The Current State of Clinical Diagnostic Algorithms for Mucosal Oral Lesions: A Scoping Review

Diagnosing oral lesions remains challenging for many dentists. Despite the availability of diagnostic algorithms, there is a dearth of comprehensive evidence synthesis and a discussion on their clinical and pedagogical applicability.

A scoping review was conducted to identify: (1) algorithms or flow diagrams that help clinicians to diagnose oral lesions in a clinical setting without additional software; (2) publications in English; (3) all age groups; (4) algorithms for oral lesions of soft tissue only. We excluded those that are: (1) black-box; (2) required additional tests; (3) older versions; (4) for non-mucosal lesions, and (5) intended for self-screening. A keyword and MeSH term search was performed across three peer-reviewed publication databases and gray literature.

Seventeen algorithms from 15 peer-reviewed manuscripts and 1 online course were identified. Most studies did not mention how the algorithms were developed, and none had been validated in a clinical setting. The algorithms often focused on one or two types of lesions and were incomplete in differential diagnoses.

Few clinical diagnostic algorithms for oral lesions are available in the literature. Notably, there are no validated and comprehensive clinical diagnostic algorithms for oral mucosal lesions.