Dentistry for patients with haemophilia: Trialling a safe and economical change in management.

INTRODUCTION: While the dental management of patients with haemophilia has changed considerably in the last decade, haemophiliacs in Western Australia have continued to receive pre-operative factor support for dentistry regardless of the type of dental procedure. AIM: To review the efficacy and safety of established dental protocols that reduce factor use in the dental management of patients with haemophilia and to estimate cost savings. METHODS: Records of 11 patients with haemophilia that were seen in the pilot programme period were reviewed. These were cross-referenced with previous dental and haematology notes that stated the amount and type of pre-operative factor used. Cost savings were estimated using the Australian National Blood Authority's Product List. RESULTS: All study participants were male, and included those with haemophilia A (n = 9), and B (n = 2). Mean age was 45 years (range 22-80). A variety of dental treatments were undertaken, and no pre-operative factor was used. Patients on prophylaxis (n = 6) received dental treatment the same day as their regular factor administration. It was estimated AUD$26,314 was saved by not using pre-operative factor. One patient had bleeding post-extraction and was seen the following day to achieve haemostasis using local measures. The remaining patients had no complaints of post-operative bleeding, and did not require any further haemostatic measures. CONCLUSION: This pilot programme supports data that haemophiliacs can safely receive a variety of dental treatments without the need for pre-operative factor, and the significant cost savings of doing so. Further data is required to support this protocol for invasive dental procedures.

Covid lockdowns and hospitalisations for oro-facial trauma among children in Australia and the United Kingdom.

BACKGROUND/AIM: This retrospective study investigated the effect of lockdowns for Covid-19 on the rates of oro-facial trauma hospitalisations in children in Australia and the United Kingdom (UK). MATERIALS AND METHODS: Hospitalisation data for children up to 19 years old for oro-facial trauma injuries (according to ICD-10-AM principal diagnosis codes) over 5 years were collected for Australian and UK children. The age-standard rate (ASR) for each age group was calculated per 100,000 population. RESULTS: In the younger Australian children, there was no statistically significant change in the ASR of oro-facial trauma hospitalisations during the 'Covid year', compared to the average rate over the 3 years preceding. However, there was a significant decrease in the ASR of oro-facial trauma hospitalisations during the 'Covid year' in older Australian children (aged 10-19), and for all UK children, except for infants under one-year-old. CONCLUSIONS: Reduction of the ASR of hospitalisations due to oro-facial trauma during the 'Covid year', and the implementation of lockdown measures in the two countries provides further evidence of the impact of physical activities and travel as contributing factors to oro-facial injuries in children. In addition to its role in reducing the spread of virus infections during the pandemic, the lockdown measures also resulted in a simultaneous decrease in trauma injuries.

Oral health providers' views of oral health promotion in Jazan, Saudi Arabia: a qualitative study.

BACKGROUND: Oral health promotion (OHP) is a crucial aspect of dental care, as it aims to improve and protect oral health of individuals. This study aimed to qualitatively explore views of oral health providers in Jazan, Saudi Arabia, on their perceptions of their responsibilities for OHP, as well as the barriers and potential opportunities for implementing health promotion in dental practice. METHODS: A convenience sample of 11 oral health providers from Ministry of Health (MOH) facilities were recruited and participated in virtual one-on-one semi-structured interviews, which were transcribed and analyzed using inductive thematic analysis with N-Vivo software. RESULTS: The results showed that the providers recognized the significant role and responsibility of OHP in improving oral health. However, several barriers hindered their OHP efforts, including a lack of training, funding, time, and a lack of interest in OHP. Potential opportunities for improvement included increasing recruitment of new oral health providers and educators, developing more training programs for providers and the community, and expanding support in terms of finances and logistics. CONCLUSION: The findings of the study suggest that oral health providers are aware of OHP, but that both patients and organizations will need to shift their behaviours and perspectives for OHP to be successfully implemented. Further research on OHP in the Kingdom of Saudi Arabia (KSA) is needed to validate these findings.

Distribution of dental practices in Jazan of Saudi Arabia: a GIS-based approach.

