Oral Medicine and Oral Pathology

Oral Med/Oral Path

School of Medicine
School of Dentistry

Oral medicine (or dental medicine) is a clinical specialty lying at the interface between dentistry and medicine as a whole. It deals with diagnosis and management of disorders of the oral cavity and orofacial tissues. There is overlap with oral surgery and maxillofacial surgery, however unlike oral surgeons, oral physicians may hold dual qualification in both medicine and dentistry, and unlike both these surgical disciplines, oral medicine is primarily a clinical (non surgical) specialty. The specialty often works closely with oral pathology to diagnose lesions. Oral pathology is a laboratory based subspeciality of pathology. Oral pathologists carry out dissection of biopsies delivered to them, and then make a microscopic examination of samples of the biospy with the use of stains. The pathologist then writes a patholgoy report describing the histological appearance, suggests a diagnosis and may choose to advise treatment. Oral pathologists are especially involved in the staging of oral cancer and premalignant lesions. A great many systemic diseases give oral signs and symptoms. Sometimes, skilled investigation of these can lead to diagnosis of the systemic pathosis. Oral medicine could also be considered to be a sub-specialty of gastroenterology, since the oral cavity is considered to be part of the gastrointestinal (GI) tract. Many dermatologic conditions may also present in the oral cavity, sometimes without lesions ever appearing on the skin. Also unique to the mouth is the sense of taste, making oral medicine involved in the differential diagnosis and management of dysgeusia (taste disturbance). Finally, there is the unique anatomical situation of hard tissue structures (i.e. teeth) penetrating the epithelial continuity (nails and hair are intra-epithelial structures) which gives rise to an extensive topic called odontogenic disease. This encompasses not only the plaque induced lesions, but also developmental anomalies (e.g. cyst formation). For more information, see the Oral medicine and Oral pathology pages on Wikipedia. This area will deal with the diagnosis, pathology and treatment of orofacial disorders. Although some of the more important anatomical and physiological background will be discussed, it is wise to review these topics beforehand to gain more. Remember, before you can understand the various ways in which the human body can go wrong, it helps to understand the normality.

## Lectures

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* Oral examination
* Orofacial pain
* Oral ulceration
* Pigmented lesions of the oromucosa
* Lumps and bumps
* Disorders of the temporomandibular joint
* Xerostomia (dry mouth)
* Halitosis and dysosmia
* Bad tastes and dysgeusia
* Plaque induced diseases
* Hard tissue pathology

These lectures are aimed at people who wish to learn more about how common complaints related to the mouth are managed clinically. Where, as is not uncommonly the case, a systemic condition is root cause of the problem in the mouth, there is particular emphasis on the signs and symptoms of said condition in the clothed patient (i.e. head, neck, hands), since often there is no opportunity for physical examination of other areas of the patient.

## External resources

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* The Maxillofacial Center for Education & Research \-- an online oral pathology resource.
* Computer Assisted Learning at the School of Dentistry at Birmingham University, UK. See particularly "Self-Assessment Case Studies in Oral Medicine", and "Soft Tissue Lesions in Paediatric Dentistry"
* For regional oral medicine member associations, see the external link section on the wikipedia page.

## Clinical images wanted

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Please feel free to upload images that would complement the learning resources, ensuring consent and ideally no personal identification possible from the image (e.g. blank out eyes).

## Contributors & Feedback wanted

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Please feel free to contribute to this project if you so wish. Feedback from students is also valuable, so if you have thoughts or suggestions about the learning resources please place comments on the relevant "discuss" page.