised the simple epithelial keratins, 8, 18 and 19) were applied to fresh tissue biopsies from 24 oral cancer and 15 normal oral mucosal biopsies. A standard immunocytochemical technique was followed (Vectastain ABC method), with keratin expression graded on a 3 point scale. Our analysis indicated that simple epithelial keratins (K8, K18, K19) were not confined to the more poorly differentiated tumors. This may be relevant to tumor prognosis. [ABSTRACT FROM AUTHOR]

In dyskeratosis congenita, the hyperkeratotic lesions affecting the mucous membranes have a propensity to undergo malignant change. Unfortunately there is presently no reliable method for predicting such an outcome. Oral mucosal biopsies were obtained from a case of dyskeratosis congenita and keratin expression identified using a panel of antikeratin antibodies. Marked changes were found from keratin profiles established for normal oral mucosa. In particular coexpression of three separate type 1 keratins (K16, K10 and K13) were observed in the ventral tongue lesion. The keratin pattern found in the tissue biopsies examined is suggestive of an unusually immature or disturbed state of tissue differentiation, and as such may be indicative of future malignant change. [ABSTRACT FROM AUTHOR]

Cellular expression of keratins (intermediate filaments) can be demonstrated by immunocytochemistry using unfixed tissue. However, for practical reasons, provision of fresh tissue to the laboratory is often difficult. Recently a fresh tissue transport medium (Patent applied for) has been developed which allows keratin immunocytochemistry to be performed up to 4 days after biopsy. In this study oral mucosal biopsies from 10 patients were hemisected, half placed in the new transport medium at 4 degrees C and the other half immediately frozen in liquid nitrogen. After 4 days frozen sections of both halves of the biopsies were stained by immunocytochemistry using various antikeratin antibodies. The morphology and staining characteristics of the two halves of the biopsies were then assessed. No significant difference could be found in either morphology or preservation of keratin expression in specimens stored in transport medium, as compared to those in liquid nitrogen. This new transport medium may offer considerable advantage for the provision of a histologic and immunocytochemical diagnostic service. [ABSTRACT FROM AUTHOR]

The first ultrastructural description of the mucosal lesions of lingual hyperkeratosis in dyskeratosis congenita is reported. The histology described may help explain the high incidence, later in life, of cancerous change in these leukoplakic patches. [ABSTRACT FROM AUTHOR]

AIMS--To assess keratin profiles from smears of malignant and contralateral normal oral mucosa as part of the development of a screening procedure for oral cancer based on exfoliative cytology. METHODS--Smears were taken from oral cancers (confirmed by biopsy) and from the contralateral site of 20 patients. Using a panel of antikeratin antibodies, the keratins expressed by these cells were identified using a standard immunocytochemical technique (Vectastain) and assessed on a 3 point scale. RESULTS--Using chi 2 analysis, noticeable differences between the keratin profiles for malignant mucosal smears compared with the contralateral mucosal smears were found. This was particularly evident for the simple epithelial keratins. CONCLUSION--Individual keratins can be identified in smears from oral cancers. The identification of simple epithelial keratins seem to be the best keratin markers associated with malignancy. Their detection within smears from oral lesions could be valuable in the early diagnosis of oral cancer. [ABSTRACT FROM PUBLISHER]

AIMS: To assess p53 protein expression in a range of odontogenic cysts arising in the mouth, including those of developmental and inflammatory origin. METHODS: p53 protein was identified using the polyclonal antibody CM-1, together with a standard immunoperoxidase technique. A total of 36 cystic lesions were examined, all of which were histologically benign. RESULTS: Expression of p53 protein was identified within the lining of five of 12 odontogenic keratocysts but was not detected in the other cystic lesions in the series. CONCLUSIONS: This is believed to be the first report that identifies increased expression of p53 protein in benign cystic epithelium. The increased expression of p53 protein in the nucleus is usually associated with malignant disease. These findings are relevant to the management of odontogenic keratocysts which have a tendency to recur, and also to Gorlin Goltz syndrome in which keratocysts and multiple basal cell carcinomas are features. [ABSTRACT FROM PUBLISHER]

Enlargement of the rat parotid salivary glands was induced by repeated administration of isoproterenol. Mean wet weights of the treated glands increased steadily to 240% of control values. Following withdrawal of the drug, quantitative histological techniques were used to investigate the balance between hypertrophy, hyperplasia and apoptosis. The volume occupied by acinar cells relative to the total gland volume together with cytoplasmic magnitude of nuclear area ratios as measures of hypertrophy increased during the early experimental period. Similarly, serous acinar cell mitotic counts increased, indicating that hyperplasia had occurred. Apoptosis was demonstrated at light microscopical level to be the main mechanism for cell deletion as the glands returned to normal size and weight. The results indicate that hypertrophy and hyperplasia of serous acinar cells contribute to isoproterenol-induced sialadenosis. The experimental animal model demonstrates that these proliferative changes are completed by 48 h and thereafter are balanced by apoptosis as the glands recover their normal size and weight. [ABSTRACT FROM AUTHOR]

