Feasibility of including trained acupuncturists in the detection of oral lesions and oral cancer screening


  • Roberta Blanco Santos School of Dentistry and Research Center
  • Luciane Zanin Medical School, Area of Public Health
  • Flávia Martão Flório School of Dentistry and Research Center




Acupuncture. Mouth neoplasms. Pathology. Oral diagnosis. Training


Aim: To demonstrate the feasibility of enabling trained acupuncturist as professionals able to detect oral lesions, with a role in the screening of oral cancer. Methods: This study was conducted in two phases. In the first, 11 acupuncturists were trained for visual detection of oral lesions and support content available on : , especially developed for this study. They were evaluated at the end of training by a written exam. The inclusion criteria were to sign the consent form and to obtain a minimum of 90% of correct answers in the assessment. Four acupuncturists fulfilled both criteria and were included as study subjects. In the second phase, the subjects and the researcher (gold standard) examined 43 volunteer patients. The inclusion criterion for volunteers was just to sign the consent form. The volunteers’ sample was established by saturation. Volunteers with changes deemed suspicious by the subjects were reexamined 15 days after the first examination. Results: First exam: mouth alterations were detected in 56% (n=24) of the volunteers. Among the alterations, 21% (n=5) were deemed suspicious by the subjects and 8% (n=2) by gold standard. Second exam: two mouth alterations remained suspicious and these volunteers were referred to the Dental Specialty Center for diagnosis and treatment. Compared to the gold standard, no injury remained undetected by the subjects. Conclusions: This study concluded for the feasibility of enabling trained acupuncturist to visually detect oral lesions and have a role in oral cancer screening


Download data is not yet available.


Metrics Loading ...

Author Biographies

Roberta Blanco Santos, School of Dentistry and Research Center

Possui Mestrado em Odontologia - área de concentração Saúde Coletiva - Faculdade de Odontologia e Centro de Pesquisas Odontológicas São Leopoldo Mandic, SP (2014). Pós-graduação 'Latu Sensu' em Psicologia Junguiana - IBMR, RJ (2003). Graduação em Odontologia - Universidade do Estado do Rio de Janeiro, RJ (1986). Formação em MTC- Acupuntura - Pro Salus, SP (2003). Atualização em Acupuntura - Nanjing University of Chinese Medicine NJUCM, Nanjing, China (2014) e Beijing University of Chinese Medicine BUCM, Beijing, China (2014).

Luciane Zanin, Medical School, Area of Public Health

Possui graduação em odontologia pelo Centro Universitário Herminio Ometto de Araras (1998), mestrado em Odontologia pela Universidade Estadual de Campinas (2002) e doutorado em Odontologia pela Universidade Estadual de Campinas (2004).

Flávia Martão Flório, School of Dentistry and Research Center

Possui graduação em Odontologia pela Universidade Estadual de Campinas (1997), mestrado em Odontologia pela Universidade Estadual de Campinas (2000) e doutorado em (Odontologia) Cariologia pela Universidade Estadual de Campinas (2003). É especialista em Odontologia em Saúde Coletiva. Atualmente é professor do Centro de Pesquisas Odontológicas São Leopoldo Mandic e foi Coordenadora do Curso de graduação desta IES entre os anos 2006 e 2011.


Eadie D, MacKintosh AM, MacAskill S, Brown A. Development and evaluation of an early detection intervention for mouth cancer using a mass media approach. Br J Cancer. 2009; 101 (Suppl 2): S73-9.

IARC. GLOBOCAN 2008 Fast Stats. Section of Cancer Information 2010 [cited: 2013 Aug 27]. Available form: http://globocan.iarc.fr/factsheets/ populations/factsheet.asp?uno=900#BOTH.

WHO Health Statistics and Health Information Systems 2013 [cited 2013 Aug 26]. Available fromt: http://www.who.int/healthinfo/mortality_data/en/ index.html.

Morse DE, Vélez-Vega CM, Psoter WJ, Vélez H, Buxó CJ, Baek LS, et al. Perspectives of San Juan healthcare practitioners on the detection deficit in oral premalignant and early cancers in Puerto Rico: a qualitative research study. BMC Public Health. 2011; 11: 391.

Kujan O, Glenny AM, Duxbury J. Evaluation of Screening Strategies for Improving Oral Cancer Mortality: A Cochrane Systematic Review. J Dent Educ. 2005; 69: 255-65.

Gomez IS, Warnakulasuriya S, Varela-Centelles PI, Lopez-Jornet P, SuarezCunqueiro M, Diz-Dios P, et al. Is early diagnosis of oral cancer a feasible objective? Who is to blame for diagnostic delay? Oral Diseases. 2010; 16: 333-4.

Applebaum E, Ruhlen TN, Kronenberg FR, Hayes C, Peters ES. Oral cancer knowledge, attitudes and practices: a survey of dentists and primary care physicians in Massachusetts. J Am Dent Assoc. 2009; 140: 461-7.

Epstein JB, Sciubba JJ, Banasek TE, Hay LJ. Failure to diagnose and delayed diagnosis of cancer: medicolegal issues. J Am Dent Assoc. 2009; 140: 1494-503.

LeHew CW, Epstein JB, Koerber A, Kaste L. Training in the primary prevention and early detection of oral cancer: Pilot study of its impact on clinicians’ perceptions and intentions. Ear Nose Throat J. 2009; 88: 748-53.

