Oral medicine
Encyclopedia
Oral medicine is the dental specialty
placed at the interface between medicine
and dentistry
.
and non-surgical management of non-dental pathology
affecting the oral
and maxillofacial region, such as oral lichen planus
, Behçet's disease
and pemphigus vulgaris
. Moreover, it often involves the diagnosis and follow-up of pre-malignant
lesion
s of the oral cavity, like leukoplakia
or erythroplakia
. Another aspect of the speciality is managing the oral condition of medically compromised patients. For example, cancer
patients who suffer from related oral mucositis
, bisphosphonate
-related osteonecrosis of the jaws or oral pathology related to radiation therapy
. Additionally, it is involved in the diagnosis and management of dry mouth conditions, such as Sjögren's syndrome
, and non-dental chronic orofacial pain conditions, such as burning mouth syndrome, trigeminal neuralgia
and temporomandibular joint
disorder.
The main facets of oral medicine are:
, FRACDS (Oral Med) and or the Royal College of Pathologists of Australasia
, FRCP. New Zealand has traditionally followed the UK system of dual training (dentistry and medicine) as a requisite for specialty practice; the University of Otago Faculty of Dentistry
currently offers a 5-year intercalated clinical doctorate/medical degree (DClinDent/MBChB) program.
, mainly based within the dental teaching hospital
s, with around 30 Consultants practising.
Specialty (medicine)
A specialty in medicine is a branch of medical science. After completing medical school, physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple year residency to become a medical specialist.-History of medical specialization:To...
placed at the interface between medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
and dentistry
Dentistry
Dentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered...
.
Scope
Oral medicine is concerned with diagnosisMedical diagnosis
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...
and non-surgical management of non-dental pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
affecting the oral
Mouth
The mouth is the first portion of the alimentary canal that receives food andsaliva. The oral mucosa is the mucous membrane epithelium lining the inside of the mouth....
and maxillofacial region, such as oral lichen planus
Oral lichen planus
Mucosal lichen planus, or oral lichen planus , is an inflammatory auto-immune disease that affects oral mucosa, with or without the involvement of the skin and other mucous membranes.- Epidemiology :...
, Behçet's disease
Behçet's disease
Behçet's disease is a rare immune-mediated systemic vasculitis that often presents with mucous membrane ulceration and ocular involvements...
and pemphigus vulgaris
Pemphigus vulgaris
Pemphigus vulgaris is a chronic blistering skin disease with skin lesions that are rarely pruritic, but which are often painful.-Pathophysiology:...
. Moreover, it often involves the diagnosis and follow-up of pre-malignant
Malignant
Malignancy is the tendency of a medical condition, especially tumors, to become progressively worse and to potentially result in death. Malignancy in cancers is characterized by anaplasia, invasiveness, and metastasis...
lesion
Lesion
A lesion is any abnormality in the tissue of an organism , usually caused by disease or trauma. Lesion is derived from the Latin word laesio which means injury.- Types :...
s of the oral cavity, like leukoplakia
Leukoplakia
Leukoplakia is a clinical term used to describe patches of keratosis. It is visible as adherent white patches on the mucous membranes of the oral cavity, including the tongue, but also other areas of the gastro-intestinal tract, urinary tract and the genitals. The clinical appearance is highly...
or erythroplakia
Erythroplakia
Erythroplakia is a flat red patch or lesion in the mouth that cannot be attributed to any other pathology.A similar term is "erythroplasia", which has a papular appearance.- Diagnosis and associated conditions :...
. Another aspect of the speciality is managing the oral condition of medically compromised patients. For example, cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
patients who suffer from related oral mucositis
Mucositis
Mucositis is the painful inflammation and ulceration of the mucous membranes lining the digestive tract, usually as an adverse effect of chemotherapy and radiotherapy treatment for cancer. Mucositis can occur anywhere along the gastrointestinal tract, but oral mucositis refers to the particular...
