An oral medicine or stomatology doctor (or stomatologist) has received additional specialized training and experience in the diagnosis and management of oral mucosal abnormalities (growths, ulcers, infection, allergies, immune-mediated and autoimmune disorders) including oral cancer, salivary gland disorders, temporomandibular disorders (e.g.: problems with the TMJ) and facial pain (due to musculoskeletal or neurologic conditions), taste and smell disorders; and recognition of the oral manifestations of systemic and infectious diseases. It lies at the interface between

medicine Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pract ...

and

dentistry Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions o ...

. An oral medicine doctor is trained to diagnose and manage patients with disorders of the orofacial region, essentially as a "physician of the mouth."

History

The importance of the mouth in medicine has been recognized since the earliest known medical writings. For example,

Hippocrates Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of ...

Galen Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be one of ...

and others considered the tongue to be a "

barometer A barometer is a scientific instrument that is used to measure air pressure in a certain environment. Pressure tendency can forecast short term changes in the weather. Many measurements of air pressure are used within surface weather analysis ...

" of health, and emphasized the diagnostic and prognostic importance of the tongue. However, oral medicine as a specialization is a relatively new subject area. It used to be termed "stomatology" (-'' stomato-'' + ''

-ology ''-logy'' is a suffix in the English language, used with words originally adapted from Ancient Greek ending in ('). The earliest English examples were anglicizations of the French '' -logie'', which was in turn inherited from the Latin ''-logia ...

''). In some institutions, it is termed "oral medicine and oral diagnosis". American physician and dentist, Thomas E Bond authored the first book on oral and maxillofacial pathology in 1848, entitled "A Practical Treatise on Dental Medicine". The term "oral medicine" was not used again until 1868.

Jonathan Hutchinson Sir Jonathan Hutchinson (23 July 1828 – 23 June 1913), was an English surgeon, ophthalmologist, dermatologist, venereologist, and pathologist. Life He was born in Selby, Yorkshire, of Quaker parents and educated in the local school. Then he ...

is also considered the father of oral medicine by some. Oral medicine grew from a group of New York dentists (primarily periodontists), who were interested in the interactions between medicine and dentistry in the 1940s. Before becoming its own specialty in the United States, oral medicine was historically once a subset of the specialty of

periodontics Periodontology or periodontics (from Ancient Greek , – 'around'; and , – 'tooth', genitive , ) is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting ...

, with many

periodontists Periodontology or periodontics (from Ancient Greek , – 'around'; and , – 'tooth', genitive , ) is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting ...

achieving board certification in oral medicine as well as periodontics.

Scope

Oral medicine is concerned with clinical diagnosis and non-surgical management of non-dental pathologies affecting the orofacial region (the mouth and the lower face). Many systemic diseases have signs or symptoms that manifest in the orofacial region. Pathologically, the mouth may be affected by many cutaneous and gastrointestinal conditions. There is also the unique situation of hard tissues penetrating the epithelial continuity (hair and nails are intra-epithelial tissues). The biofilm that covers teeth therefore causes unique pathologic entities known as plaque-induced diseases. Example conditions that oral medicine is concerned with are lichen planus, Behçet's disease and pemphigus vulgaris. Moreover, it involves the diagnosis and follow-up of pre-malignant lesions of the oral cavity, such as leukoplakias or erythroplakias and of chronic and acute pain conditions such as paroxysmal neuralgias, continuous neuralgias, myofascial pain, atypical facial pain, autonomic cephalalgias, headaches and migraines. Another aspect of the field is managing the dental and oral condition of medically compromised patients such as cancer patients with 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, such as burning mouth syndrome, trigeminal neuralgia and temporomandibular joint disorder.

Lumps and swellings of the mouth

Types of lumps and swelling

It is not uncommon for an individual to experience a lump/swelling in the oral environment. The overall presentation is highly variable and the progression of these lesions can also differ, for example: development of a lesion into a bulla or a malignant neoplasm. Lumps and swellings can occur due to a variety of conditions, both benign and malignant such as: * Normal variation lesions **

Pterygoid hamulus The pterygoid hamulus is a hook-like process at the lower extremity of the medial pterygoid plate of the sphenoid bone of the skull. It is the superior origin of the pterygomandibular raphe, and the levator veli palatini muscle. Structure The p ...

