Prevention and detection of oral cancer: the views of primary care dentists in Northern Ireland.

Our objective was to describe the management of oral cancer and pre-cancer as stated by primary care dentists and their views on screening. We conducted a survey of all general dental practitioners and community dentists in Northern Ireland (n = 635), to which 428 replied (response rate: 67%). 94% stated that examination of the oral soft tissues constituted part of their usual practice during the regular dental check-up. Suspicious lesions were generally referred early, 68.5% of dentists referring white lesions within one month of presentation. The corresponding figures for red lesions, lumps and persistent ulcers were 80.1%, 89.7% and 91.7%. The incidence of oral cancer was over-estimated (median '70' cases/year, versus the true figure of approximately 40/year) as, in all likelihood, was the percentage by which mortality could be reduced by screening (median: 50%). Accordingly the adoption of a screening programme was favoured over investment in health promotion. Indeed, only 14% said that their patients records routinely contained information about smoking or alcohol habits. Although there are some areas of practice which could improve and the potential of screening is probably over-valued, primary care dentists in Northern Ireland already opportunistically screen and refer patients promptly.