Factors Affecting the Performance of Oral Cancer Screenings by Texas Dental Hygienists

Jane C. Cotter; Ann L. McCann; Emet D. Schneiderman; Janice P. De Wald; Patricia R. Campbell

Abstract

Purpose: The 5 year survival rates for oral cancer have not changed in the last 50 years. A simple intra– and extra–oral examination provided by health care professionals could help to reduce morbidity and mortality of oral cancer. This study focused on Texas dental hygienists' performance of oral cancer screenings (OCS) and factors that influenced their performance of this examination.

Methods: A 33 question survey of 608 randomly selected Texas dental hygienists was conducted. Frequency, chi–square and Spearman correlation tests were performed.

Results: Three hundred and six hygienists replied and provided the data for this study. The data indicated that 45.8% “always” performed OCS, 23.5% performed OCS at the initial appointment and 47.4% at the recall appointment. Experience and comfort level were the greatest influences on OCS performance. Dental hygienists practicing for 16 or more years performed OCS 51.2% of the time, while those with only 0 to 5 years of experience performed OCS 25.5% of the time. A statistically significant correlation (ρ=0.15, p<0.007) was found between years of experience and performance of OCS. A significant correlation (ρ=0.18, p<0.001) was found between the identification of a suspicious lesion and the performance of OCS. Forty–nine percent of dental hygienists reported feeling “very comfortable” with intra–oral examinations, but only 26.5% felt “very comfortable” with extra–oral examinations. A statistically significant correlation (ρ=0.16, p<0.001) was found between comfort level in the performance of an OCS and reported frequency of OCS. The majority of subjects performed poorly on the knowledge portion of the survey (mean=53%). There was a significant correlation (ρ=0.22, p<0.001) between attendance at OCS continuing education courses and the performance of OCS.

Conclusion: Dental hygienists' knowledge about oral cancer was not current and comfort levels with performing OCS were low. These indicate a need for a stronger emphasis on the importance of OCS for students during dental hygiene education and a more thorough continuing education for practicing dental hygienists.

Footnotes

Jane C. Cotter, RDH, MS, is the Dental Services Coordinator at Baylor Charles A Sammons Oncology Outpatient Dental Clinic. She is also the 1st place winner of the 2009 Dentsply/AHDA Graduate Student Clinicians Program for this research. Ann McCann, PhD, is a professor and Director of Planning and Assessment. Emet Schneiderman, PhD, is an associate professor. Janice De Wald, BSDH, DDS, MS, is a professor, chairman and director of the Caruth School of Dental Hygiene. Patricia Campbell, RDH, MS, is an associate professor and the Graduate Program Director. All work at Texas A&M Health Science Center, Baylor College of Dentistry.
This study supports the NDHRA priority area, Clinical Dental Hygiene Care: Assess the use of evidence–based treatment recommendations in dental hygiene practice; Investigate how dental hygienists identify patients who are at–risk for oral/systemic disease.