Knowledge and Practicing Attitude for Diagnostic Approaches to Non-Healing Oral Ulcers Among Dental Practitioners in Pakistan: A Cross-Sectional Studies

Komal Malik; Maira Izhar; Muhammad Ibrahim; Noor ul ain waheed; Muhammad Farrukh; Hafsa Shahid

doi:10.61919/pzs5t335

Authors

Komal Malik Altamash Institute of Dental Medicine, Karachi, Pakistan Author
Maira Izhar Bibi Aseefa Dental College, SMBBMU, Larkana, Pakistan Author
Muhammad Ibrahim Altamash Institute of Dental Medicine, Karachi, Pakistan Author
Noor ul ain waheed Dow University of Health Sciences, Pakistan Author
Muhammad Farrukh Margalla Institute of Health Sciences, Rawalpindi, Pakistan Author
Hafsa Shahid Karachi Medical and Dental College, Pakistan Author

DOI:

https://doi.org/10.61919/pzs5t335

Keywords:

non-healing oral ulcer; oral cancer; biopsy; dental practitioners; diagnostic practice; Pakistan

Abstract

Background: Persistent oral ulcers may represent traumatic, inflammatory, infectious, potentially malignant, or malignant conditions and require timely assessment. Dental practitioners play an important role in early recognition, biopsy selection, and referral. Objective: To evaluate dental practitioners’ knowledge, attitudes, self-reported confidence, diagnostic practices, referral behaviour, and perceived barriers regarding non-healing oral ulcers in Pakistan. Methods: A cross-sectional questionnaire-based survey was conducted among 227 dental practitioners recruited through professional and academic networks. Information was collected on professional characteristics, recognition of suspicious features, biopsy awareness, initial management, referral practices, and diagnostic barriers. Data were analysed descriptively using frequencies and percentages. Results: Fair or good knowledge was reported by 207 participants (91.2%). A 14-day persistence threshold was identified by 158 (69.6%), while 179 (78.9%) recognized induration and rolled margins as suspicious. Biopsy was considered the diagnostic gold standard by 211 (93.0%), but only 54 (23.8%) selected biopsy as their first approach. Removal of local irritants followed by review was selected by 105 (46.3%), and 114 (50.2%) deferred referral until initial treatment failed. Inadequate training was the leading barrier (36.1%). Conclusion: Respondents demonstrated favourable awareness but reported less consistent implementation of timely biopsy and referral. Practical training and standardized referral pathways may help reduce this knowledge–practice gap

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