BACKGROUND: Jazan region in the Kingdom of Saudi Arabia (KSA) has been extensively studied regarding access to dental care services, but there is currently no specific study on the distribution of public (primary healthcare centres (PHCs) and hospitals) and private dental healthcare facilities in the area. This study aimed to evaluate the spatial distribution of public and private dental care facilities in the Jazan region in relation to the population distribution in each governorate of the region. METHODS: The most up-to-date, easily accessible, and anonymous data and information were used for this investigation. The Ministry of Health's (MOH) Statistical Yearbook 2020 and interactive map were used to identify the locations of healthcare facilities. These locations were plotted on a map using Google Maps, and the data was converted to longitude and latitude with 90% level building accuracy. QGIS's integrated database was used to develop buffer zones and perform attribute analysis. The data was then exported for analysis in Microsoft Excel, where healthcare facility-to-population ratios were determined. RESULTS: In Jazan region, consisting of 17 governorates and a population of 1,726,739, there were 275 public and private dental clinics, with a ratio of one dental clinic per 6,279 people in terms of general health services. Only 12.4% of these clinics were located beyond 20 km of the city centre, serving approximately 70% of the region's population. CONCLUSION: The uneven distribution of dental clinics in the Jazan region has hampered access to dental treatments and has led to a significant burden on dental health facilities, reducing the quality of care available in the region. Mapping the distribution of MOH, private, and other health facilities, as well as the burden of oral disease in the Jazan region, is necessary for further research.

Distribution of Australian dental practices in relation to the ageing population.

OBJECTIVE: The purpose of this study was to analyse and map the distribution of the ageing population, by sociodemographic profiling, in private and public dental practices in Australia. BACKGROUND: The rapid increase in the aged population in Australia requires a comprehensive approach to ensure accessibility to geriatric dental services. However, the availability of dental services for the older people requires further investigation of the demographic distribution of need. MATERIALS AND METHODS: Dental practices were located and mapped against the ageing population data. The address for each dental practice in Australia was compiled from online access sources. Australian socioeconomic data were integrated with dental practices, clinic locations and older populations using Geographic Information System (GIS) technology. RESULTS: There was an uneven distribution of dental practices across Australia's States and Territories (NT and ACT). Tasmania had the highest ratio of private practices to the older population (1:1000) and the highest percentages of this ageing cohort (32%, 61%) that lived more than 5 km from private and public dental practices respectively. Higher percentages of dental practices were located in areas of lower socioeconomic status in Tasmania, Queensland and South Australia (47%, 42% and 38%) respectively, however, these areas were associated with higher ageing population densities. CONCLUSION: There is a geographic maldistribution of dental practices in relation to the spatial distribution of Australia's older population, with the inequity most pronounced in the most disadvantaged areas. This inequality requires a National approach to match dental services to the population that they serve.

Geographic accessibility to public dental practices in the Jazan region of Saudi Arabia.

BACKGROUND: It is impossible to attain good general health without maintaining oral health and this becomes problematic when dental services are located far from the population that needs to utilise them. This study aimed to assess the geographic accessibility of dental clinics located in public primary healthcare clinics (PHCs) and hospitals in the Jazan region of Saudi Arabia and how long it takes to reach them by car and on foot. METHODS: The location of clinics and hospitals, maps of road systems, and the governorates' borders (administrative areas) within the Jazan region were downloaded using the QGIS mapping tool. The time taken to travel to the clinics and hospitals, either by driving or walking, was assessed. If the time was 30 min or less, residents in the area were classified as 'serviced'. It was more than 30 min, they were 'underserved'. RESULTS: Only 31% of Jazan residents were found to live in a serviced area if they drove to clinics and hospitals. Residents of Jazan's seven mountainous governorates were more likely to require services. Only 40% could drive less than 30 min to a primary health dental clinic. Only 19% of people could walk to a hospital in less than 30 min. Only two governorates had a majority of residents who lived in serviced areas. CONCLUSION: The study demonstrates an accessibility issue, as many Jazan inhabitants must drive or walk for an extended period (> 30 min) to reach a healthcare facility, whether a primary health care centre or a hospital. This issue may result in many people not receiving necessary health care, compromising their oral health status. Additional research is needed to identify public, private and other health facilities in the region and the prevalence of oral disease.

