Preparedness of dental interns to identify oral potentially malignant disorders and oral cancer: a multi‑state cross‑sectional survey in India

BACKGROUND: Dental interns are frontline clinicians who can detect oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) at an early stage. This study assessed the knowledge, attitudes, and self-reported practices (KAP) regarding OPMDs and OSCC among a multi-state sample of dental interns in India recruited through online platforms. METHODS: A cross-sectional online survey was conducted among 1220 dental interns across India (September-December 2025). Participants were recruited via professional WhatsApp groups, Facebook, and Instagram. A validated, structured online questionnaire comprised 8 knowledge items (multiple-choice/true-false), 4 attitude statements (5-point Likert scale), and 3 practice items. Content validity was established by five experts (item-level content validity index [I-CVI] 0.83-1.00); the instrument was pilot-tested on 20 interns. Reliability of the knowledge scale (KR-20 = 0.62) and attitude scale (Cronbach's α = 0.88) was assessed. Descriptive statistics, independent t-tests, Pearson's correlation, one-way ANOVA, linear regression, and chi-square tests were applied (SPSS v26). Significance was set at p < 0.05. RESULTS: Respondents were from 23 states and 3 union territories. The largest representations were from Maharashtra (12.3%, n = 150), Karnataka (10.8%, n = 132), Tamil Nadu (9.7%, n = 118), Uttar Pradesh (8.9%, n = 109), and West Bengal (7.6%, n = 93). Mean knowledge score was 5.48 ± 1.08 (median 6, range 1-7) out of 8. While 99.2% had heard of OPMDs and 100% knew that early OPMDs are reversible, only 70.5% correctly identified the malignant transformation rate of leukoplakia (1-5%). Attitudes were strongly positive (mean 19.67 ± 1.09/20); >94% strongly agreed that early detection reduces mortality and that they have a responsibility to refer. In practice, 86.9% (n = 1060) always examined high-risk oral sites and 93.4% (n = 1140) always counselled on tobacco risks; 92.6% (n = 1130) reported having identified and referred a suspicious lesion. Knowledge correlated positively with practice (r = 0.42, p < 0.001). Linear regression showed knowledge was associated with practice frequency (β = 0.39, 95% CI: 0.29-0.49, p < 0.001). Interns who always screened or counselled scored higher in knowledge than those who did not (p < 0.001). Chi-square analysis demonstrated a significant association between knowledge tertile and consistent practice (χ² = 24.6, df = 2, p < 0.001). CONCLUSION: This multi-state online survey found that dental interns demonstrated moderate overall knowledge and strongly positive attitudes, with frequent self-reported screening and counselling practices. However, specific knowledge gaps regarding malignant transformation rates persist. Findings should be interpreted with caution given the convenience sampling and reliance on self-reported data. Targeted curricular updates and periodic hands-on training are recommended to strengthen early detection competencies.