The Practice of Oral Medicine in South Africa
DOI:
https://doi.org/10.17159/2519-0105/2022/v77no6a5Keywords:
oral medicine, oral mucosal disease, special investigations, scope of practiceAbstract
Oral medicine is a clinical discipline, practiced by periodontists, which concerns itself mostly with the non surgical management of oral mucosal diseases. Many of these diseases are rare and the discipline less well known – making it essential to identify the obstacles this discipline faces. The purpose of this study was to describe the private and academic practice of Oral Medicine. A self-administered, internet-based, questionnaire was distributed to South African periodontists which questioned the clinician’s competency, diseases managed, special investigations performed, referral sources, proportional time and monetary distribution of the discipline, and perceived barriers to the practice. Twenty-six periodontists completed the questionnaire. In comparison to periodontology and implantology, periodontists generally feel less competent, spend less time on, and receive less money from Oral Medicine. Lack of awareness of the speciality (55.6% - 59.3%) was identified as the biggest constraint, with only 11.2% of referrals received from medical doctors. Immune-mediated diseases (29.3%) and benign neoplasms (26.5%) are managed the most, and surgical biopsies (80.2%) are used most regularly to diagnose oral mucosal disease. Oral Medicine is still a lesser-known clinical speciality. Despite the heavy burden of HIV-related oral disease and oral mucosal malignancies, this speciality remains underutilised.
Downloads
References
Miller CS, Hall EH, Falace DA, Jacobson JJ, Lederman DA, Segelman AE. Need and demand for oral medicine services in 1996. Oral Surg Oral
Med Oral Pathol Oral Radiol Endodontology. 1997 Dec;84(6):630–4. DOI: https://doi.org/10.1016/S1079-2104(97)90364-4
Haberland CM, Allen CM, Beck FM. Referral patterns, lesion prevalence, and patient care parameters in a clinical oral pathology practice. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 May;87(5):583–8. DOI: https://doi.org/10.1016/S1079-2104(99)70138-1
Farah CS, Simanovic B, Savage NW. Scope of 358 > RESEARCH www.sada.co.za / SADJ Vol. 77 No. 6practice, referral patterns and lesion occurrence of an oral medicine service in Australia. Oral Dis. 2008;14(4):367–75. DOI: https://doi.org/10.1111/j.1601-0825.2007.01392.x
British Society for Oral Medicine Constitution (2018) [Internet]. British & Irish Society for Oral Medicine. 2018 [cited 2020 Oct 27]. Available from: https://bisom.org.uk/british-society-for-oral-medicine constitution-2018/
Press Release: Oral Medicine Is Now an ADArecognized Dental Specialty [Internet]. [cited 2020 Oct 22]. Available from:https://maaom.memberclicks.net/index.php?option=com_content&view=article&id=588:press-release--oral-medicine-is-nowan-ada-recognized-dental-specialty&catid=21:news&Itemid=285?utm_source=website&utm_medium= homepage&utm_campaign =member engagement
Steele JC, Clark HJ, Hong CHL, Jurge S, Muthukrishnan A, Kerr AR, et al. World Workshop on Oral Medicine VI: an international validation
study of clinical competencies for advanced training in oral medicine. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Aug;120(2):143-151.e7. DOI: https://doi.org/10.1016/j.oooo.2014.12.026
Bez C, Sklavounou A, Carrozzo M. Oral medicine in Europe: past, present and future. Br Dent J. 2017 Nov;223(9):726–8. DOI: https://doi.org/10.1038/sj.bdj.2017.891
Stoopler ET, Shirlaw P, Arvind M, Russo LL, Bez C, Rossi SD, et al. An international survey of oral medicine practice: Proceedings from the
th World Workshop in Oral Medicine. Oral Dis. 2011;17(s1):99–104. DOI: https://doi.org/10.1111/j.1601-0825.2011.01795.x
Fincham JE. Response rates and responsiveness for surveys, standards, and the Journal. Am J Pharm Educ. 2008 Apr 15;72(2):43. DOI: https://doi.org/10.5688/aj720243
Friesen R, McGaw T, Peters E, Lai H. A retrospective analysis of referral patterns to a university oral medicine clinic. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Oct;128(4):381–5. DOI: https://doi.org/10.1016/j.oooo.2019.04.007
Guan G, Lau J, Yew V, U J, Qu W, Lam J, et al. Referrals by general dental practitioners and medical practitioners to oral medicine specialists in New Zealand: a study to develop protocol guidelines. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Jul;130(1):43-51.e5. DOI: https://doi.org/10.1016/j.oooo.2020.03.050
