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The Future of Oral Medicine*
Abstract and Figures
Oral Medicine has been a specialty at the cross roads of medicine and dentistry, not entirely recognized as a specialty by organized dentistry (at least in the US) and not embraced by medicine. The current paper makes a case for its place as a specialty of Medicine.
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... Among these only a few countries have a postgraduate program in the specialty. [7][8][9] Though there is no doubt that oral conditions are related to systemic diseases, stomatological diseases fall under the grey areas of medicine and dentistry. 10 Many medical doctors are less acquainted with the oral cavity, its normal anatomic landmarks, normal anatomic variations, and oral diseases bearing systemic origin. ...
... [11][12][13][14][15] Many a time, oral conditions are not high on the list within the medical practice. 8,13,15 A general dentist can fall short of knowledge regarding the systemic, environmental, food, and drug influences on oral lesions due to lack of adequate exposure to such cases. 16,17 Hence, although dentistry has many basic and medical science components in the undergraduate degree, specific training is deemed necessary to deal with oral mucosal diseases. ...
Oral Medicine is a branch within dentistry that deals with orofacial diseases. In the absence of adequate awareness and formalized referral system, there has been “doctor hopping” by patients with many sophisticated and needless investigations and management approaches in simple orofacial diseases. The objective of the study was to know the awareness level of medical practitioners about the Oral Medicine specialty and the volume and patterns of referral of patients with oral diseases. Validated questionnaire was sent to 148 medical doctors having a clinical practice in B. P. Koirala Institute of Health Sciences. Frequency and proportion were calculated. A total of 94 medical practitioners responded to the questionnaire. Out of them, 86.18% of medical doctors were aware about the existence of the Oral Medicine specialty. Only 17.02% of total clinicians referred patients to the Oral Medicine department for oral manifestations of systemic diseases, 21.27% referred for facial and TMJ problems, 38.29% referred for oral mucosal lesions and 15.96% referred patients for salivary gland disorders. There is a need to advocate the scope of Oral Medicine specialty for fostering interprofessional practice for better patient care.
... In the UK, pursuing a medical and dental degree together shortens oral medicine training from 5 to 3 years. Given that medical approaches to oral conditions are on the rise and that an extensive medical background is required in the field of oral medicine, it has been suggested that oral medicine be classified as a subdiscipline of medicine, rather than dentistry in the USA [33]. Such proposal is mainly based on that merely expanding medical focus in dental schools to account for oral medicine which faces the obstacle of lack of curriculum space and time constraints for the field to be properly learned, noting that the majority of oral medicine programs in the USA are already housed in dental schools [33]. ...
... Given that medical approaches to oral conditions are on the rise and that an extensive medical background is required in the field of oral medicine, it has been suggested that oral medicine be classified as a subdiscipline of medicine, rather than dentistry in the USA [33]. Such proposal is mainly based on that merely expanding medical focus in dental schools to account for oral medicine which faces the obstacle of lack of curriculum space and time constraints for the field to be properly learned, noting that the majority of oral medicine programs in the USA are already housed in dental schools [33]. Dental education could, of course, benefit from such additional focus in medicine, whether the oral medicine specialty changes to be a subdiscipline of medicine or not as training in 6 DOI: 10.1159/000515358 medicine will be useful to dentists who encounter patients with health comorbidities that can complicate dental treatments. ...
b> Background: Oral medicine is a subdiscipline of dentistry that concerns itself with the oral health of patients; it focuses on providing diagnosis and management of oral and maxillofacial diseases, as well as direct dental care for those in medically complex situations. As primary healthcare providers, physicians and dentists are often the first to evaluate patients with orofacial symptoms and make diagnoses related to oral health, whether explicit or manifested through systemic diseases. However, a lack of familiarity with oral medicine among healthcare providers often leads to significant delays in the accurate diagnosis and appropriate treatment of many oral and maxillofacial disorders. It has been well established that a lack of training and education in oral health among physicians is an impediment to alleviating the situation. Summary: Several studies and scientific reports in the medical community have shown a greater professional interest in oral health and medicine, with numerous recent articles reflecting a clear rise in multiple factors: an increased interest in additional training and a rise in oral diseases. This review focuses on the need for a multidisciplinary approach in modern healthcare systems that implements the oral medicine specialty. It also serves to emphasize the role of oral medicine in medical training and education, while simultaneously discussing the prevalence of oral diseases and awareness of oral health among physicians in Saudi Arabia. Key Messages: The prevalence of oral health conditions in Saudi Arabia appears to be high yet is accompanied by a scarcity of oral medicine specialists in this part of the world. Furthermore, numerous studies have revealed that physicians from different specialties in Saudi Arabia lack training in oral health and possess an insufficient awareness of the oral medicine specialty. This paucity of oral medicine specialists in Saudi Arabia presents a key issue as the clinical services and medical education provided by such specialists in healthcare systems can have a profound positive impact on each patient’s quality of life and health outcomes, as well as the standards of physicians’ training.