The effect of radiotherapy on normal buccal mucosa was investigated using the quantitative techniques of cytomorphology (measurement of nuclear and cytoplasmic area) and DNA cytophotometry. These techniques were applied to smears obtained before, during, and after irradiation. Nuclear area and cytoplasmic area increased and DNA values were abnormal in most cases as a result of radiotherapy, returning to within normal limits one month after treatment. This contrasts strongly with the changes seen in smears from previously irradiated uterine cervices, where changes in cytomorphology may persist for several years. [ABSTRACT FROM PUBLISHER]

The effect of cigarette smoking on the oral mucosa was assessed through the application of quantitative cytomorphometric analysis to smears obtained from clinically normal buccal mucosa. The nuclear (NA) and cytoplasmic (CA) area of cells within each smear were measured using a Vids V semi-automatic image analysis system. Mean values for NA (smokers - 78.74 μ[SUP2], non-smokers - 72.28 μ[SUP2] and for CA (smokers - 3273.9 μ[SUP2], non-smokers - 3098.96 μ[SUP2]) were obtained. A two-sample t-test revealed a significant elevation in NA for smokers, but no significant variation in CA between the two groups. These results would suggest that for normal buccal mucosa smoking does appear to influence cytomorphology. [ABSTRACT FROM AUTHOR]

Alcohol consumption and affordability in the UK has increased over the last 50 years and is associated with a range of adverse oral health outcomes, the most serious of which, oral cancer, is also increasing in incidence. Despite this, routine screening and intervention relating to alcohol consumption within general dental practice remains uncommon. This review of the literature describes the background and outlines the evidence base for undertaking alcohol screening and delivering brief interventions in general dental practice. Consideration will be given to the rationale for, and range of issues related to, introducing this into general dental practice. [ABSTRACT FROM AUTHOR]

Background and aims The diagnosis of early and pre-malignant lesions of oral squamous cell carcinoma is of paramount importance given the mortality rate of late stage disease. Although studies have been undertaken examining how dentists manage and refer potentially malignant lesions, the majority of the research has used questionnaires, with the inherent bias this introduces. The aim of this study was to use qualitative methods to understand in more detail how practitioners manage potentially malignant lesions once they have been discovered.Methods Semi-structured interviews were undertaken with eighteen dentists in Sheffield, transcribed and analysed using thematic analysis.Results Five codes were identified relating to the mechanics of the referral, the management of the lesion and the patient's risk factors. Health promotional activities were not being undertaken by all the participants and for some, explaining positive results and giving advice about alcohol was perceived as particularly difficult.Conclusion Overall, the present research suggests that further training is required to help dentists broach difficult issues with their patients. [ABSTRACT FROM AUTHOR]

Aim To determine the potential of a pathology-free impacted lower third molar to cause symptoms within a year and whether these symptoms can be linked to clinical characteristics, lifestyle or socio-demographic status.Design One-year prospective cohort study of patients registered in general dental practice in Scotland with at least one asymptomatic impacted lower third molar.Methods All general dental practices with panoramic radiography facilities in Tayside, Fife and Greater Glasgow (Scotland, UK) were invited to participate in the study. Orthopantomographs taken between 1995 and 2002 were reviewed and eligible patients were contacted and invited to participate. Patients were assessed in their own dental surgery by the same research dentist. In this baseline assessment, the presence of impaction was confirmed and all patients with a previous history of symptoms and/or pathology were excluded from further analysis. Clinical characteristics such as the angulation and the degree of impaction were recorded. Patients also completed a socioeconomic questionnaire. Eligible patients were re-assessed by the same research dentist one year later when they were asked about their experience of symptoms within the past year. Information was cross-referenced with patients' dental records.Results A total of 613 patients attended the baseline appointment. Of those, 30 (4.89%) had a history of symptoms and were excluded from the study, leaving 583 (95.10%) eligible patients. From those, 421 (69%) patients with a total of 676 lower third molars were examined one year later. 22.67% of all vertically impacted teeth examined had developed symptoms, along with 13.15% of all mesially impacted, 30.69% of all distally impacted and 6.45% of all horizontal third molars. This association was statistically significant (p ≤0.001). 23.05% of all partially erupted teeth and a surprising 10.49% of all unerupted teeth were associated with symptoms during the study period. This association was also significant (p ≤0.001). There was also a statistically significant inverse association between the development of symptoms and age (p = 0.0028).Conclusions The predictability that an impacted lower third molar will develop symptoms in future remains unclear. However, some clinical characteristics such as the angulation, the degree of impaction and the patient's age could be useful in predicting the likelihood of future symptomatology. [ABSTRACT FROM AUTHOR]

