Diagnostic Confidence and Management of Pediatric Oral Mucosal Lesions in Primary Care

A cross-sectional survey of Croatian primary healthcare professionals assessed how they described their knowledge, diagnostic confidence, and management of pediatric oral mucosal lesions in routine practice.

The authors used an anonymous online questionnaire to capture self-reported exposure, knowledge, diagnostic confidence, management practices, and referral patterns. The sample included 632 participants (262 dentists, 278 family/general practitioners, and 92 pediatricians).

Dentists reported higher diagnostic confidence than pediatricians and family/general practitioners in hand-foot-and-mouth disease, herpangina, herpetic gingivostomatitis, and candidiasis. The authors reported no statistically significant interprofessional differences in diagnostic confidence for recurrent aphthous ulcerations, geographic tongue, or traumatic oral mucosal injury.

Respondents also described differences in routine oral examination, independent management, and referral destinations. Routine pediatric oral examinations were reported by 96.9% of dentists, while most pediatricians (80.4%) and family/general practitioners (77.0%) reported routinely examining the oral cavity in children. Independent treatment of oral mucosal lesions was reported by 75.2%, 52.2%, and 70.9%, respectively (p<0.001 for the group comparison). When respondents indicated referral rather than independent treatment, the most commonly selected destinations differed by profession; for example, family/general practitioners most frequently reported referring to general dentists (65.1%), while dentists most frequently reported referring to oral pathologists (59.5%).

Key Takeaways:

• Dentists reported higher self-assessed knowledge and diagnostic confidence than pediatricians and family/general practitioners in this Croatian survey.
• Reported diagnostic confidence differences varied by condition; for recurrent aphthous ulcerations, geographic tongue, and traumatic oral mucosal injury, no statistically significant between-group differences were observed.