... Even as Oral Medicine and Oral & Maxillofacial Pathology continue to demonstrate their value through research, teaching, and direct patient care, they encounter systemic barriers that prevent full integration into high-demand health services [14][15][16][17][18][19] . This lack of recognition is not a reflection of the competencies or contributions of these dental specialties, rather, it seems to be a symptom of entrenched attitudes within contemporary healthcare management. ...
... substantial evolution, with varying trajectories worldwide (Gangwani & Kolokythas, 2019). The growth of women in the dental workforce was slower in developing countries: in India, women joined the dental workforce in the early 1940s, and in Saudi Arabia, women entered dental education in 1978, reflecting a conservative societal shift (Spielman, 2018). ...
Objectives: To analyze gender inequities and trends in the authorship of articles published in high-impact factor journals of the field of Oral Medicine and Pathology.
Methods: The gender and country of first and last authors were retrieved from original articles published between 2000 and 2022. Poisson regression models and classification and regression tree (CART) analysis were performed.
Results: A total of 6595 studies were analyzed for first authorship, and 6627 for last
authorship. Only 39.2% (CI 95% 38.0–40.3) of the first authors and 24.1% (CI 95%
23.1–25.1) of the last authors were females. Females consistently faced underrepresentation throughout the 23-year evaluation. The only region where female first authors are not a minority is Latin America. Having a female as the last author increased the prevalence of females in the first author position by 42% (PR = 1.42, CI 95% [1.30–1.54]). The most important discriminant variable by CART was the first author region.
Conclusion: Although a slight decrease in underrepresentation was noted over the
period, after 2020, the gender gap tended to widen for both first and last authors. It
is crucial to implement measures aimed at attracting, retaining, and advancing women in the field of science, while also actively monitoring advancements toward achieving gender equity.
... Regarding the integration of OMR specialists with SCD, there was a considerable variation in the responses; dental surgeons from Canada, India, Spain, Israel, Italy, Brazil, the United States, the United Kingdom, and Thailand agreed the most. 4 An OMR specialist's responsibilities in SCD included: ...
... Oral medicine is a dental specialty that combines medicine and dentistry by dealing with the diagnosis and treatment of disorders affecting the oral and maxillofacial area. Oral and Maxillofacial Radiography is the area that deals with the production and interpretation of images and data generated by all modalities of radiant radiation utilized for disease diagnosis and management [5]. Hence, an early identification and treatment of oral lesions are critical, as misdiagnosis and missed diagnosis can have a negative impact on the patient by imposing excessive expenditures for completing unsuitable or unneeded diagnostic procedures, inappropriate therapy depending on the diagnosis [6], overtreatment [7]. ...
Background and objective: There is a paradigm shift in the medical and dental fields due to the introduction of artificial intelligence (AI). Since AI has a potential impact on current and future practitioners, understanding the basic concept, working principle, and likely applications of AI as a diagnostic tool in Oral Medicine and Radiology is necessary for its widespread use. Therefore, this study aims to assess the knowledge, attitude, and perception of dental students and dentists regarding the possible applications of AI in the field of Oral Medicine and Radiology. Materials and methods: This was a cross-sectional questionnaire-based study comprising 15 questions circulated through Google Forms® to 460 dental students and professionals. The questionnaire collected demographic data of participants and assessed their knowledge, perception, and attitude about AI in Oral Medicine and Radiology answered using a 5-point Likert scale. Responses obtained were statistically analyzed using descriptive statistics and a chi-square test. Results: Out of 460 participants, majority had an idea about AI (94.13%) and its working principle (73.30%). Participants agreed that AI can be used in the diagnosis and formulating of treatment plans (88.47%), early detection of cancer (77.82%), forensic dentistry (74.13%), and as a prognostic (80.65%) and quality control tool (81.30%). A majority felt that AI should be incorporated into the dental curriculum (92.39%) and most of them were against suggesting AI in clinical incorporation (35.87%) with a fear that AI might replace the clinician in the future (76.52%). Conclusion: Based on the findings of the study, we strongly recommend that further research and insights into AI should be delivered through lectures, curricular courses, and scientific meetings to explore and increase awareness about this fascinating technology.