ObjectivesTo assess general medical practitioners' (GMPs') and general dental practitioners' (GDPs') awareness of prevention and early detection of oral cancer.DesignCross-sectional questionnaire-based study.SettingPrimary careMethodQuestionnaires were delivered to all GMPs and GDPs in Tayside, assessing oral examination habits, delivery of advice on oral cancer risk factors, knowledge of oral cancer risk factors and clinical appearance, preferred point of referral and requests for further information.ResultsResponse rates of 71% and 84% were obtained from GMPs and GDPs respectively. GMPs were less likely to examine patients' oral mucosa routinely, less likely to advise patients about risk factors for oral cancer, identified fewer risk factors for, and felt less confident about diagnosing oral cancer from clinical appearance than their dental counterparts. Seventy-one percent and 80% of GMPs and GDPs respectively requested further information about oral cancer.ConclusionPatients with oral lesions often present to their general medical practitioner. The incidence of oral cancer is rising in the United Kingdom, therefore the role of general medical practitioners in prevention and detection of oral cancer is becoming ever more important. This study highlights the need for improved education of general medical practitioners on oral cancer. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses the incidence of oral cancer seen by dentists on their entire career.

As p53 expression has been associated with malignant disease its presence was assessed in biopsy specimens from dorsal lingual hyperkeratosis, taken over a five year period. p53 expression, using CM1, was assessed using a standard immunoperoxidase technique. p53 was not identified in the first biopsy specimen in 1986 but was identified in all subsequent ones. Only in the latest biopsy specimen was there evidence for dysplasia in haematoxylin and eosin stained sections. It is suggested that p53 expression may be a reliable marker for predicting premalignant change in keratoses occurring in dyskeratosis congenita. [ABSTRACT FROM PUBLISHER]

A letter to the editor is presented in response to the article on the issue raised by National Institute for Health and Clinical Excellence (NICE) guidelines about wisdom teeth in the previous 2013 issue.

Objectives To determine whether general dental practitioners (GDPs) currently provide alcohol-related advice (ARA) and to inform the development of an intervention, should one be required.Method Cross-sectional postal survey of a random sample of 300 GDPs in Scotland. The questionnaire assessed beliefs derived from psychological models that explain behaviour in terms of beliefs that are amenable to change, and so may inform development of an intervention to encourage the provision of ARA.Results Sixty percent of GDPs responded. Eighty-three percent of participating GDPs (145/175) had not provided ARA to patients in the previous ten working days. Attitude (perceived consequences), control beliefs (perceived difficulty), subjective norm (perceived social pressure), and self-efficacy (confidence) significantly predicted intention to provide ARA. Alcohol-related knowledge or personal alcohol behaviour did not predict intention to provide ARA.Conclusions There is scope to increase the provision of ARA in primary care dentistry and this study identified predictive beliefs, which could be targeted to encourage this behaviour. The next phase is to develop and test an intervention to encourage GDPs to provide ARA. [ABSTRACT FROM AUTHOR]

Alcohol consumption and affordability in the UK has increased over the last 50 years and is associated with a range of adverse oral health outcomes, the most serious of which, oral cancer, is also increasing in incidence. Despite this, routine screening and intervention relating to alcohol consumption within general dental practice remains uncommon. This review of the literature describes the background and outlines the evidence base for undertaking alcohol screening and delivering brief interventions in general dental practice. Consideration will be given to the rationale for, and range of issues related to, introducing this into general dental practice. [ABSTRACT FROM AUTHOR]

Objective To identify salient beliefs of general dental practitioners (GDPs) regarding their role in the identification of alcohol misuse and the provision of an alcohol related health message in the primary dental care setting.Method A convenience sample of 12 GDPs practising in the North Highland region of Scotland underwent semi-structured interview. An inductive approach was used with subsequent basic thematic content analysis performed on the transcripts.Results GDPs universally agreed that alcohol consumption plays a role in both oral health and general health but this did not translate into effective communication about alcohol during dental consultation. Current knowledge of recommended safe alcohol consumption guidelines was poor - evidence of potential GDP training requirements. The primary barriers related to disruption of the clinician-patient relationship, embarrassment or the perceived irrelevance to the clinical situation. GDPs expressed low confidence in approaching alcohol related problems.Conclusions GDPs felt that alcohol based discussions in primary care would not be relevant and would inevitably lead to disruption of the patient-clinician relationship. Further research is necessary to more fully understand the attitudes, behaviour and knowledge of GDPs regarding the provision of alcohol related health advice. The results of this study have informed the design of a paper postal survey for wider distribution. [ABSTRACT FROM AUTHOR]

