title: A qualitative study examining the experience of primary care dentists in the detection and management of potentially malignant lesions. 1. Factors influencing detection and the decision to refer.
abstract: OBJECTIVE
  Many oral squamous cell carcinomas present as late stage disease and so the detection of early and pre-malignancy is considered to be of paramount importance. The majority of research examining primary care dentists' experience of the detection and management of early disease has been undertaken using questionnaires, with the inherent bias this introduces. The aim of this study was to use qualitative methods to develop a richer account of practitioners' views about screening and what factors influence the decision to refer a patient.
  
  
  METHODS
  Semi-structured interviews were undertaken with eighteen dentists in Sheffield, transcribed and analysed using thematic analysis. Ten codes were identified according to the aims of the study and organized into four overarching themes.
  
  
  RESULTS
  Although many dentists were screening regularly, some did not appear to be adopting a rigorous and systematic approach. A number of participants also placed more reliance on 'classical' presentations rather than the more varied presentation of potentially malignant lesions and were more influenced by the clinical history of the lesion rather than risk factors.
  
  
  CONCLUSIONS
  Overall, the present research suggests that for some dentists, more rigour is required when examining for early disease.
authors.affiliation: School of Dentistry, The University of Manchester, Higher Cambridge Street, Manchester.
authors.forename: P R
authors.initials: PR
authors.lastname: Brocklehurst
authors.forename: S R
authors.initials: SR
authors.lastname: Baker
authors.forename: P M
authors.initials: PM
authors.lastname: Speight
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D002983:Clinical Competence; D003657:Decision Making; D003812:Dentist-Patient Relations; D055088:Early Detection of Cancer; D005260:Female; D005792:General Practice, Dental; D019983:Guideline Adherence; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis*; D019239:Practice Patterns, Dentists'; D011230:Precancerous Conditions / Q000175:diagnosis*; D036301:Qualitative Research; D012017:Referral and Consultation; D012307:Risk Factors