The use of exfoliative cytology for the early diagnosis of oral cancers: is there a role for it in education and private practice?

Abstract

Background: Early detection of oral cancers is not easy, because oral precancerous lesions and early oral cancers can mimic many benign conditions in the mouth, leading to delays in diagnosis and treatment. There is a need to emphasize the early diagnosis of oral cancers in order to reduce the unacceptably high morbidity and mortality.

Methods: A survey regarding oral exfoliative cytology was completed by 132 dentists in Virginia who were randomly chosen from a mailing list.

Results: Less than half of the dentists (41.7%) had been taught how to obtain a cytologic smear, and only 26.0% knew the clinical indications for doing so. Only 9.2% of the dentists had ever obtained a cytologic smear in private practice. Of the 13 dentists in the survey who had done so, 12 had been trained in the technique. Interest in learning the cytologic technique and getting the needed supplies was indicated by 79.2% of the dentists.

Conclusions: Diagnostic aids in the evaluation of oral mucosal lesions can serve an important role by identifying lesions that need to be biopsied in spite of a "benign" appearance. Exfoliative cytology, as well as vital staining, may aid in this goal. This has implications regarding undergraduate and postdoctoral education.