: This is a hook-shaped structure protruding postero-laterally from the inferior boundary of the medial plate of the pterygoid process ** Parotid papillae: This is the exiting duct from the parotid gland which is commonly found adjacent to the upper second molar on the buccal mucosa **

Lingual papillae Lingual papillae (singular papilla) are small structures on the upper surface of the tongue that give it its characteristic rough texture. The four types of papillae on the human tongue have different structures and are accordingly classified as c ...

: Seen covering the dorsum of the tongue * Inflammatory **

Abscess An abscess is a collection of pus that has built up within the tissue of the body. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pressed. The area of redness often extends b ...

: An abscess is a painful collection of pus, usually caused by a bacterial infection **

Cellulitis Cellulitis is usually a bacterial infection involving the inner layers of the skin. It specifically affects the dermis and subcutaneous fat. Signs and symptoms include an area of redness which increases in size over a few days. The borders of t ...

: Commonly due to a bacterial infection spreading to the deeper layers of the skin leading to a multitude of complications **

Cysts A cyst is a closed sac, having a distinct envelope and division compared with the nearby tissue. Hence, it is a cluster of cells that have grouped together to form a sac (like the manner in which water molecules group together to form a bubble) ...

: A cyst is an epithelial lined sac of tissue that has either fluid or semi-fluid content inside **

Sialadenitis Sialadenitis (sialoadenitis) is inflammation of salivary glands, usually the major ones, the most common being the parotid gland, followed by submandibular and sublingual glands. It should not be confused with sialadenosis (sialosis) which is a non ...

: Infection of the salivary glands **

Pyogenic granuloma A pyogenic granuloma or lobular capillary hemangioma is a vascular tumor that occurs on both mucosa and skin, and appears as an overgrowth of tissue due to irritation, physical trauma, or hormonal factors. It is often found to involve the gums, ...

: Is a relatively common, tumor-like, exuberant tissue response to localized irritation or trauma * Chronic granulomatous disorders **

Orofacial granulomatosis Orofacial granulomatosis (OFG) is a condition characterized by persistent enlargement of the soft tissues of the mouth, lips and the area around the mouth on the face, causing in most cases extreme pain. The mechanism of the enlargement is granulom ...

: This is an uncommon condition but is seen to be increasing in prevalence. This condition presents with facial/labial swellings commonly accompanied with angular stomatitis or cracked lips, ulcers, mucosal tags, cobblestone mucosea or gingival swellings **

Crohn's disease Crohn's disease is a type of inflammatory bowel disease (IBD) that may affect any segment of the gastrointestinal tract. Symptoms often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, abdominal distension ...

: This is a disease affecting the bowel but commonly has oral lesions associated. Examples of some oral presentations are: raised gingival lesions, hyperplastic folds/cobble-stone mucosa, ulcers, facial swelling and/or angular cheilitis **

Sarcoidosis Sarcoidosis (also known as ''Besnier-Boeck-Schaumann disease'') is a disease involving abnormal collections of inflammatory cells that form lumps known as granulomata. The disease usually begins in the lungs, skin, or lymph nodes. Less commonly af ...

: Sarcoidosis is a multi-system condition which may lead to gingival enlargement or salivary gland swelling which may result in xerostomia * Developmental ** Unerupted teeth **

Odontogenic cysts Odontogenic cyst are a group of jaw cysts that are formed from tissues involved in odontogenesis (tooth development). Odontogenic cysts are closed sacs, and have a distinct membrane derived from rests of odontogenic epithelium. It may contain air, ...

Eruption cysts An eruption cyst, or eruption hematoma, is a bluish swelling that occurs on the soft tissue over an erupting tooth. It is usually found in children. The fluid in the cyst is sometimes clear creating a pale-coloured cyst although often they are blu ...

Haemangioma A hemangioma or haemangioma is a usually benign vascular tumor derived from blood vessel cell types. The most common form, seen in infants, is an infantile hemangioma, known colloquially as a "strawberry mark", most commonly presenting on the ski ...

Lymphangioma Lymphangiomas are malformations of the lymphatic system characterized by lesions that are thin-walled cysts; these cysts can be macroscopic, as in a cystic hygroma, or microscopic. The lymphatic system is the network of vessels responsible for ...

