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Barriers to and facilitators of general dentists performing intraoral biopsies
Angela Ritchie1, David Ajayi2, Heather L Taylor3
1Department of Oral Pathology, Medicine and Radiology, School of Dentistry, Indiana University, Indianapolis, IN.
Background:
Early detection of oral potentially malignant disorders and oral cancer relies heavily on biopsy for definitive diagnosis. Yet biopsies remain underused in general dentist practices. To better understand these practice behaviors, the authors examined whether general dentists perform intraoral biopsies and what they perceived to be barriers to and facilitators of their biopsy-related behaviors in practice.
Methods:
A cross-sectional online survey was distributed to licensed members of the Indiana Dental Association. The survey was used to assess demographic characteristics, training, practice characteristics, attitudes, and self-reported barriers and facilitators related to oral biopsies. Data specific to general dentists were descriptively analyzed.
Results:
Of 477 respondents (17.8% response rate), 377 self-identified as general dentists. Although 83.5% agreed that performing biopsies falls within their professional scope, 67.3% reported never having performed a biopsy and 76.3% routinely referred biopsy cases to specialists. Only 18.2% felt well prepared by dental school to perform biopsies, and 22.4% felt well prepared by continuing education. Overall, 82.2% reported a lack of training or confidence as a barrier to performing biopsies. Most general dentists selected hands-on training or workshops (85.4%), and clear biopsy indication guidelines as potential facilitators of performing more biopsies.
Conclusions:
Despite broad acknowledgment that oral biopsy is within their scope, most general dentists do not perform biopsies, citing inadequate training and logistical barriers. Addressing these gaps through enhanced predoctoral and continuing education, standardized biopsy guidelines, and supportive practice infrastructure may strengthen general dentists' capacity to perform biopsies more frequently.
Practical Implications:
The capacity for the dental workforce to detect oral malignancies and cancers early may be inhibited by means of how infrequently general dentists perform intraoral biopsies, if at all, in their practices.
