Knowledge and awareness of pollen-food allergy syndrome among dentists: A cross-sectional survey

Background and objective: This cross-sectional survey represents the first study to systematically quantify pollenfood allergy syndrome (PFAS) awareness and clinical management approaches among actively practising dentists. Methods: Seventy-seven dentists in Istanbul, Turkey participated (mean age 34.4 ± 7.9 years; 72.7% female) in this cross-sectional, descriptive survey. The survey was distributed via an open link through professional messaging and social media platforms; accordingly, a response rate could not be calculated. Results: Nearly all participants (97.4%) had received no postgraduate allergy training, and 94.8% reported inadequate or absent PFAS awareness. A critical recognition–application gap was identified: 62.3% selected the correct definition from multiple-choice options, yet only 37.7% correctly interpreted an equivalent clinical scenario involving raw versus cooked food reactions – and notably, 41.7% of those who correctly identified the definition still failed this scenario. More strikingly, 93.5% had never considered PFAS in differential diagnosis despite 54.5% reporting encounters with oral mucosal complaints in the preceding year. PFAS knowledge showed no association with professional experience, specialty, or prior patient encounters (all P > 0.05), indicating a systemic educational deficit rather than an experience-dependent gap. Conversely, 71.4% correctly identified allergy and immunology as the appropriate referral specialty, and 81.8% rated their educational need at the highest level. Conclusions: These findings reveal that PFAS remains a diagnostically invisible syndrome in dental practice. Given dentists’ frontline position in encountering oral mucosal symptoms – the hallmark presentation of PFAS – integration of allergic syndromes into dental curricula, structured allergist–dentist referral pathways, and practical screening protocols are urgently needed.