... Oral mucosal diseases are characterized by complex etiology, multiple clinical lesions and close involvements with systemic diseases. [1,9] The clinical diagnosis and treatment of difficult cases need the joint consultation of pathology, oral surgery, skin and endocrine. Furthermore, the time duration of standardized training for oral medicine department is fixed and short, usually only 1 to 2 months, which is a challenge for teachers to achieve the teaching goal and improve students' clinical ability like diagnosis level. ...
Hotly used in student-centered medical education worldwide, case based learning (CBL) is worthen with WeChat, the most popular communication app and is widely used in all walks of life. We have practiced several years combining WeChat and CBL in the clinical training of oral medicine for young doctors, promoting outcomes over traditional bedside training. This article's objective is demonstrating the acceptability and merits of WeChat CBL in the clinical training of oral medicine for young doctor. A total of eighty young doctors and 2 tutors participated in this study for interns of a every 2-month training during January 2018 to 2020. The control group used clinical bedside mode; the experimental group used bedside plus WeChat CBL mode. The evaluations included participation passion, daily routine and final test. Ten clerkships and thirty residents were in same number respectively of experiment and control groups. The participants in the experimental group produced a higher degree of participation in discussions. The twice and above Q&A action percentage is 40% in experimental group rather than 25% in control group. Daily assessment and final examination scores in the experimental group were significantly higher than those in the control group (P < .001). WeChat CBL mode has a positive effect on students' learning enthusiasm, assessments and evaluations in clinical training of oral medicine.
... Despite the great variability depending on the country to which reference is made, OM specialists (OMs) care for patients with a wide range of conditions, including mucosal diseases, oral manifestations of systemic diseases, oral drug-related complications, salivary gland disorders, orofacial pain and temporomandibular conditions [11]. OM inherently has strong relationships with various medical specialities, particularly dermatology, immunology and infectious diseases, pathology, imaging, neurology, oncology, ear-nose-throat specialist (ENT), paediatrics, psychiatry, psychology and rheumatology [12]. Thus, OM is placed at the interface between medicine and dentistry and should ideally serve as a model for interdisciplinary collaboration. ...
The aim of this study was to analyze the referral process to the Oral Medicine Unit in a university-based tertiary center in Southern Italy. A chart review of new referrals to the Oral Medicine Unit during a 24-month period was conducted. The following data were recorded: demographic characteristics, medical history, number of physicians seen prior to Oral Medicine assessment, referral source, diagnostic procedures ordered by referrals, reason for referral, site of lesion/condition, final diagnosis. Then, the rates of correct identification for health-care professionals and the appropriateness of the reference diagnosis based on the disease were calculated with descriptive statistic indicators. There were 583 new first consultations. A total of 62.9% of patients were referred by general dental practitioners, 27.4% by physicians, and 9.7% did not have a referral. The most common diseases for referral were immune-mediated diseases (39.6%) and oro-facial pain disorders (25.2%). Only 28.5% of patients had a correct provisional diagnosis. The results of this study show the need to implement curricula in the field of oral medicine among dentistry and medical students, and to support the continuing education among healthcare providers to reduce diagnostic delay for oral diseases.
... Moreover, OMR specialist as a private practitioner have a better knowledge of logistic use of drug preparations like medium/ high potency topical steroidal orapaste, chemotherapeutic orapaste and mouthwashes, antihistaminic orapaste, miracle mouthwashes, immunomodulators, mucin stimulators, antibiotics, saliva substitutes, nonfoaming nonflavored tooth paste preparations, Benzydiamine mouth washes, probiotics, etc., that may prove valuable to maintain a long symptom-free period in patients. [16] challenges faced by oMr specIalIst In settIng of prIvate practIce 1. Priority one: "Lack of referrals from medical/general dental practitioners." 2. Priority two: "Lack of awareness among patients regarding Oral physicians as specialist in treating oral mucosal lesions." 3. Priority three: "Including OMR specialist in Oncology teams." 4. Priority four: "Head and Neck cancer patients lacking awareness about oral medicine and radiology dental speciality." 5. Priority five: "Overlapped OPD with dermatology, ENT, and oncology." 6. Priority six: "Lack of awareness for dental radiologist as diagnostic and interventional imageologist." ...
... Oral medicine and pathology are specialties at the intersection of medicine and dentistry, focused on oral symptoms, diagnosis, and the oral care of medically compromised patients. 21 These fields were identified as specialties by Dr. Samuel Charles Miller when he founded the American Academy of Oral Medicine in 1945 (https://www.aaom.com/history). ...