Australian dental students' knowledge on antibiotics prophylaxis for dental procedures.

BACKGROUND: Prescribing medicine is integral to clinical dentistry. Infective endocarditis may be rare but fatal if left untreated. As a result, judicious prescribing of antibiotics should be implemented due to potential. To our knowledge, no Australian study has examined dental students' knowledge and perceptions about antibiotic prophylaxis for dental procedures. METHODS: Australian dental students were invited to undertake the survey comprising case vignettes to investigate their medication knowledge. A total of 117 responses were received. The questions were 12 clinically relevant questions and three perception-based questions. Results were analysed using descriptive statistics as well as the chi-squared test. RESULTS: The 117 respondents had a mean correct response of 7.34 ± 2.64 (range 3-12 out of 12). Out of 117 students, 89 (76%) answered more than half of the questions correctly. Only three students (3%) answered all the questions correctly. Nearly two-thirds felt that they knew about antibiotic prophylaxis used for dental procedures. CONCLUSION: Most respondents answered more than half, but not all, of the clinical questions correctly. It is crucial to highlight that dental student may never receive any more training on antimicrobial stewardship (AMS) at any point in their future careers. It may be ideal that this issue is addressed at the dental school. One way to target this is to potentially nationalised teaching delivery of dental AMS across Australia.

Adult capped dental payment model applied within a university setting: an Australian reflective case study.

BACKGROUND: Capitation models of care in dentistry started around 1973 with varying degrees of success in meeting the needs of the individuals and expectations of the participating private practitioners. These studies mostly identified that capitation payments resulted in under treatment whilst fee-for-service models often led to over treatment. The objective of this study was to develop a new way of doing business using an outsourcing capitation model of care to meet population health needs and activity-based funding requirements of rural Local Health Districts with a local university dental school. This payment model is an alternate referral pathway for public oral health practitioners from the existing New South Wales Oral Health Fee-for-Service Scheme that focuses on urgent treatment to one that offers an all-inclusive preventive approach that concentrates on sustaining good long-term oral health for the individual. METHOD: The reflective study analysed various adult age cohorts (18-24, 25-34, 35-44, 45-54, 55-64, 65-74 and 75 + years) based on 950 participants randomly selected from the Greater Southern adult public dental waiting lists. The study's capitation formula was derived from NSW government adult treatment items (n = 447,625). Dental care was provided through the local university's dental clinics utilising only dental students under clinical supervision. All data were sourced from NSW Oral Health Data Warehouse during 1 January 2012-30 June 2018 and analysed by using SAS 9.3 and Version 13 Microsoft Excel. RESULTS: There were 10,305 dental care items and 1129 capitation courses of care totalling A$599,026. This resulted in an average of 11 dental care items being provided to each participant. The capitation payment formula utilising the most provided dental care items of 100 individual patients proved to be economical and preventive focused. CONCLUSION: The systematic reflection showed that this unique methodology in developing an adult capitation payment formula associated to diagnostic pathways that resulted in: (i) more efficient usage of government expenditure on public dental services, (ii) provision of person-centred courses of dental care, and (iii) utilisation of university dental education programs to best practice treatment and holistic care.

Factors Associated with Participation in Research Activities among Oral Health Providers in Jazan, Saudi Arabia: A Cross-sectional Study.

