The use of tools to support oral lesion description in oral medicine referrals

Abstract

Poor description of oral lesions jeopardize the prioritization of appointments in Oral Medicine. The present study investigated whether the use of support tools changes the quality of descriptions focusing on health care prioritization. Two oral lesions (A and B) were described by 64 dental students and 48 dentists using three methods: (a) without support tools (free); (b) using the oral examination form from the Specialties Manual in Oral Health/Brazilian Ministry of Health (SMOH form); and (c) using the OralDESC guideline. The descriptions were compared with a gold standard and percentage of agreement was analyzed by the Kruskal-Wallis and Dunn's tests (p<0.05). Descriptions with the OralDESC presented higher information quality. Considering items essential for prioritization, the OralDESC demonstrated better performance for lesion A; for lesion B, free descriptions and descriptions using the OralDESC were of higher quality than those using SMOH form. Therefore, the OralDESC offered greater support for the description of oral lesions for health care prioritization in Oral Medicine.

Oral Lesion Description: A Mini Review

“…7,10 According to another definition, it should be smaller than 5 mm in diameter. 3,11 However, Bricker described that, macules occur in the same plane of the skin/ mucosa and may be of any size. 9 This term can be used for amalgam tattoos, ephelis, freckles, focal argyrosis, etc.…”

“…7,9,11 In two papers, nodules were defined to be greater than 5 mm and less than 20 mm in diameter. 2,3 Clinically, nodules may be above, level with, or below the skin/mucosa and can be detected by palpation. 7,12 Benign mesenchymal tumors such as lipoma and neuroma can be present as a nodule in the oral mucosa.…”

“…2 Lack of detailed description of oral lesions, can lead to difficulties in prioritizing the oral medicine appointments. 3,4 A thorough oral lesion description must include the following nine items: size (length, width, and height), number (single, multiple), outline (regular, irregular), surface (smooth, granular, verrucous, papillomatous, pebbly, cobblestone), base (pedunculated, sessile, nodular, domeshaped), site (mucosal, intra-bony, dental), color (red, pink, white, red-white combined, blue, purple, gray, yellow, black, or brown according to their prevalence in oral mucosa), consistency (soft, hard, cheesy, firm, rubbery, and fluctuant), origin (acquired, non-acquired), and morphology or clinical appearance (primary lesions, secondary lesions). 2,[5][6][7] The morphology component is the most challenging aspect of lesion description, which is the main purpose of this review.…”

“…Study by Zimmermann and colleagues demonstrated that, when lesions have been described based on a guideline and standard definitions in medicine referrals, information quality was higher compared to cases based on a free. 3 The description and diagnosis of oral lesions, require a basic knowledge about dermatology since, many disorders of the oral mucosa also affect the skin. 1,8 There are two terms in dermatology glossary for lesion description namely, primary lesions and secondary lesions.…”

Evaluation of the quality of referral letters: experience of a Brazilian oral medicine service

“…Further, it should be legible and contain all the necessary information to avoid delaying the patient's diagnosis and treatment. 9,10 Currently, most referral letters are incomplete, not allowing the professional to receive the correct information about the patients, which may make it difficult to exactly understand the needs or concerns of those who referred them. Therefore, this study aimed to analyze all referral letters received by a single oral medicine service in Brazil.…”