Palatal tori A torus palatinus (pl. tori palatini), or palatal torus (pl. palatal tori), is a bony protrusion on the palate. Palatal tori are usually present on the midline of the hard palate.Neville, B.W., D. Damm, C. Allen, J. Bouquot. ''Oral & Maxillofaci ...

and

mandibular tori Torus mandibularis is a bony growth in the mandible along the surface nearest to the tongue. Mandibular tori are usually present near the premolars and above the location of the mylohyoid muscle's attachment to the mandible. In 90% of cases, ther ...

: formation of new bone upon the surface of a present bone **

Lingual thyroid Thyroid dysgenesis is a cause of congenital hypothyroidism where the thyroid is missing, ectopic, or severely underdeveloped. It should not be confused with iodine deficiency, or with other forms of congenital hypothyroidism, such as thyroid dysho ...

: this is an abnormal mass of ectopic thyroid tissue seen at the base of tongue * Traumatic ** Denture-induced hyperplasia **

Epulis Epulis ( gr, ἐπουλίς; plural ''epulides'') is any tumor like enlargement (i.e. lump) situated on the gingival or alveolar mucosa. The word literally means "(growth) on the gingiva", and describes only the location of the mass and has no fu ...

** Fibroepithelial polyp **

Haematoma A hematoma, also spelled haematoma, or blood suffusion is a localized bleeding outside of blood vessels, due to either disease or trauma including injury or surgery and may involve blood continuing to seep from broken capillaries. A hematoma is b ...

Mucocele A mucocele is a distension of a hollow organ or cavity because of mucus buildup. By location Oral Oral mucocele is the most common benign lesion of the salivary glands generally conceded to be of traumatic origin. It is characterized by the pool ...

** Surgical emphysema * Hormonal ** Pregenancy epulis ** Oral contraceptive pill

gingivitis Gingivitis is a non-destructive disease that causes inflammation of the gums. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms (also called plaque) that is attached ...

* Metabolic **

Amyloidosis Amyloidosis is a group of diseases in which abnormal proteins, known as amyloid fibrils, build up in tissue. There are several non-specific and vague signs and symptoms associated with amyloidosis. These include fatigue, peripheral edema, weight ...

* Drugs **

Phenytoin Phenytoin (PHT), sold under the brand name Dilantin among others, is an anti-seizure medication. It is useful for the prevention of tonic-clonic seizures (also known as grand mal seizures) and focal seizures, but not absence seizures. The intr ...

Calcium channel blockers Calcium channel blockers (CCB), calcium channel antagonists or calcium antagonists are a group of medications that disrupt the movement of calcium () through calcium channels. Calcium channel blockers are used as antihypertensive drugs, i.e., as ...

Ciclosporin Ciclosporin, also spelled cyclosporine and cyclosporin, is a calcineurin inhibitor, used as an immunosuppressant medication. It is a natural product. It is taken orally or intravenously for rheumatoid arthritis, psoriasis, Crohn's disease, ...

* Allergy **

Angioedema Angioedema is an area of swelling ( edema) of the lower layer of skin and tissue just under the skin or mucous membranes. The swelling may occur in the face, tongue, larynx, abdomen, or arms and legs. Often it is associated with hives, which ...

* Infective **

HPV Human papillomavirus infection (HPV infection) is caused by a DNA virus from the '' Papillomaviridae'' family. Many HPV infections cause no symptoms and 90% resolve spontaneously within two years. In some cases, an HPV infection persists and re ...

* Fibro-osseous **

Cherubism Cherubism is a rare genetic disorder that causes prominence in the lower portion in the face. The name is derived from the temporary chubby-cheeked resemblance to putti, the chubby-faced infants featured in Renaissance paintings, which were often m ...

Fibrous dysplasia Fibrous dysplasia is a disorder where normal bone and marrow is replaced with fibrous tissue, resulting in formation of bone that is weak and prone to expansion. As a result, most complications result from fracture, deformity, functional impairme ...

** Paget's disease * Neoplasms **

Carcinoma Carcinoma is a malignancy that develops from epithelial cells. Specifically, a carcinoma is a cancer that begins in a tissue that lines the inner or outer surfaces of the body, and that arises from cells originating in the endodermal, mesodermal ...