This study aimed to analyze the 100 most-cited papers in the field of oral medicine and pathology over time, identifying the areas of more intense research. Papers in journals of oral medicine and pathology were identified using the Web of Science database. The specified research period was between 1900 and 2019. Descriptive statistics was used to analyze the data. Pearson’s correlation analysis was used to explore the relationships among Web of Science citations, Dimensions citations, and Altmetric Attention Score. The number of citations of an article in the top 100 most-cited papers published in 1953 or later ranged from 541 to 3623. The papers were published in 47 different journals. The New England Journal of Medicine, American Cancer Society, and Nature Genetics published the most papers. Authors from 18 different countries published papers on head and neck cancer, craniofacial congenital anomalies, and osteonecrosis. Most of the papers were laboratory and descriptive studies. A correlation analysis showed a strong correlation only between Web of Science and Dimensions citations. In sum, although non-specific journals for pathology and oral medicine published the majority of the 100 most-cited papers, this biometric citation study show that head and neck cancer was the issue with the most citations. Together, these results make an important scientific contribution by providing a historical perspective on the research carried out.
... Moreover, OMR specialist as a private practitioner have a better knowledge of logistic use of drug preparations like medium/ high potency topical steroidal orapaste, chemotherapeutic orapaste and mouthwashes, antihistaminic orapaste, miracle mouthwashes, immunomodulators, mucin stimulators, antibiotics, saliva substitutes, nonfoaming nonflavored tooth paste preparations, Benzydiamine mouth washes, probiotics, etc., that may prove valuable to maintain a long symptom-free period in patients. [16] challenges faced by oMr specIalIst In settIng of prIvate practIce 1. Priority one: "Lack of referrals from medical/general dental practitioners." 2. Priority two: "Lack of awareness among patients regarding Oral physicians as specialist in treating oral mucosal lesions." 3. Priority three: "Including OMR specialist in Oncology teams." 4. Priority four: "Head and Neck cancer patients lacking awareness about oral medicine and radiology dental speciality." 5. Priority five: "Overlapped OPD with dermatology, ENT, and oncology." 6. Priority six: "Lack of awareness for dental radiologist as diagnostic and interventional imageologist." ...
Practicing Oral Medicine and Radiology in Private Setup: A Comprehensive Review
... Moreover, OMR specialist as a private practitioner have a better knowledge of logistic use of drug preparations like medium/ high potency topical steroidal orapaste, chemotherapeutic orapaste and mouthwashes, antihistaminic orapaste, miracle mouthwashes, immunomodulators, mucin stimulators, antibiotics, saliva substitutes, nonfoaming nonflavored tooth paste preparations, Benzydiamine mouth washes, probiotics, etc., that may prove valuable to maintain a long symptom-free period in patients. [16] challenges faced by oMr specIalIst In settIng of prIvate practIce 1. Priority one: "Lack of referrals from medical/general dental practitioners." 2. Priority two: "Lack of awareness among patients regarding Oral physicians as specialist in treating oral mucosal lesions." 3. Priority three: "Including OMR specialist in Oncology teams." 4. Priority four: "Head and Neck cancer patients lacking awareness about oral medicine and radiology dental speciality." 5. Priority five: "Overlapped OPD with dermatology, ENT, and oncology." 6. Priority six: "Lack of awareness for dental radiologist as diagnostic and interventional imageologist." ...
Oral Medicine and Radiology (OMR) branch is an important bridge between Dentistry and Medicine and it must not be regarded largely as an institutional specialty. The vitality of the specialty can be advanced through establishment of an independent Private practice (PP) option as is found in all other clinical dental specialities. The option of PP might create broader appeal for entry into specialty and moreover, the patients also can avail the expertise of Oral physician more easily. Therefore, together we need to develop a global strategy to promote the clinical practice of Oral Medicine among patients and all other healthcare professionals to increase awareness of the speciality.
... 6 Unfortunately, all countries have cast-off the medical training required for oral medicine. 7 One of the early pioneers in the field was, Dr. McCarthy who first introduced oral medicine lectures at a dental school (Tufts), in 1925. 8 Dr. Sidney Sorrin formed the first large oral medicine society in the world, termed the Academy of Dental Medicine, which is now called the American Academy of Oral Medicine (AAOM). ...