Navarro CM, Onofre MA, Sposto MR. Referral letters in oral medicine: an approach for the general dental practitioner. Int J Oral Maxillofac Surg. 2001 Oct;30(5):448–51. DOI: https://doi.org/10.1054/ijom.2001.0108
Sardella A, Demarosi F, Lodi G, Canegallo L, Rimondini L, Carrassi A. Accuracy of Referrals to a Specialist Oral Medicine Unit by General Medical and Dental Practitioners and the Educational Implications. J Dent Educ. 2007;71(4):487–91. DOI: https://doi.org/10.1002/j.0022-0337.2007.71.4.tb04300.x
Villa A, Stock S, Aboalela A, Lerman MA, Woo S-B, Sonis ST, et al. Oral Medicine referrals at a hospital based practice in the United States. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Apr;119(4):423–9. DOI: https://doi.org/10.1016/j.oooo.2015.01.003
Laronde DM, Williams PM, Hislop TG, Poh C, Ng S, Bajdik C, et al. Influence of fluorescence on screening decisions for oral mucosal lesions in community dental practices. J Oral Pathol Med Off Publ Int Assoc Oral Pathol Am Acad Oral Pathol. 2014 Jan;43(1):7–13. DOI: https://doi.org/10.1111/jop.12090
Bhatnagar P, Rai S, Bhatnagar G, Kaur M, Goel S, Prabhat M. Prevalence study of oral mucosal lesions, mucosal variants, and treatment required for patients reporting to a dental school in North India: In accordance with WHO guidelines. J Fam Community Med. 2013;20(1):41–8. DOI: https://doi.org/10.4103/2230-8229.108183
Miller CS, Epstein JB, Hall EH, Sirois D. Changing oral care needs in the United States: the continuing need for oral medicine. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Jan;91(1):34–44. DOI: https://doi.org/10.1067/moe.2001.110439
Shulman JD, Beach MM, Rivera-Hidalgo F. The prevalence of oral mucosal lesions in U.S. adults: data from the Third National Health and Nutrition Examination Survey, 1988-1994. J Am Dent Assoc 1939. 2004 Sep;135(9):1279–86. DOI: https://doi.org/10.14219/jada.archive.2004.0403
Jovanovic A, Schulten EAJM, van der Waal I. Referral pattern of patients with oral mucosal lesions in The Netherlands. Community Dent Oral Epidemiol. 1992 Apr;20(2):94–6. DOI: https://doi.org/10.1111/j.1600-0528.1992.tb00685.x
Bokkasam V, Raviraj J, Gundlapalle P, Kolugundla V, Vardhan H, Thombarapu L. Awareness of oral medicine specialty among medical practitioners in and around Tirupati: A survey. J Indian Acad Oral Med Radiol. 2015;27(1):59. DOI: https://doi.org/10.4103/0972-1363.167082
Scully C, Miller CS, Aguirre Urizar J-M, Alajbeg I, Almeida OPD, Bagan JV, et al. Oral medicine (stomatology) across the globe: birth, growth, and future. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Feb;121(2):149-157.e5. DOI: https://doi.org/10.1016/j.oooo.2015.10.009
http://www.statssa.gov.za/publications/P0302/P03022021.pdf
Tappuni AR. The global changing pattern of the oral manifestations of HIV. Oral Dis. 2020 Sep;26 Suppl 1:22–7. DOI: https://doi.org/10.1111/odi.13469
Mello FW, Miguel AFP, Dutra KL, Porporatti AL, Warnakulasuriya S, Guerra ENS, et al. Prevalence of oral potentially malignant disorders: A systematic review and meta-analysis. J Oral Pathol Med Off Publ Int Assoc Oral Pathol Am Acad Oral Pathol. 2018 Aug;47(7):633–40. DOI: https://doi.org/10.1111/jop.12726
https://gco.iarc.fr/today/data/factsheets/populations/710-south-africa-fact-sheets.pdf
Poh CF, Ng S, Berean KW, Williams PM, Rosin MP, Zhang L. Biopsy and histopathologic diagnosis of oral premalignant and malignant lesions. J Can Dent Assoc. 2008 Apr;74(3):283–8.
Farah CS, Lynch N, McCullough MJ. Oral fungal infections: an update for the general practitioner. Aust Dent J. 2010 Jun;55 Suppl 1:48–54. DOI: https://doi.org/10.1111/j.1834-7819.2010.01198.x
Williams DW, Lewis MA. Isolation and identification of Candida from the oral cavity. Oral Dis. 2000 Jan;6(1):3–11. DOI: https://doi.org/10.1111/j.1601-0825.2000.tb00314.x
Manfredi M, Polonelli L, Aguirre-Urizar JM, Carrozzo M, McCullough MJ. Urban legends series: oral candidosis. Oral Dis. 2013 Apr;19(3):245–61. DOI: https://doi.org/10.1111/odi.12013
Mehrotra R, Hullmann M, Smeets R, Reichert TE, Driemel O. Oral cytology revisited. J Oral Pathol Med. 2009;38(2):161–6. DOI: https://doi.org/10.1111/j.1600-0714.2008.00709.x
Farah CS, McIntosh L, Georgiou A, McCullough MJ. Efficacy of tissue autofluorescence imaging (VELScope) in the visualization of oral mucosal lesions. Head Neck. 2012 Jun;34(6):856–62. DOI: https://doi.org/10.1002/hed.21834
Downloads
Published
Versions
- 2023-06-28 (2)
- 2022-10-10 (1)
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
.png){kind=spacer}