Guest Editorial

Abstract

Oral medicine is the dental specialty extending beyond the areas of health traditionally regarded as “dentistry” and bridging to those covered by the umbrella of “medicine”. International descriptions reflect this and oral medicine is defined as “the dental specialty placed at the interface between medicine and dentistry and is concerned with the diagnosis and management of (non-dental) pathology affecting the oral and maxillofacial region”. In Australia, oral medicine has existed comfortably within the fold of oral pathology and oral medicine over many years but this is historical and oral pathology (a diagnostic, laboratory based specialty) is now clearly a separate specialty with both specialties having defined training programmes, specialist registration requirements and career pathways. The Oral Medicine Society of Australia and New Zealand is the representative body and membership is open to general practitioners and specialists. This supplement on contemporary oral medicine is compiled as an aid to dental and medical practitioners, as well as undergraduate and postgraduate students. It presents papers provided by specialist practitioners in Australia, and the Journal gratefully acknowledges their contributions. All papers were invited and they reflect a small part of the contribution of oral medicine specialists to the oral and general health of Australian patients. It does not show the great contribution that specialists have made to science and knowledge within oral medicine over the past 50 years. Some readers will recall with gratitude the opportunity to study under scholars of the standing of Peter Reade, Ken Adkins, Ken Sutherland and Mark Jolly. The first paper in the supplement identifies papers published in the Australian Dental Journal over the past 10 years with relevance to oral medicine. It is only a thumbprint but it shows the strong activity in the discipline and the willingness of authors to publish for the Australian dental profession rather than internationally in specialty journals where access to Australian practitioners is difficult. Oral medicine is like most of the specialty areas of dental science in general practice. It provides an opportunity to enhance the routine health services to patients. It also provides the opportunity to add value to patient health with both surveillance, treatments and referrals that bridge from cautious clinical management to life-saving situations. Oral medicine specialists have a significant load of premalignant and malignant disease, and this reflects what is being seen and recognized in general practice. A single malignancy recognized in a practising lifetime is very likely a life saved. It makes all the effort worthwhile. A follow-on question examines the boundaries of responsibility of the dental practitioner and how these should be included in general dental practice. The focus of this supplement is exclusively on non-dental pathology but that does not make surveillance any different from periodontal examinations or mixed dentition analyses. The dental practitioner is in the ideal situation with a large volume of patients who attend in regular cycles for oral examination under excellent conditions not found elsewhere in health facilities. Reasonably, the current author, and many others, feel the dental practitioner should include all visible cervico-facial skin surfaces in the examination and a full examination of cervical lymph node chains. The aim is not to become an expert diagnostician but to become skilled in the recognition of abnormality and then the decision to watch, treat or refer can be made. Many practices already undertake this level of examination and it is one of the aims of this supplement to provide assistance in this “additional” level of care.