The Pharmacy Study

Title  A survey of pharmacists’ advice on mouth ulcers
Study Type Cross-Sectional Study
Status  Completed in 2008 – to be repeated
Funding  Saving Faces – The Facial Surgery Research Foundation
Ethics TBC


Mouth ulcers are a classic symptom of oral cancer. The National Health Service (NHS) advises a GP, dentist or specialist should be consulted for all ulcers lasting more than 3 weeks.


Saving Faces devised a study to evaluate whether pharmacists were giving the appropriate advice on a mouth ulcer: 453 pharmacists in England, Scotland and Wales were canvassed by OMFS, trainees and students, in the 2 weeks around UK Mouth Cancer Action Week 2008.

They gave the following account to the pharmacist:

“My dad had an ulcer on his tongue for 4 weeks. He’s tried Bonjela and salt water mouthwashes, but it isn’t any better and it’s still sore. What advice can you give?”

Researchers had further information about the patient, to give to the pharmacist if asked which identified them as high risk for mouth cancer.


The proportion of pharmacists who gave incorrect advice is worryingly high as it was found that 48.6% of pharmacists primarily offered a variety of over-the-counter “better” medication and the referral to an expert is the only recommended course of action. This demonstrates that pharmacists are either unaware of the symptoms of mouth cancer or attempting to sell products despite the risk.

45.3% first advised seeing a medical professional. The tiny proportion who suggested a referral to a dentist (2.4%) also raises questions about how dentists are perceived by pharmacists and the general public, although experts in the field.

It was also discovered that independent pharmacists did better than chains: 68.9% of independent pharmacists made it clear that medical attention was essential, while only 57.8% of chain pharmacies did so.

What next

Successive governments have expanded the role of the pharmacist as primary care providers and they are expected to offer NHS treatment for many minor ailments for people who do not need to go to their local GP. This would include the recognition of common oral cancer symptoms, like ulceration, and appropriate treatment. So, we want to repeat this study to see if pharmacists have improved in giving appropriate advice from 2008.


For further information, please contact Fran Ridout.