Preparedness for early detection of oral cancer and oral potentially malignant disorders among Saudi dental students: a multicenter cross-sectional survey

Abstract

Oral cancer remains a major global health challenge, with delayed diagnosis contributing to poor prognosis and reduced survival. Dental students play an important role in early detection; however, deficiencies in preparedness and diagnostic confidence have been reported. This study assessed oral cancer knowledge, oral potentially malignant disorder (OPMD) awareness, and diagnostic confidence among Saudi dental students. A quantitative cross-sectional online survey was conducted among 354 dental students and interns from governmental and private dental schools in Saudi Arabia. The questionnaire assessed oral cancer knowledge, OPMD knowledge, and self-reported diagnostic confidence related to screening and biopsy procedures. Participants were classified as meeting or not meeting a study-defined minimum operational threshold of ≥60% of the maximum possible score in each domain; this cutoff was not interpreted as a definition of “good” performance or clinical competence. Associations between participant characteristics and study outcomes were examined using chi-square tests and multivariable binary logistic regression analyses. Overall, 81.9% of participants met the oral cancer knowledge threshold, 55.4% met the OPMD knowledge threshold, and 24.0% met the diagnostic confidence threshold. Most participants correctly identified major oral cancer risk factors, including tobacco smoking (97.2%), alcohol consumption (92.7%), and human papillomavirus infection (86.7%). However, clinically oriented response patterns highlighted areas for educational attention. 20.1% selected the prespecified specialist-referral response for management of a persistent suspicious lesion, while 35.6% recognized factors associated with increased malignant transformation risk in leukoplakia. Intern status remained independently associated with meeting the oral cancer knowledge and diagnostic confidence thresholds in multivariable analyses. The diagnostic-confidence outcome reflected self-perceived preparedness rather than observed screening, referral, or procedural competence. A high proportion of Saudi dental students met the study-defined oral cancer knowledge threshold; however, self-reported diagnostic confidence and preparedness for early detection remained considerably lower. Strengthening competency-based oral cancer education and clinical training may improve early detection preparedness and referral practices among future dental practitioners. Because the domains assessed different constructs and had different effective cutoffs, their threshold proportions should not be compared directly; the diagnostic-confidence findings represent perceived preparedness only.