AIMS AND OBJECTIVES: This study aimed at quantifying participation in dental research-related activities reported by the Saudi Ministry of Health-associated oral healthcare providers in Jazan and to investigate its association with sociodemographic and professional characteristics, as well as practitioners' perceptions of the Research and Development (R&D) index. MATERIALS AND METHODS: An online cross-sectional questionnaire was sent to oral health providers in Jazan using a convenience sampling technique. The questionnaire collected data on demographic characteristics and the 16 items of the R&D index. One-way ANOVA and t-tests were used to establish factors associated with R&D index scores. Multiple regression analyses with adjusted effects were conducted to identify the significant predictors for the factors associated with participation in dental research. RESULTS: In total, 113 study participants completed the questionnaire with a response rate of 56.5%. Just over half (53.1%) of the participants were working in primary healthcare centers, and 46.9% were working in hospitals. Most of the study samples were dentists (92.0%), while a small percentage were dental hygienists (4.4%) and assistants (3.4%). The sample's participation in dental research was low with a mean of 3.57 (standard deviation = 3.69). The R&D support (p<0.001) and intentions (p = 0.050) significantly predicted the providers' participation in dental research. CONCLUSION: The current study found that R&D support and intention significantly predicted the providers' participation in dental research. Hence, it is recommended that comprehensive educational and training programs on dental research be developed that focus on the increase and implement it in their practice. CLINICAL SIGNIFICANCE: This study provides insights into factors and obstacles that influence dental research, which may be useful for future investigations.

Are diabetes and dental care providers in the Republic of Mauritius advising patients about the importance of oral health in diabetes management?

Diabetes and dental care providers may greatly contribute in the early detection of oral diseases and diabetes, respectively, and in the prevention of complications of diabetes. However, there is limited collaboration and referrals between these two groups of health professionals. OBJECTIVE: To investigate whether diabetic providers are addressing the importance of oral care in the management of diabetes and whether dental care providers are advising their patients with diabetes about the importance of glycaemic control. METHOD: Descriptive statistics was used to report data collected from 720 patients with diabetes using a closed-end questionnaire. Logistic regression analysis revealed the factors significantly impacting whether participants received advice from healthcare providers. RESULTS: The majority of participants did not receive advice from either diabetes (84%) or dental (75%) care providers regarding the reciprocal nature of diabetes and periodontitis. The factors significantly affecting receiving advice from diabetes care providers were place of residence (p = 0.003), self-reported type of diabetes (p = 0.000) receiving advice from dental care providers (p = 0.000); from dental care providers - education (p = 0.020), place of residence (p = 0.004), the number of years since diagnosis of diabetes (p = 0.002), frequency of dental visits (p = 0.000) and receiving advice from diabetes care providers (p = 0.000). CONCLUSION: Diabetes and dental care providers in Mauritius are not addressing oral health care as an essential component of diabetes care. Patients with diabetes are neither being advised about the importance of regular dental visits by their treating doctor, nor about the importance of glycaemic control in the prevention of oral complications by their dentist.

Fluorescence-aided selective removal of resin-based composite restorative materials: An in vitro comparative study.

AIM: During removal of resin-based composite (RBC) restorations, removal of adjacent sound tooth structure can easily occur. The aim of the study was to compare the fluorescence-aided identification of restorations (FAIR) method with the conventional method (CM) using white light illumination for the selective removal of tooth-colored RBC restorations. MATERIALS AND METHODS: Sixty extracted teeth were used to prepare 15 sets of models, each with four teeth. Cavities were prepared in each tooth and a digital three-dimensional scan of each model was taken in STL format. The teeth were then restored with either Admira Fusion, GRADIA DIRECT X, or TPH Spectra LV (20 teeth for each). Five dentists removed the restorations from sets of 12 teeth (six each using FAIR, and six using CM). From a postoperative scan, changes in intercuspal cavity width were measured using the 3D tool CAD software. RESULTS: Using FAIR, changes in cavity width were not significant (P = .17), and there was no significant interoperator variance (P = .3). In contrast, when using CM, there was a significant increase in cavity width (P = .0025), and considerable interoperator variance (P = .03). FAIR allowed faster completion of the task of restoration removal (average time 100.23 seconds, vs 165.13 seconds from CM). CONCLUSION: The FAIR method facilitates the selective removal of tooth-colored RBC restorations, with reduced time and less inadvertent removal of sound tooth structure. CLINICAL SIGNIFICANCE: By enhancing the differentiation between the restorative material and adjacent tooth structure, the FAIR method facilitates removal of tooth-colored restorations, while concurrently prevents unnecessary removal of healthy tooth structure. The same approach may have applications for removal of resin-based materials such as resin cements under restorations, resin fissure sealants, and orthodontic brackets bonding resins.