, bisphosphonate
Bisphosphonate
Bisphosphonates are a class of drugs that prevent the loss of bone mass, used to treat osteoporosis and similar diseases...
-related osteonecrosis of the jaws or oral pathology related to radiation therapy
Radiation therapy
Radiation therapy , radiation oncology, or radiotherapy , sometimes abbreviated to XRT or DXT, is the medical use of ionizing radiation, generally as part of cancer treatment to control malignant cells.Radiation therapy is commonly applied to the cancerous tumor because of its ability to control...
. Additionally, it is involved in the diagnosis and management of dry mouth conditions, such as Sjögren's syndrome
Sjögren's syndrome
Sjögren's syndrome , also known as "Mikulicz disease" and "Sicca syndrome", is a systemic autoimmune disease in which immune cells attack and destroy the exocrine glands that produce tears and saliva....
, and non-dental chronic orofacial pain conditions, such as burning mouth syndrome, trigeminal neuralgia
Trigeminal neuralgia
Trigeminal neuralgia , tic douloureux is a neuropathic disorder characterized by episodes of intense pain in the face, originating from the trigeminal nerve. It has been described as among the most painful conditions known...
and temporomandibular joint
Temporomandibular joint
The temporomandibular joint is the joint of the jaw and is frequently referred to as TMJ. There are two TMJs, one on either side, working in unison. The name is derived from the two bones which form the joint: the upper temporal bone which is part of the cranium , and the lower jaw bone called the...
disorder.
The main facets of oral medicine are:
- Clinical care
- ResearchResearchResearch can be defined as the scientific search for knowledge, or as any systematic investigation, to establish novel facts, solve new or existing problems, prove new ideas, or develop new theories, usually using a scientific method...
- Undergraduate and postgraduate teaching
USA
The American Dental Association (CODA) accredited programs are a minimum of two years in length.Australia/New Zealand
Australian programs are accredited by the Australian Dental Council (ADC) and are 3 years in length and culminate with either a Master degree (MDS) or a Doctor of Clinical Dentistry degree (DClinDent). Fellowship can then be obtained with the Royal Australasian College of Dental SurgeonsRoyal Australasian College of Dental Surgeons
The Royal Australasian College of Dental Surgeons or RACDS is a professional college established in 1965 that administers Fellowship Exams for both general and specialist dental practitioners in the Australasian region...
, FRACDS (Oral Med) and or the Royal College of Pathologists of Australasia
Royal College of Pathologists of Australasia
The Royal College of Pathologists of Australasia is a medical organization that promotes the science and practice of pathology. It has members in Australia, New Zealand, Hong Kong, Singapore, Malaysia and Saudi Arabia....
, FRCP. New Zealand has traditionally followed the UK system of dual training (dentistry and medicine) as a requisite for specialty practice; the University of Otago Faculty of Dentistry
University of Otago Faculty of Dentistry
University of Otago Faculty of Dentistry is one of the faculties of the University of Otago.Founded in 1907, the Faculty of Dentistry is the only Faculty and School of Dentistry in New Zealand. It forms an integral part of the Division of Health Sciences within the University of Otago in Dunedin...
currently offers a 5-year intercalated clinical doctorate/medical degree (DClinDent/MBChB) program.
Canada
Canadian programs are accredited by the (CDAC) and are a minimum of two years in length and usually culminate with a master (MSc or MDent) degree. Graduates are then eligible to sit for the Fellowship exams with the Royal College of Dentists of Canada (FRCD (C)).UK
Most UK oral medicine specialists have dual qualification with both primary medical and dental degrees. Specialist training currently consists of a 3 to 5 year programme, with many undertaking a PhD or MD in addition to their basic training. Currently there are 15 oral medicine units within the United KingdomUnited Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
, mainly based within the dental teaching hospital
Teaching hospital
A teaching hospital is a hospital that provides clinical education and training to future and current doctors, nurses, and other health professionals, in addition to delivering medical care to patients...
s, with around 30 Consultants practising.