** Leukeamia **

Lymphoma Lymphoma is a group of blood and lymph tumors that develop from lymphocytes (a type of white blood cell). In current usage the name usually refers to just the cancerous versions rather than all such tumours. Signs and symptoms may include enlar ...

Myeloma Multiple myeloma (MM), also known as plasma cell myeloma and simply myeloma, is a cancer of plasma cells, a type of white blood cell that normally produces antibodies. Often, no symptoms are noticed initially. As it progresses, bone pain, anemi ...

Odontogenic tumours An odontogenic tumor is a neoplasm of the cells or tissues that initiate odontogenic processes. Examples include: * Adenomatoid odontogenic tumor * Ameloblastic fibroma * Ameloblastic fibro-odontoma * Ameloblastoma, a type of odontogenic tum ...

** Minor salivary gland tumours So as seen above the list is extensive and by no means is this a complete and comprehensive representation of all the possible lumps/swellings that can occur in the mouth as to the means of acquiring a swelling in the mouth. When considering what a lump might be caused by the site of which it has appeared can be of significance. Below are some examples of swellings/lumps which usually are present as specific locations in the oral cavity: * Gingiva ** Congenital hyperplasia ** Abscesses ** Pyogenic granuloma ** Neoplastic ** Pregnancy epulis ** Drug-induced hyperplasia ** Angioedema ** Papilloma/warts * Palate ** Torus palatinus ** Abscesses ** Unerupted teeth ** Pleomorphic adenomas/salivary neoplasms ** Invasive carcinoma from maxillary sinus **

Kaposi’s sarcoma Kaposi's sarcoma (KS) is a type of cancer that can form masses in the skin, in lymph nodes, in the mouth, or in other organs. The skin lesions are usually painless, purple and may be flat or raised. Lesions can occur singly, multiply in a limit ...

** Developmental swellings associated with Paget's disease * FOM ** Most commonly salivary calculi and denture-induced hyperplasia **

Ranula A ranula is a mucus extravasation cyst involving a sublingual gland and is a type of mucocele found on the floor of the mouth. Ranulae present as a swelling of connective tissue consisting of collected mucin from a ruptured salivary gland caus ...

** Mandibular tori * Tongue and buccal mucosa ** Congenital haemangioma ** Congenital macroglossia ** Mucocele ** Vesiculobullous lesions **

Ulcers An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing o ...

Hyperplasia Hyperplasia (from ancient Greek ὑπέρ ''huper'' 'over' + πλάσις ''plasis'' 'formation'), or hypergenesis, is an enlargement of an organ or tissue caused by an increase in the amount of organic tissue that results from cell proliferati ...

Diagnosis of the cause of a lump or swelling

If there is any suspect or unknown reason as to why a lump has arisen In an individuals mouth it is important to establish when this first was noticed and the accompanied symptoms if any. On examination ensure that there is not an obvious cause to the swelling/lump via a thorough: medical, social, dental and family history, followed by an oral examination. Whilst examining the suspected lesion there are some diagnostic aids to note which can be used to formulate a provisional diagnosis. There are many factors taken into consideration in this diagnosis, such as: * The anatomical position & symmetry ** Midline associated lesions tend to be of a developmental origin (e.g. torus palatinus) ** Bilateral lesions tend to be benign (e.g.

sialosis Parotitis is an inflammation of one or both parotid glands, the major salivary glands located on either side of the face, in humans. The parotid gland is the salivary gland most commonly affected by inflammation. Etymology From Greek παρωτῖ ...

, diabetes etc.) ** Consider associations with surrounding anatomical structures ** Malignant lesions are usually unilateral * Size and shape ** Diagrams or photographs are usually recorded alongside the actual measurement of the lesion * Colour ** Brown and black pigmentation may occur from a variety of aetiologies s such as: tattoo, naeuvus,

melanoma Melanoma, also redundantly known as malignant melanoma, is a type of skin cancer that develops from the pigment-producing cells known as melanocytes. Melanomas typically occur in the skin, but may rarely occur in the mouth, intestines, or eye ( ...