Global Dental Publications in PubMed Databases between 2009 and 2019-A Bibliometric Analysis.

The objective of this study was to evaluate the publications in the field of dentistry on the PubMed database over a span of 10 years, from 2009 to 2019. Articles published between January 2009 to December 2019 were searched for in the MEDLINE database via PubMed. Data analysis was done using R-base packages, including the specialized R-packages Bibliometrix and String. For descriptive statistics and sequence charting, SPSS version 23.0 was used. A total of 104,975 articles were extracted, with a total of 153,530 authors in the given time frame. The proportion of articles steadily increased from 2009, plateauing at its peak from 2010 to 2016, and then seeing a decline from 2017 to 2019. Journal articles (60.58%), comparative studies (16.05%) and case reports (10.8%) were recorded as the most reported type of publication globally, accounting for 81.43% of the total documents extracted. All the articles came from 81 countries, with the USA reporting the greatest number of published articles (45,911). Dentistry proves to be a multi-faceted arena and many researchers and authors around the globe are contributing to the burgeoning literature over time.

Prevalence of disability among the major cities in Australia 2012 with geographical representation of distribution in Western Australia.

ISSUE ADDRESSED: The aim of this study was to use a novel approach to geographically model the relationship between socio-economic disadvantage and prevalence of profound and severe disability. METHOD: This study used national census data and the survey of disability, ageing and carers data to geographically model the relationship between socio-economic disadvantage and prevalence of profound and severe disability. RESULT: The results in this study show that there were more people living in the least disadvantaged areas (wealthiest) when compared to the most disadvantaged (poorest) areas. Whereas for people with a disability as the relative socio-economic disadvantage of the area increased, the number of people reporting any disability also increased, with the highest number coming from the most disadvantaged areas. The maps show a significant distribution with fewer cases of disability in metropolitan areas and relatively higher number in the rural area along with the higher proportion of people with disability living in the relatively more disadvantaged areas. CONCLUSION: Socio-economic profile is one of the key factors influencing the various aspects of health and hence should hold an important place during policy making. Policy should be formulated and implemented to help reduce the inequality by either directly aiming at the most disadvantaged group or by trying to bridge the gap between them. SO WHAT?: This paper provides a geographic visualisation of the distribution of people with profound and severe disability to help identify priority areas with high prevalence of disability.

Teledentistry as a novel pathway to improve dental health in school children: a research protocol for a randomised controlled trial.

BACKGROUND: Despite great improvement in child oral health, some children subgroups still suffer from higher levels of dental caries. Geographic and socioeconomic barriers and the lack of access to dental care services are among common reasons for poor oral health in children. Historically in Australia, oral health therapists or dental therapists have been responsible for providing dental care for school children through the School Dental Services (SDS). The current SDS has been unable to provide sustainable dental care to all school children due to a reduction in workforce participation and limited resources. We propose a paradigm shift in the current service through the introduction of user-friendly technology to provide a foundation for sustainable dental care for school children. METHODS/DESIGN: We describe an ongoing parallel, two-armed, non-inferiority randomised controlled trial that compares routine and teledental pathway of dental care in children aged 4-15 years (n = 250). Participating schools in Western Australia will be randomly assigned to the control or teledental group, approximately three schools in each group with a maximum of 45 children in each school. All participants will first receive a standard dental examination to identify those who require urgent referrals and then their teeth will be photographed using a smartphone camera. At the baseline, children in the control group will receive screening results and advice on the pathway of dental care based on the visual dental screening while children in the teledental group will receive screening results based on the assessment of dental images. At 9 months follow-up, all participants will undergo a final visual dental screening. The primary outcomes include decay experience and proportion of children become caries active. The secondary outcomes include the diagnostic performance of photographic dental assessment and costs comparison of two pathways of dental care. DISCUSSION: The current project seeks to take advantage of mobile technology to acquire dental images from a child's mouth at school settings and forwarding images electronically to an offsite dental practitioner to assess and prepare dental recommendations remotely. Such an approach will help to prioritise high-risk children and provide them with a quick treatment pathway and avoid unnecessary referrals or travel. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12619001233112. Registered 06 September 2019.