Background
Health professionals are known to use various combinations of knowledge and skills, such as critical thinking, clinical reasoning, clinical judgment, problem-solving, and decision-making, in conducting clinical practice. Clinical reasoning development is influenced by knowledge and experience, the more knowledge and experience, the more sophisticated clinical reasoning will be. However, clinical reasoning research in dentistry shows varying results .
Aims
This study aims to observe the clinical reasoning pattern of undergraduate dental students when solving oral health problems, and their accordance with their knowledge acquisition.
Material and methods
This qualitative study employed the think-aloud method and the result was assessed through verbal protocol analyses. Five respondents from final year dental undergraduate students were agreed to participate. A unique hypothetical clinical scenario was used as a trigger. The audio data were transcribed, interpreted, and categorized as a clinical reasoning pattern; and the concept maps created were assessed by a Structure of Learning Outcomes (SOLO) taxonomy as knowledge acquisition.
Results
Observations on clinical reasoning patterns and the level of knowledge acquisition in five undergraduate dental students showed varying results. They applied clinical reasoning patterns according to their knowledge acquisition during didactical phase. Learners with inadequate knowledge relied on guessing, meanwhile learners with adequate knowledge applied more sophisticated reasoning pattern when solving problems.
Conclusions
Various problem-solving strategies were encountered in this study, which corresponded to the level of knowledge acquisition. Dental institutions must set minimum standards regarding the acquisition of conceptual knowledge accompanied by improvement of clinical reasoning skills, as well as refinement of knowledge and procedural skills.
Background:
During the past decades, the rapid development of modern teaching tools and methods has been observed, and the new teaching module constructed through digitization or networking has been widely used in the field of medical education. This study aimed to investigate the effectiveness and acceptability of the online learning combined with case-based discussion (CBD) approach in oral medicine education.
Methods:
Sixty senior students majoring in stomatology were randomly divided into two groups. One group (new module-based teaching group [NG], n = 30) watched an online teaching video and discussed clinical cases in groups. The control group (traditional lecture-based group [TG], n = 30) was assigned to the traditional lecture-based teaching. Subsequently, a theory assessment was conducted on the topics taught, and the scores of both groups were compared. Feedback about this teaching model was obtained from the NG.
Results:
The results showed that students in the NG had significantly better performance in terms of mastering professional knowledge than did students in the TG. Moreover, most students in the NG had a high degree of satisfaction with this new teaching method, as they agreed that it can mobilize their learning enthusiasm and promote their engagement, interaction, and cooperation in the learning of oral medicine.
Conclusions:
Our findings indicate the effectiveness and high satisfaction of CBD combined with online learning in the teaching of oral medicine. This study is expected to provide new ideas for improving the dental teaching quality.
Objective
The aim of this study was to examine the awareness level among general dental practitioners and medical practitioners with regard to common oral mucosal diseases and orofacial pain, investigate their orofacial screening and oral medicine referral practices, assess the information to be included in the referral, and evaluate the perceived need for supplementary resources and guidelines for referral.
Study Design
In total, 51 general dental practitioners and medical practitioners were recruited to investigate their orofacial screening and oral medicine referral practices. Three oral medicine specialists were interviewed to understand the referrals received from dentists and physicians.
Results
Of the participants, 87.5% dentists and 52.6% physicians considered orofacial screening as treatment priority. However, 71.9% dentists performed orofacial screening routinely, whereas none of the physicians did. Of the dentists, 50% referred relevant patients to oral medicine specialists every time they encountered such cases, and 31.6% of the physicians did so. Referrals should include the patient’s background and medical history, full descriptions of the lesions, and results and photos from special tests. Of the participants, 65.6% of the dentists and 78.9% of the physicians believed that continuing professional development courses in oral medicine would be beneficial, and 93.8% of the dentists and 89.5% of the physicians agreed that standardized national referral guidelines would be useful.
Conclusions
Standardized national referral guidelines, as well as continuing professional development courses in oral medicine, would be helpful to dental practitioners in the management of patients.
Oral medicine (stomatology) is a recognized and increasingly important dental specialty in many parts of the world that recognizes and fosters the interplay between medical health and oral health. Its dental activities rely greatly on the underlying biology of disease and evidence-based outcomes. However, full recognition of the importance of oral medicine to patient care, research, and education is not yet totally universally acknowledged. To address these shortcomings, we outline the birth, growth, and future of oral medicine globally, and record identifiable past contributions to the development of the specialty, providing an accurate, unique, and valuable resource on oral medicine. Although it was challenging to gather the data, we present this information as a review that endeavors to summarize the salient points about oral medicine, based on MEDLINE, other internet searches, communication with oral medicine and stomatological societies across the world, the web page http://en.wikipedia.org/wiki/List-of-dental-organizations, and discussions with a wide range of key senior persons in the specialty.