Melo NS, Figueiredo PTS, Leile AF, Souza TAC, Lucena, EHG, Zanetti CHG. Early oral diagnosis in the Uniûed National Health System: individual analysis, health surveillance and teamwork as a (re)structuring possibility. Tempus - Actas Saude Colet. 2011 [cited 2013 Sep 21]; 5: 89-103. Available from: http://www.tempusactas.unb.br/index.php/tempus/article/view/1045.

Choi SH. WHO Traditional Medicine Strategy and Activities “Standardization with Evidence-based Approaches”. J Acupunct Meridian Stud. 2008; 1: 153-4.

Tesser CD, LUZ MT. [Medical rationalities and integrality]. Cienc. Saude Colet. 2008; 13: 195-206. Available from: http://www.scielo.br/pdf/csc/v13n1/ 23.pdf. Portuguese.

Brazil. Ministry of Health. National Policy on Integrative and Complementary Practices in Unified Health System - Extension attitude access. Brasília: Ministry of Health, 2006.

World Health Organization (WHO). Consultation on acupuncture guidelines on basic training and safety in acupuncture. WHO: Cervia; 1996.

IARC. IARC Screening Group. A digital manual for the early diagnosis of oral neoplasia [cited 2013 Aug 27]. Available from: http://screening.iarc.fr/ atlasoral.php.

Brazil - INCA. National Cancer Institute. Mouth cancer. 2012 [cited 2013 Jul 27]. Available from: http://www2.inca.gov.br/wps/wcm/connect/ tiposdecancer/site/home/boca/evidencias_cientificas_para_rastreamento.

Kankou - The acupuncturist and the inspection of the tongue. Learn to optimize your routine clinical examination and participate in the prevention of mouth cancer. 2013 [cited 2014 Mar 18]. Available from: http://www.kankou.com.br.

Denzin NK, Lincoln YS, editors. Handbook of qualitative research. Thousand Oaks: Sage Publications; 1994.

Santos JDP, Duncan BB, Sirena SA, Vigo A, Abreu MSN. [Indicators of effectiveness of the Unified Health System Smoking Cessation Program in Minas Gerais, Brazil, 2008]. Epidemiol Serv Saude. 2012; 21: 579-88. Portuguese.

Aranda F. IG homepage. [Health and Wellbeing]; 2010 Aug 24 [cited 2014 Mar 3]. Available from: http://saude.ig.com.br/bemestar/ em+dois+anos+acupuntura+gratuita+cresce+128+no+pais/ n1237750946329.html. Portuguese.

Cardoso BAP, Pacheco CMA, Souza RF. [Website development on the internet. Permanent improvement in nursing: Contribution for continuing education]. Enfermeria Global. 2010 [cited 2013 Aug 27]; (19). Available from: http://scielo.isciii.es/pdf/eg/n19/miscelanea2.pdf. Spanish.

Rezende EJC, Melo MCB, Tavares EC, Santos AF; Souza C. [Ethics and eHealth: reflections for a safe practice]. Rev Panam Salud Publica. 2010; 28: 58-65.Portuguese 23. Rendeiro MMP, Vieira P, Figueiredo DLTM. [Infoculture: a barrier of access to permanent learning?] Rev Hosp Univ Pedro Ernesto. 2012 [cited 2014 Jan 1];11(Suppl 1). Available at: http://revista.hupe.uerj.br/ detalhe_artigo.asp?id=303.

Rethman MP, Carpenter W, Cohen EE, Epstein J, Evans CA, Flaitz CM et al. Evidence-based clinical recommendations regarding screening for oral squamous cell carcinomas. J Am Dent Assoc. 2010; 141: 509-20.

Brazil. Ministry of Health. [Screening: Series A - Standards and Technical Manuals. Primary Care Guide, n. 29]. Brasília: Ministry of Health; 2010. Portuguese.

Rios IC. [Health humanization pathways - practice and reflection]. São Paulo: Áurea; 2009 [cited 2015 nov 3]. Available from: http:// pessoacomdeficiencia.sp.gov.br/usr/share/documents/ CAMINHOS_DA_HUMANIZACAO_NA_SAUDE.pdf. Portuguese.

Kurebayash LSF, Oguisso T, Freitas GF. Acupuncture in brazilian nursing practice: ethical and legal dimensions. Acta Paul Enferm. 2009; 22: 210-2.

Gondim DV, Carvalho KM, Vale ML. Pain behavior to electroacupuncture in rabbit tooth pulp. Braz J Oral Sci. 2010; 9: 415-20.

Sousa IM, Bodstein RC, Tesser CD, Santos F de A, Hortale VA. [Integrative and complementary health practices: the supply and production of care in the Unified National Health System and in selected municipalities in Brazil]. Cad Saude Publica. 2012; 28: 2143-54. Portuguese.

Wade J, Smith H, Hankins M, Llewellyn C. Conducting oral examinations for cancer in general practice: what are the barriers? Fam Pract. 2010; 27: 77-84.

Decuyper S, Dochy F, Van den Bossche P. Grasping the dynamic complexity of team learning: An integrative model for effective team learning in organisations, Educ Res Rev. 2010; 5: 111-33.



How to Cite

Santos RB, Zanin L, Flório FM. Feasibility of including trained acupuncturists in the detection of oral lesions and oral cancer screening. Braz. J. Oral Sci. [Internet]. 2015 Jan. 1 [cited 2022 Sep. 29];14(3):230-3. Available from: https://periodicos.sbu.unicamp.br/ojs/index.php/bjos/article/view/8642878




Most read articles by the same author(s)