Distribution of private dental practices and dentists 2011 and 2018: Analysis by regional area.

OBJECTIVE: The aim of this study was to determine whether there has been a change in access to private dental services in regional and remote areas of Australia by comparing the distribution of private dental practices and dentists in 2011 to the distribution in 2018 according to state and territory and the Accessibility/Remoteness Index of Australia Plus. DESIGN AND SETTING: A database of dental practices and dentists in Australia was compiled from open-access sources for 2011 and 2018; dental practices were mapped by state, Accessibility/Remoteness Index of Australia Plus and Statistical Area 2 census district and linked to population data. MAIN OUTCOME MEASURES: Change in number of private dental practices, mean number of dentists per private practice, population per dental practice and mean number of dentists per population by geographic location from 2011 to 2018. RESULTS: There were more dental practices in rural and remote areas in 2018 than in 2011. The percentage of Statistical Area 2s without a private dental practice was lower in 2018 but remained high in rural areas and increased with remoteness-inner regional 23.1%; outer regional 31.6%; and remote and very remote 48%. Growth in registered dentist numbers did not match population growth, and on average, there were less dentists per practice in inner regional and remote and very remote areas by the end of the study. CONCLUSION: There has been an improvement in spatial access to private dental services in regional areas of Australia, but slower rate of growth of dentist numbers compared to population growth resulted in poorer access to dental services and large population numbers must still travel outside their local Statistical Area 2 census district to access dental care.

The Right of the Child to Oral Health: The Role of Human Rights in Oral Health Policy Development in Australia.

Marginalised and vulnerable children bear the burden of untreated dental disease in Australia. The lack of progress in improving the oral health of these groups signifies a need to review the effectiveness of existing child oral health policy. The current approach to oral health policy design in Australia is inconsistent and discriminatory across States and Territories. This implies that the right to health does not have a major influence in policy drafting. This article seeks to develop a stronger understanding of the obligations pursuant to ratification of the Convention on the Rights of the Child in progressively realising the right to the highest attainable standard of health and to the benefits of redesigning child oral health policy to conform to a Human Rights-Based Approach to health system planning. Child oral health policy would be improved by the appointment of a Chief Dental Officer to coordinate oral health policy nationally.

Comparing the outcomes of gold-standard dental examinations with photographic screening by mid-level dental providers.

OBJECTIVES: To determine the detectability of the intra-oral photographic method in comparison to the baseline, comprehensive dental examination (CDE), in children when performed by different levels of dental practitioners. MATERIALS AND METHODS: As part of a quality assurance program, intra-oral photographs were obtained from 77 patients (2-18 years) as part of a CDE before undertaking dental treatment under general anaesthesia. A DSLR camera was utilised to acquire images which were subsequently uploaded to a cloud-based server. The baseline for each participant was established during the CDE, utilising both visual and radiographic examination, which was then compared to the assessment made by a mid-level dental practitioners (MLDP). The evaluation was based on utilising an odontogram where the teeth were charted either as decayed or filled. RESULTS: Specificity (95%) was higher than sensitivity (61.5%) when comparing the photographic assessment with the benchmark CDE assessment. The inter-rater reliability between the two methods of assessment was substantial, with a kappa score of 0.62. The photographic assessment method underestimated the decayed and filled teeth, as observed by the caries experience (dft/DFT scores) (CDE = 7.01 vs. photographic assessment = 5.22). There were lower levels of diagnostic detection in the posterior teeth as compared to the anterior teeth assessments. CONCLUSIONS: Although the CDE is still considered to be the gold-standard, this study found that the photographic caries assessment by MLDP produced an acceptable diagnostic level of detection particularly for the anterior teeth. CLINICAL RELEVANCE: The photographic method could offer a potential cost-saving and user-friendly screening.