Graphs of tooth decay trends for 12 year olds in 24 countries, prepared using the most recent World Health Organization data, show that the decline in dental decay in recent decades has been comparable in 16 nonfluoridated countries and 8 fluoridated countries which met the inclusion criteria of having (i) a mean annual per capita income in the year 2000 of US$10,000 or more, (ii) a population in the year 2000 of greater than 3 million, and (iii) suitable WHO caries data available. The WHO data do not support fluoridation as being a reason for the decline in dental decay in 12 year olds that has been occurring in recent decades.
The health care delivery system is poised for substantial change in the coming years. The foremost vector driving this change is economics. However, use of evidence-based principles of practice and a high desire, if not a national mandate, for increased quality in health care delivery are also very important factors. Nestled within this large national health care debate are a set of issues that directly impact dental education and practice. Among them is the potential impact of expanded intraprofessional and interprofessional collaborations among dentists, dental therapists, dental hygienists, and nurse practitioners, among others, in search of better oral and general health care for all Americans. This article explores many of the issues involved in this possible transition with special reference to the impact of the changes on dental education.
88 members of the UK specialty society of oral medicine were asked about career satisfaction and their views on training programmes. 70% responded (79% of consultants and all accredited trainees). Men work longer hours than women, report less control over their work and experience more stress. Although high work satisfaction is reported, nearly one-third regret their choice of specialty. Men more than women do locum work while training. Most respondents would welcome flexible training, job shares, financial support during training and a mentoring scheme.
This article reviews trends in dental caries, periodontal disease, and tooth loss for the United States along with population dynamics and risk factors that might influence these trends going forward. Dental caries experience remains high in the primary dentition. Caries severity in permanent teeth of children has declined to historically low levels, and long-standing inequalities in untreated caries appear to be narrowing. Declines in caries severity of children's permanent teeth have stabilized at a low level, but likely will contribute to future reductions in dental caries severity in adults. The prevalence of periodontal disease is high in adults, and only a small percentage have severe forms of the disease. Countervailing trends in determinants would suggest little change in the prevalence of periodontal disease in the future, but the lack of an obvious trend over the last two decades makes projections uncertain. Tooth loss as a consequence of dental disease has declined markedly over the last half century and has been all but eliminated in high-income groups. However, notable exceptions to these favorable trends are evident. Progress in prevention policies and programs that affect disease experience appears slower than progress in meeting population-level caries treatment needs. Clearly, long-standing inequities related to political and social determinants remain for all dental diseases, and income disparities in dental disease are widening for some indicators. Growing inequalities raise ethical and public health concerns that should be prominent in discussions of dental workforce needs and strategies for the next 25 years. This article was written as part of the project "Advancing Dental Education in the 21(st) Century."
Advanced dental education has evolved in the context of societal needs and economic trends to its current status. Graduate programs have positioned their role in the context of health systems and health science education trends in hospitals, interprofessional clinical care teams, and dental schools and oral health care systems. Graduate dental education has been a critical factor in developing teams in trauma care, craniofacial disorders, pediatric and adult medicine, and oncology. The misalignment of the mission of graduate dental programs and the demands of private practice has posed a challenge in the evolution of programs as educational programs have been directed towards tertiary and indigent care while the practice community focuses on largely healthy affluent patients for complex clinical interventions. Those seeking graduate dental education today are smaller in number and include more international dental graduates than in the past. Graduate dental education in general dentistry and in the nine recognized dental specialties now includes Commission on Dental Accreditation (CODA) recognition of training standards as part of its accreditation process and a CODA accreditation process for areas of clinical education not recognized as specialties by the American Dental Association. Current types of programs include fellowship training for students in recognized specialties. This article was written as part of the project "Advancing Dental Education in the 21(st) Century."
Medical providers of all types are beginning to engage in oral health, both academically and in practice. The process has been slow; however, momentum has increased over the past two decades as major health care organizations have emphasized the importance of oral health as a vital part of overall health. This article begins by defining which health providers have and should engage the public in oral health and then briefly reviews the influences that have led health professionals to address oral health in education and practice. This overview is followed by an examination of current trends and successes in oral health education in the health sciences, why oral health is a natural fit for medical care, and the need for a comprehensive approach. The article concludes by exploring roles for each profession and addressing the resources and political will that will be required to meet common goals. This article was written as part of the project "Advancing Dental Education in the 21(st) Century."
