Relationship of oncological alerts and magnification of precancer lesions of the oral mucosa in the practice of a dentist

Abstract

In daily practice, a dentist encounters diseases of the oral mucosa, while some lesions are potentially malignant. Premalignant lesions of the oral mucosa, such as leukoplakia, lichen planus, chronic fissure of the lower lip, etc. in the absence of proper treatment, they are malignant with a high degree of probability. Complicating the situation is the asymptomatic course of oral cancer, until the tumor progresses to an inoperable stage of the process. Often, patients do not seek help until a pain symptom appears or the tumor increases in size. All this and many other factors lead to the fact that malignant tumors of this localization are detected at III—IV stages of the disease, which undoubtedly affects the effectiveness of treatment.
Materials and methods.
On the basis of the Ivanovo Regional Oncology Center, in accordance with descriptive and evaluative methods of epidemiological research, a retrospective epidemiological analysis of the structure, prevalence and stage of oral cancer was carried out. We used data from 429 medical records of patients in the surgical department of head and neck tumors from 2010 to 2017 and accounting and reporting forms from 2011 to 2021. The main complaints of patients when visiting the oncology clinic were identified, and the level of active detection of pathology by dentists was determined.
Results.
Almost 70% of cases of a malignant process were detected at late stages (III—IV) of the oncological process according to the TNM classification (p<0.05). In 14.7% of cases, a widespread process with metastasis to the lymph nodes (pT3N1M0, pT4N1M0, pT3N2M0, pT3N2M0) was diagnosed. In 91.8% of cases, endophytic forms of cancer of the floor of the mouth occur. As a result of morbidity, the quality of life of patients decreases. The level of active detection of MNs of the oral cavity by dentists using the example of the Ivanovo region for 2021 was 22.0%.
Conclusions.
These data confirm the low level of patients seeking dental care in the early stages of oral cancer (I—II) and the insufficient level of oncological alertness of dentists.