** Purple or red pigmentation may occur due to conditions such as: haemangioma, kaposi's sarcoma or a giant cell lesion * Temperature ** If the lesion is warm it is thought an inflammatory cause is most likely (e.g. abscess or haemangioma) * Tenderness ** If a lesion is significantly tender on palpation the origin is usually thought to be inflammatory * Discharge ** Are there any secretions associated with the lesion upon palpation or spontaneously occurring * Movement ** The lesion should be tested to determine whether it is attached to adjacent structures or the overlying mucosa * Consistency ** Carcinoma is usually suggested by a hard/indurated consistency ** If a lesion is palpated and a crackling, ‘egg shell’ sound occurs this tends to be a swelling overlying a bony cyst * Surface texture ** Abnormal vascular changes suggests neoplasm ** Malignant lesions tend to be nodular and may ulcerate ** Papillomas are usually comparative to a wart-like appearance * Ulceration ** Squamous cell carcinoma is an example of a malignancy which can present with superficial ulceration * Margin ** Malignant lesions tend to have an ill-defined margin ** Benign lesions tend to have a clearly defined margin * Number of lesions ** Multiple lesions might suggest an infective or developmental aetiology

Investigations

Once the surrounding tissues and the immediate management of any lumps/swellings are taken care of, an image of the full extent of the lesion is needed. This is done to establish what the lump/swelling is associated with and to ensure that any damaging probability is kept to a minimum. There are a variety of imaging technique options which are chosen based on the lesion: size, location, growth pattern etc. Some examples of images used are: DPT,

Scintigraphy Scintigraphy (from Latin ''scintilla'', "spark"), also known as a gamma scan, is a diagnostic test in nuclear medicine, where radioisotopes attached to drugs that travel to a specific organ or tissue (radiopharmaceuticals) are taken internally and ...

Sialography Sialography (also termed radiosialography) is the radiographic examination of the salivary glands. It usually involves the injection of a small amount of contrast medium into the salivary duct of a single gland, followed by routine X-ray projection ...

Computed Tomography A computed tomography scan (CT scan; formerly called computed axial tomography scan or CAT scan) is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers ...

Magnetic Resonance Imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio wave ...

and

Ultrasound Ultrasound is sound waves with frequency, frequencies higher than the upper audible limit of human hearing range, hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hea ...

. As described some lumps or swellings can be in close relation to anatomical structures. Commonly, Teeth are associated in a lesion which brings about the question – “are they still vital?” In order to clarify, any tooth that is associated with a lump or swelling is vitality tested, examined for any pathology or restorative deficiencies in order to determine the long term prognosis of this tooth and how this might affect treatment of the lump/swelling at hand. Alongside any radiographs which may be justified, Blood tests may be needed in order to obtain a definitive diagnosis if there is a suspicion of potential

blood dyscrasia In medicine, both ancient and modern, a dyscrasia is any of various disorders. The word has ancient Greek roots meaning "bad mixture". The concept of dyscrasia was developed by the Greek physician Galen (129–216 AD), who elaborated a model of h ...

s or any endocrinopathy involvement. Finally, a particularly vital means of diagnosis is a biopsy. These tend to be regularly done in the cases of singular, chronic lesions and are carried out in an urgent manner as lesions of this category have a significant malignant potential. The indications to carry out a biopsy include: * Lesions that have neoplastic or premalignant features or are enlarging * Persistent lesions that are of uncertain aetiology * Persistent lesions that are failing to respond to treatment Once a small piece of tissue is removed for the biopsy, it is then microscopically histopathologically examined.

Training and practice

Australia

Australian programs are accredited by the Australian Dental Council (ADC). They are three years in length and culminate with either a master's degree (MDS) or a Doctor of Clinical Dentistry degree (DClinDent). Fellowship can then be obtained with the

Royal Australasian College of Dental Surgeons The Royal Australasian College of Dental Surgeons (RACDS) is a postgraduate professional education body established in 1965 to provide a broad range of activities to enhance the professional development of both general and specialist dentists thr ...

, FRACDS (Oral Med) and or the

Royal College of Pathologists of Australasia The Royal College of Pathologists of Australasia, more commonly known by its acronym RCPA is a medical organization that promotes the science and practice of pathology. The RCPA is a leading organisation representing pathologists and other sen ...

