Knowledge, Attitudes, and Practices of Iranian Practitioners regarding Oral Lesions: A Cross-Sectional Study Using Image-Based Clinical Scenarios

Background Oral lesions (OLs) encompass a diverse range of conditions, from benign disorders to potentially malignant and malignant entities. In Iran, general practitioners (GPs) and general dental practitioners (GDPs) often serve as the first points of contact for patients with OLs. However, delays in diagnosis and inappropriate management remain common, partly owing to inadequate training and unclear referral protocols. Methods A cross-sectional study was conducted from November 2023–December 2024 among 213 clinicians (91 GPs and 122 GDPs) registered with the Islamic Republic of Iran Medical Council (IRIMC). The participants completed a validated, image-based questionnaire assessing their knowledge, attitudes, and practices (KAP) regarding OLs. Clinical scenarios and high-quality images were used to simulate real-world decision-making. Descriptive and inferential statistics were applied to analyze the KAP scores and demographic correlations. Results GDPs demonstrated significantly higher knowledge scores than GPs did (M = 33.2 vs. 29.3, p  < .001), particularly among female practitioners. Knowledge was positively correlated with appropriate clinical decisions across the scenarios. However, misconceptions persist, particularly among GPs, regarding benign tongue lesions and systemic associations. Only 7% of the participants reported performing biopsies, whereas 88.3% referred patients when needed. The attitudes toward OLs were generally positive, and 87.8% expressed interest in further education. Conclusion Despite favorable attitudes, significant knowledge and practice gaps exist among primary care providers in Iran, especially GPs. Integrating image-based, scenario-driven training into undergraduate curricula and continuing education programs is essential to improve the early recognition and management of OLs.