Knowledge and Misconceptions About White Patch Lesions Among Dental Undergraduates of Pakistan

Abstract

Background: Oral white patch lesions, particularly oral leukoplakia, require early recognition because some lesions may represent oral potentially malignant disorders. Dental undergraduates are expected to identify suspicious lesions and initiate appropriate referral, but misconceptions may affect clinical decision-making. Objective: This study aimed to assess knowledge and misconceptions regarding oral white patch lesions among dental undergraduates in Pakistan and to identify educational gaps relevant to early detection. Methods: A multicenter cross-sectional descriptive study was conducted among third- and final-year BDS students across Pakistan from November 2025 to January 2026. Data were collected through a structured self-administered questionnaire covering demographic characteristics, awareness, clinical responses, diagnostic confidence, and misconceptions. Descriptive statistics were reported as frequencies and percentages. Results: A total of 391 students participated. Most respondents identified tobacco as the main etiological factor for leukoplakia (69.3%), recognized the association of areca nut and betel quid with oral submucous fibrosis (90.8%), and agreed that oral white lesions may be precancerous (85.9%). Referral or biopsy was selected by 49.9% after observing a white patch, while 32.5% preferred observation. Misconceptions were frequent: 82.1% considered leukoplakia and candidiasis clinically similar, and 68.0% believed leukoplakia is painful in early stages. Conclusion: Dental undergraduates showed adequate awareness of selected concepts but had important misconceptions and variable clinical decision-making. Strengthened case-based training, differential diagnosis teaching, and biopsy-referral guidance are needed