, FRCP.

Canada

Canadian programs are accredited by the Canadian Commission on Dental Accreditation (CDAC). They are a minimum of three years in length and usually culminate with a master's (MSc) degree. Currently, only the

University of Toronto The University of Toronto (UToronto or U of T) is a public research university in Toronto, Ontario, Canada, located on the grounds that surround Queen's Park. It was founded by royal charter in 1827 as King's College, the first institution ...

, the

University of Alberta The University of Alberta, also known as U of A or UAlberta, is a public research university located in Edmonton, Alberta, Canada. It was founded in 1908 by Alexander Cameron Rutherford,"A Gentleman of Strathcona – Alexander Cameron Rutherfor ...

, and the

University of British Columbia The University of British Columbia (UBC) is a public university, public research university with campuses near Vancouver and in Kelowna, British Columbia. Established in 1908, it is British Columbia's oldest university. The university ranks a ...

offer programs leading to the specialty. Most residents combine oral medicine programs with oral and maxillofacial pathology programs leading to a dual specialty. Graduates are then eligible to sit for the Fellowship exams with the Royal College of Dentists of Canada (FRCD(C)).

India

Indian programs are accredited by the Dental Council of India (DCI).Oral Medicine is in conjunction with oral radiology in India and it is taught in both graduate and post graduate levels as Oral Medicine and Radiology. They are three years in length and culminate with a master's degree (MDS) in Oral Medicine and Radiology.

New Zealand

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 ("Dare to be wise") , established = 1907 , city = Dunedin , country = New Zealand , websitehttps://www.otago.ac.nz/dentistry} University of Otago Faculty of Dentistry is one of the faculties of the University of Otago. Foun ...

currently offers a 5-year intercalated clinical doctorate/medical degree (DClinDent/MBChB) program. On 9 July 2013, the dental council of New Zealand proposed that the prescribed qualifications for oral medicine be changed to include the new DClinDent in addition to a medical degree, with no requirement for a standard dental degree.

United Kingdom

In the UK, oral medicine is one of the 13 specialties of dentistry recognized by the

General Dental Council The General Dental Council (GDC) is an organisation which regulates dental professionals in the United Kingdom. It keeps an up-to-date register of all qualified dentists and other dental care professionals such as: dental hygienists, dental ther ...

(GDC). The GDC defines oral medicine as: " oncerned withoral health care of patients with chronic recurrent and medically related disorders of the mouth and with their diagnosis and non-surgical management." Unlike many other countries, oral medicine physicians in the UK do not usually partake in the dental management of their patients. Some UK oral medicine specialists have dual qualification with both medical and dental degrees. However, in 2010 the GDC approved a new curriculum for oral medicine, and a medical degree is no longer a prerequisite for entry into specialist training. Specialist training is normally 5 years, although this may be reduced to a minimum of 3 years in recognition of previous training, such as a medical degree. In the UK, oral medicine is one of the smallest dental specialties. According to the GDC, as of December 2014 there were 69 clinicians registered as specialists in oral medicine. As of 2012, there were 16 oral medicine units across the UK, mostly based in dental teaching hospitals, and around 40 practising consultants. The British & Irish Society for Oral Medicine has suggested that there are not enough oral medicine specialists, and that there should be one consultant per million population. Competition for the few training posts is keen, although new posts are being created and the number of trainees increased.

United States

The

American Dental Association The American Dental Association (ADA) is an American professional association established in 1859 which has more than 161,000 members. Based in the American Dental Association Building in the Near North Side of Chicago, the ADA is the world's ...

(CODA) accredited programs are a minimum of two years in length. Oral medicine, is an

recognized speciality, and many oral medicine specialists fulfil a very important role by teaching at dental schools and graduate programs to ensure dentists and other dental specialists receive excellent training in medical topics pertinent to the dental practice. The ADA has recently started a dental practice parameters for world-class quality service

References

External links

British & Irish Society for Oral MedicineAmerican Academy of Oral MedicineOral Medicine Society of Australia and New ZealandInternational Academy of Oral MedicineEuropean Association of Oral Medicine

Indian Academy of Oral Medicine and Radiology
{{medicine Oral and maxillofacial surgery Dentistry branches Dentistry education