Aim To determine the potential of a pathology-free impacted lower third molar to cause symptoms within a year and whether these symptoms can be linked to clinical characteristics, lifestyle or socio-demographic status.Design One-year prospective cohort study of patients registered in general dental practice in Scotland with at least one asymptomatic impacted lower third molar.Methods All general dental practices with panoramic radiography facilities in Tayside, Fife and Greater Glasgow (Scotland, UK) were invited to participate in the study. Orthopantomographs taken between 1995 and 2002 were reviewed and eligible patients were contacted and invited to participate. Patients were assessed in their own dental surgery by the same research dentist. In this baseline assessment, the presence of impaction was confirmed and all patients with a previous history of symptoms and/or pathology were excluded from further analysis. Clinical characteristics such as the angulation and the degree of impaction were recorded. Patients also completed a socioeconomic questionnaire. Eligible patients were re-assessed by the same research dentist one year later when they were asked about their experience of symptoms within the past year. Information was cross-referenced with patients' dental records.Results A total of 613 patients attended the baseline appointment. Of those, 30 (4.89%) had a history of symptoms and were excluded from the study, leaving 583 (95.10%) eligible patients. From those, 421 (69%) patients with a total of 676 lower third molars were examined one year later. 22.67% of all vertically impacted teeth examined had developed symptoms, along with 13.15% of all mesially impacted, 30.69% of all distally impacted and 6.45% of all horizontal third molars. This association was statistically significant (p ≤0.001). 23.05% of all partially erupted teeth and a surprising 10.49% of all unerupted teeth were associated with symptoms during the study period. This association was also significant (p ≤0.001). There was also a statistically significant inverse association between the development of symptoms and age (p = 0.0028).Conclusions The predictability that an impacted lower third molar will develop symptoms in future remains unclear. However, some clinical characteristics such as the angulation, the degree of impaction and the patient's age could be useful in predicting the likelihood of future symptomatology. [ABSTRACT FROM AUTHOR]

Objective To assess general medical practitioners' (GMPs') and general dental practitioners' (GDPs') awareness of prevention and early detection of oral cancer.Design Cross-sectional questionnaire-based study.Setting Primary care.Method Questionnaires were delivered to all GMPs and GDPs in Tayside, assessing oral examination habits, delivery of advice on oral cancer risk factors, knowledge of oral cancer risk factors and clinical appearance, preferred point of referral and requests for further information.Results Response rates of 71% and 84% were obtained from GMPs and GDPs respectively. GMPs were less likely to examine patients' oral mucosa routinely, less likely to advise patients about risk factors for oral cancer, identified fewer risk factors for, and felt less confident about diagnosing oral cancer from clinical appearance than their dental counterparts. Seventy-one percent and 80% of GMPs and GDPs respectively requested further information about oral cancer.Conclusion Patients with oral lesions often present to their general medical practitioner. The incidence of oral cancer is rising in the United Kingdom, therefore the role of general medical practitioners in prevention and detection of oral cancer is becoming ever more important. This study highlights the need for improved education of general medical practitioners on oral cancer. [ABSTRACT FROM AUTHOR]

ObjectiveThe 2003/04 West of Scotland Cancer Awareness Programme oral cancer campaign was designed to raise public awareness of the signs and symptoms of oral cancer. The objectives of this study were to explore general dental practitioners' (GDPs) awareness and perceptions of the campaign, and its impact on local dental practices.MethodsA self-completing questionnaire was sent to GDPs in the West of Scotland (N = 983) at the conclusion of the public awareness campaign.ResultsA response rate of 68.6% was achieved. Most dentists (92%) had heard of the campaign and a large percentage had displayed the promotional materials in their practice. The majority of respondents rated the campaign materials, including a television advertisement, in a very positive manner. Over 40% of dentists reported that, during the active phase of the campaign, patients had asked for information concerning the programme, and 66% indicated that registered patients had asked for advice regarding a specific lesion. Additionally, 41% of dentists reported non-registered patients had attended asking for advice regarding a 'worrying' lesion. Over 60% of dentists had referred a patient during the campaign and 40% of these practitioners indicated an increased referral rate during this period.ConclusionsMost respondents were positive in their assessment of the campaign and reported an increased awareness of oral cancer among patients. [ABSTRACT FROM AUTHOR]