The purpose of this study was to assess the knowledge, practice, confidence, and perceived barriers to oral cancer screening among teaching faculty in Japan. Results were compared by specialist as well as years of clinical experience. A 25-question survey was used to assess the oral cancer screening practices of faculty dentists at Iwate Medical University, School of Dental Medicine, the only dental school located in the northeast (Tohoku) region of Japan. The study was approved by the Institutional Review Board of Iwate Medical University. The response rate was 83% (n = 110, 71.8% were male). This survey revealed that only 43.6% of the dentists performed oral cancer screening frequently (always or usually) at the initial appointment, and there was no significant differences between specialists and clinical experience. Visual inspection of the oral cavity was the primary screening method, but the frequency and content of the examination (TMJ and tonsil) was significantly different between specialties. A history of cancer and tobacco use motivated providers to perform an examination and was significantly different between various specialists and clinically experienced providers. In contrast, HPV and alcohol consumption were a weak motivator. The confidence level of providers on their examination knowledge/skills was poor, especially among junior faculty. More than 80% of junior faculty indicated a lack of knowledge/skills as a major barrier.
Background Several large health care systems in the United States have pioneered the integration of dentistry into their medical care delivery models. To date, no studies or case reports on combining medical information into the dental electronic health record within U.S. academic dental centers were found in the extant literature.
Objective This report details how we developed and implemented customized primary care elements into axiUm, a popular dental practice management software primarily used in dental schools, to facilitate medical–dental clinical integration. This work was undertaken to provide the infrastructure for nurse practitioners and dentists to deliver a holistic, integrated, person-centered approach to care.
Methods A multidisciplinary design team used the Centers for Disease Control and Prevention's Framework for Patient-centered Health Risk Assessments, an evidence-based framework to guide the adaptation of the existing axiUm dental record. The design featured individual data fields to source data, generate reports, and analyze information to improve clinical care and operations.
Results To date, medical information on more than 260 dental patients over 600 clinic visits has been documented in the adapted electronic health record.
Conclusion The customization capability of axiUm facilitated efficient and effective development and implementation processes. Training and user support were essential for effective implementation and led to further system refinements.
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