Projects
044 - Equipping Rural Dentists via Telehealth for local Oral Lesion Diagnosis and Management
- Chief Investigator A: A/Prof Tami Yap
- Chief Investigator B: Michael McCullough
- Chief Investigator C: Stacey Bracksley-O’Grady
- Chief Investigator D: Antonio Celentano
- Chief Investigator E: Virginia Dickson-Swift
Introduction
Oral squamous cell carcinoma is a significant health issue in Australia, with incidence rising and late-stage diagnosis occurring in nearly 50% of patients. Late detection leads to poor prognosis, with 5-year survival rates dropping significantly compared to early detection. Rural and remote communities are at higher risk of adverse outcomes and engage in higher rates of risk behaviours.
Currently, these communities face major barriers to timely assessment of suspicious oral lesions due to limited access to specialist advice and fragmented care pathways. Individuals living further from treatment centres experience poorer outcomes and difficulties accessing care.
This project proposes a pilot in three Victorian regions to upskill general dentists through targeted CPD and embed a digital annotated image platform (MouthMap) for direct specialist linkage. By strengthening local capability to identify and triage abnormalities, and creating efficient referral workflows, this project aims to reduce delays and improve diagnostic quality. This model aligns with the need to address workforce shortages in regional areas, where dental practitioner ratios are already significantly lower than in metropolitan areas and specialist ratios, even more so.
Aims
To assess the feasibility and potential of utilising digitally enabled shared-care in improving the access to closer-to-home oral lesion assessment in rural and remote communities.
- Evaluate if targeted CPD improves general dentists’ knowledge, confidence, and case selection for oral lesions.
- Assess how effectively a telehealth software-enabled workflow supports image capture and remote specialist input.
- Examine the feasibility and acceptability of this model for dentists, specialists, and health services.
- Measure the impact on process measures, such as referral completeness, time to diagnosis, and access to care.
- Define an evidence-based, scalable model of care to improve oral health equity in rural settings.
Methodology
This mixed-methods pilot will test a digital oral-lesion referral model in general dental practices. Dentists will receive CPD training on lesion recognition, digital imaging and use of the MouthMap platform before implementation. During routine visits, they will identify lesions, obtain patient consent and upload standardised images and clinical data to MouthMap for asynchronous specialist review. Dentists will complete pre- and post-CPD surveys, and qualitative interviews with dentists and specialists will assess feasibility and usability. Process data, including referral completeness and time to specialist advice, will be extracted from system records.
What are the expected outcomes?
We hope to learn how current pathways to specialist assessment and histopathology for oral mucosal lesions function in rural and remote Victorian settings, and where the key barriers and delays occur. The study will evaluate whether targeted CPD improves general dentists’ knowledge, confidence, and case selection, and how effectively a tele-health software-enabled workflow supports image capture, remote specialist input, and clearer decision-making. We will assess the feasibility and acceptability of this model for dentists, specialists, and services, and examine its impact on process measures such as referral completeness, time to diagnosis, and access to downstream care. Ultimately, we aim to define an evidence-based, scalable model of care that could be adopted more widely to improve equity in oral lesion assessment and diagnosis for rural and remote communities.