In the light of our decades of observations and experience in the field, we have chosen as the topic of this editorial to address the training of specialists in oral medicine and, as an unavoidable by-product, the education of dentists. As givens, dentistry is often defined as the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, commonly those of the dentition but also the oral mucosa, and of adjacent and related structures and tissues, particularly in the maxillofacial area. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
Objectives:
Tooth retention has improved over the past few decades, but it is not known whether these trends have been observed across all demographic/socioeconomic subgroups. We examined number of missing teeth among dentate individuals (n = 9,113) as well as edentulism and systematically modeled their trends over time by using clinical examination data.
Methods:
We investigated the association between social stratification and trends in tooth retention among adults ages 50+ from 1988 to 2004, using four waves of the National Health and Nutrition Examination Surveys (NHANES) (n = 11,812).
Results:
The prevalence of edentulism declined from 24.6% in NHANES III (1988-1994) to 17.4% in 2003-2004, and the mean number of missing teeth declined from 8.19 to 6.50. Older participants, Blacks, the less educated and those with lower income were higher on both edentulism and number missing teeth. Both edentulism and number of missing teeth declined over time, but their patterns varied. For edentulism, age and socioeconomic related disparities decreased over time due to more decline among older and low-income participants. For missing teeth, there was less decrement among older and low-income participants, resulting in increased age and socioeconomic related disparities.
Conclusions:
Our study found disparities in trends of tooth loss across demographic/socioeconomic strata. Findings suggest that racial/ethnic disparities are partially explained by socioeconomic status. Interventions designed to improve oral health for older adults, particularly those with low levels of income, need special attention.
Oral medicine is a specialized area of study within the scope of dental medicine. This discipline is often viewed as the crossroads between medicine and dentistry and has become integral in both pre-and postdoctoral dental education. Oral medicine is recognized as a dental specialty throughout most of the world and currently represents an emerging specialty in the United States. Historically, oral medicine has been loosely defined in the United States without a clear consensus definition. Recent published studies regarding international oral medicine postdoctoral programs and clinical practice have helped to provide more specific information regarding oral medicine from many perspectives. This article will review the literature relevant to defining oral medicine in the United States and present a new definition of this important discipline based on recent studies.
(i) To define the current state of oral medicine clinical practice internationally, and (ii) to make recommendations for future modeling of the practice of oral medicine.
A survey was designed by an international panel of oral medicine experts to assess the current state of oral medicine practice internationally. The survey was sent to oral medicine experts across the world, and responses were electronically stored and analyzed using descriptive statistics.
Two hundred respondents completed the survey representing 40 countries from six continents. The two most common settings for an oral medicine practice were in a hospital and a dental school. More than 88% of respondents considered management of oral mucosal disease, salivary dysfunction, oral manifestations of systemic diseases, and facial pain in the definition of oral medicine.
(i) Oral medicine clinicians diagnose and manage a wide variety of orofacial conditions; (ii) There are significant differences in the definition of oral medicine clinical practice from country to country; (iii) India has the largest expansion of oral medicine services as defined by escalating numbers of clinicians within the specialty as compared with other countries; (iv) oral medicine practitioners have a wide range of professional responsibilities.
The aim of this preliminary study was to investigate postgraduate Oral Medicine training worldwide and to begin to identify minimum requirements and/or core content for an International Oral Medicine curriculum.
Countries where there was believed to be postgraduate training in Oral Medicine were identified by the working group. Standardized emails were sent inviting participants to complete an online survey regarding the scope of postgraduate training in Oral Medicine in their respective countries.
We received 69 total responses from 37 countries. Of these, 22 countries self-identified as having postgraduate Oral Medicine as a distinct field of study, and they served as the study group. While there is currently considerable variation among Oral Medicine postgraduate training parameters, there is considerable congruency in clinical content of the Oral Medicine syllabi. For example, all of the training programs responded that they did evaluate competence in diagnosis and management of oral mucosal disease.
This preliminary study provides the first evidence regarding international Oral Medicine postgraduate training, from which recommendations for an international core curriculum could be initiated. It is through such an initiative that a universal clinical core syllabus in postgraduate Oral Medicine training may be more feasible.
