Abstract
Objective Oral medicine specialists provide care to patients with oral and systemic conditions. Descriptive and retrospective studies have been conducted internationally to understand the referral patterns for oral health conditions, but have not been conducted in Trinidad and Tobago. The purpose of this study was to identify patients’ demographics and lesion types, referral sources to the University of the West Indies (UWI) Dental School, Department of Oral Medicine (UWI OM Department) and Oral Pathology and to determine the mean time (in working days) from patient referral to consultation. Methods Dental students and residents assigned to the OM rotation, completed a questionnaire for all patients referred to the UWI OM department for consultation and treatment, during one year from 2017-2018. All patients were examined using a standard oral assessment protocol by residents of the department. Diagnosis was made based on histological or clinical assessment. Results There were 106 referrals. Patients’ mean age was 47.1yrs, 60.4% were females, 50% were Indo-Caribbean. Most referrals (45.3%) were from private general dentists, followed by dental referrals from a health centre (19.8%). The most common diagnoses included: Mucocele (10.4%), Lichen Planus (8.5%) and Erosive Lichen Planus (7.5%). Oral lesions were most common in sites labelled as “other”. Conclusion The findings suggest that referrals by general dental practitioners were higher in proportion compared to medical practitioners. There were more female participants and most referrals were for oral white lesions. There was just over a two week, mean-time, in working days between the initial referral and date of consultation.
Highlights
Dental students and residents assigned to the Oral Medicine (OM) rotation, completed a questionnaire for all patients referred to the University of the West Indies (UWI) OM department for consultation and treatment, during one year from 2017-2018
The findings suggest that referrals by general dental practitioners were higher in proportion compared to medical practitioners
Oral Medicine (OM) and diagnosis are important disciplines since there is enough evidence that suggests a relationship between oral diseases and systemic diseases, such as, the systemic conditions presenting with oral manifestations and influencing the oral health care.[3,4]
Summary
A standardized oral assessment protocol was developed, incorporating guidelines suggested by the National Health and Nutrition Examination Survey III.[10] The questionnaire was initially pilot tested and later completed by 4th/5th year dental students and residents assigned to the oral medicine clinic rotation for 3 months, for all first-time patients who were referred for consultation. The students and residents were trained by RB & HAB in a seminar-based setting, regarding the oral examination and diagnosis protocol for two days This was later followed by clinical practice where the students and residents examined patients using sterilized/ disposable instruments, under standard infection control guidelines, in the UWI OM department and collected the data.
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