Prevalence of Accessory Mental Foramina: A Study of 4,000 CBCT Scans.

The presence of accessory mental foramina (AMF) is an important consideration prior to any dental implant and surgical treatment to avoid injury to the neurovascular bundle and subsequent postoperative complications. The aim of this retrospective study was to determine the prevalence of AMF from a substantially large sample of the Australian population. The cone beam computed tomography (CBCT) scans of 4,000 patients showing the mandible were examined. All mental foramen (MF) were visualized and no cases were excluded. The number of MF/AMF, sex, and age were recorded. The prevalence of AMF was found to be 6.4% (254 patients) in this study. Twelve patients exhibited bilateral AMF, and 11 had three mental foramina on one side. One case had a total of five mental foramina with three on the right and two on the left side. No significant sex preference was discovered. This is the largest study ever to be conducted to evaluate the prevalence of AMF. With nearly one in 15 individuals found to have AMF, clinicians must be acutely aware of this anatomical variation and treatment plan for each case accordingly. Clin. Anat. 32:1048-1052, 2019. © 2019 Wiley Periodicals, Inc.

Disparities in Oral Cancer Awareness: a Population Survey in Tehran, Iran.

Oral cancer is a life-threatening disease with low survival rates, especially when diagnosed in an advanced stage. Lack of awareness about this cancer among the population is proposed as a possible reason for this diagnostic delay. The aim of this study was to evaluate oral cancer awareness, as well as the association of this with sociodemographic status in Tehran. In this cross-sectional population-based survey, 1800 self-administered questionnaires (collecting sociodemographic data, questions regarding oral cancer awareness and the source of information) were distributed through multistage stratified random sampling. Scores for questions ranged from 0 to 4, and totals were summed. The outcome of question responses was also analyzed separately. In total, 1312 questionnaires were available for analysis, from 788 females and 489 males (37.8 ± 9.02 years). Only 30% of the respondents were aware of oral cancer. The average score for awareness was 1.09 ± 1.6 with no significant differences between age groups and genders. Almost 6.5% of participants had complete awareness about oral cancer. A significant difference was found between mean scores in different levels of education and occupation (p = 0.0001). From 585 responses to the "source of information" question, "public media" was the most important source (almost 50%). Only 2% mentioned "dentists" as a source of information. This study indicated an alarming lack of oral cancer awareness and literacy in Tehran, Iran. Dentists should be obliged to practice their pivotal role in informing the public about oral cancer.

Population Survey of Knowledge about Oral Cancer and Related Factors in the Capital of Iran.

Knowledge about oral cancer risk factors and signs is thought to improve prevention and early diagnosis, and in turn, increases survival. In this population-based survey, knowledge about oral cancer was assessed in Iran. A total of 1800 self-administered questionnaires (collecting sociodemographic data and questions regarding oral cancer risk factors and signs) were distributed through random sampling. Final scores ranged between 0 and 15 for the risk factors and 0-11 for the signs. Scores below the median indicated a low level of knowledge, scores representing the third quartile of correct answers indicated a moderate level of knowledge, and scores representing the upper quartile indicated a high level of knowledge. Statistical tests were used for analysis of knowledge level in different sociodemographic categories. A total of 1312 participants completed the questionnaires. The average of knowledge scores for risk factors was 5.3 ± 3.0 and for signs was 4.5 ± 2.9. Overall, 75 and 56% respectively were able to identify major risk factors (smoking and alcohol); 23.5% could not define any related signs and symptoms. Dividing scores into quartiles indicated that three out of four people had "low" knowledge about risk factors and 58% had "low" knowledge about signs and symptoms. Females and highly educated people had more knowledge of oral cancer. Significant difference was found between job and level of knowledge (P = 0.001). This survey revealed that public knowledge of oral cancer was not satisfactory in Iran. Efforts should be done to inform and educate people with risk factors, initial clinical presentation, and symptoms, in order to improve prevention and promote early diagnosis.