This paper relates recent modes of dental practice to changes that the public and government are likely to ask the health care professions to make in the future. As usual they are asking for the best of all worlds. First, that we maintain the clinical model to the highest standards of personal dental care based and tested against the best research at our disposal, whilst we ensure there is no reduction in the high technical standards for which british dentists have a reputation. Second, that the profession is required to consider ways of providing care on the medicosocial model for the whole community at an economic level the country will afford. The broad changes in dental education have been reviewed, from the technical apprenticeship to the establishment of strong university departments in teaching hospitals. The importance of a sound biomedical foundation and of research both to education and the credibility of dental practice as a primary health care profession is stressed if the profession is to retain its position as a sister to medicine and not slide down to that of a technical ancillary.
Number of Practicing Dentists per Capita in the United States Will Grow Steadily
- B Munson
- M Vujicic
Munson, B., & Vujicic, M. (2016). Number of Practicing Dentists per Capita in the
United States Will Grow Steadily, ADA, Health Policy Institute.
http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0
616_1.pdf Accessed on August 5, 2017.
Oral Medicine (Stomatology) across the globe: birth, growth, and future. Oral Surgery Oral Medicine Oral Pathology Oral Radiology The Future of Oral Health Care Provided by Physicians and Allied Professionals
- C Scully
- C S Miller
- J M A Urizar
- I Alajbeg
- O P D Almeida
- J V Bagan
- K Birek
- Y Zadik
Scully, C., Miller, C.S., Urizar, J.M.A., Alajbeg, I., Almeida, O.P.D., Bagan, J.V.,
Birek, K.,.Zadik, Y. (2016). Oral Medicine (Stomatology) across the globe: birth,
growth, and future. Oral Surgery Oral Medicine Oral Pathology Oral Radiology 121:
149-157. doi: 10.1016/j.oooo.2015.10.009
17.
Silk H (2017). The Future of Oral Health Care Provided by Physicians and Allied
Professionals, Journal of Dental Education, 81(Suppl 8): eS171-eS179.
doi:10.21815/JDE.017.024
The patient will see you now. The future of medicine is in your hand. Basic Books. 22. US Census Bureau
- E Topol
Topol E (2015). The patient will see you now. The future of medicine is in your
hand. Basic Books.
22.
US Census Bureau, Occupations at the Twelfth Census,
https://www.census.gov/prod/www/decennial.html. Accessed on August 5, 2017
23.
Vesalii, Andreae bruxellensis, scholae medicorum Patavinae professoris, de
Predicting the future. Oral Surgery Oral Medicine Oral Pathology Oral Radiology
- C S Miller
Miller, C.S. (2016). Predicting the future. Oral Surgery Oral Medicine Oral
Pathology Oral Radiology 121: 113-114. DOI: 10.1016/j.oooo.2015.10.022
Andreae bruxellensis, scholae medicorum Patavinae professoris, de Humani corporis fabrica Libri septem, Basileae, ex officina Ioannis Oporini
- Vesalii
Vesalii, Andreae bruxellensis, scholae medicorum Patavinae professoris,
de Humani corporis fabrica Libri septem, Basileae, ex officina Ioannis
Oporini. (1543). Basel, Chapter 11: 45.
Oral medicine: Defining an emerging specialty in the United States
- T P Solecito
- H Rogers
- L Prescott-Clements
- D H Felix
- R Kerr
- D Wray
- P Shirlaw
- E T Stoopler
Solecito, T.P., Rogers, H., Prescott-Clements, L., Felix, D.H., Kerr, R., Wray, D.,
Shirlaw, P.,.Stoopler, E.T. (2013). Oral medicine: Defining an emerging specialty in
the United States, Journal of Dental Education 77: 392-394.
Dental education at a crossroads: challenges and change
- M. J. Field
Curriculum, Table 1. Dental School Curricular Hours
ADA. 2010-11. Survey of Dental Education, Volume 4: Curriculum, Table
1. Dental School Curricular Hours 2010-2011. Retrieved from http://
www.ada.org/~/media/ADA/Science%20and%20Research/HPI/
Files/SDE4_2010-11_final.xlsx?la=en.
Occupations at the Twelfth Census
- Us Census
- Bureau
US Census Bureau. Occupations at the Twelfth Census. Retrieved from
https://www.census.gov/prod/www/decennial.html.
Dental Education at a Crossroads: Challenges and Change, Institute of Medicine (US) Committee on the Future of Dental Education
- M J Field
Field, M.J. (ed) (1995). Dental Education at a Crossroads: Challenges and Change,
Institute of Medicine (US) Committee on the Future of Dental Education, editor.
Washington (DC): National Academies Press (US); Chapter 2. p. 39.
http://www.nap.edu/catalog/4925.html
Oral medicine: Defining an emerging specialty in the United States
- Solecito