Oral medicine

Oral medicine is the specialty at the interface between medicine and dentistry.

Scope
Oral medicine is concerned with clinical diagnosis and non-surgical management of non-dental pathologies affecting the oral and maxillofacial region, such as oral lichen planus, Behçet's disease and pemphigus vulgaris. Moreover, it involves the diagnosis and follow-up of pre-malignant lesions of the oral cavity, sauch 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 suffering from 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.

USA
The American Dental Association (CODA) accredited programs are a minimum of two years in length. Oral medicine, however, is not an American Dental Association recognized specialty, but many oral medicine specialists fulfill 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 pertient to dental practice. Before becoming its own specialty in the United States, oral medicine was historically once a subset of the specialty of periodontics, with many periodontists achieving board certification in oral medicine as well as periodontics.

Australia and New Zealand
Australian programs are accredited by the Australian Dental Council (ADC). They are three years in length and culminate with either a Master degree (MDS) or a Doctor of Clinical Dentistry degree (DClinDent). Fellowship can then be obtained with the Royal Australasian College of Dental Surgeons, FRACDS (Oral Med) and or the Royal College of Pathologists of Australasia, FRCP. 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 currently offers a 5-year intercalated clinical doctorate/medical degree (DClinDent/MBChB) program. On the 9th of 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.

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 and the University of British Columbia 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)).

UK
Most UK oral medicine specialists have dual qualification with both medical and dental degrees. However, dual qualification is no longer a prerequisite for entry into specialist training. Specialist training currently consists of a three to five-year programme. Unlike many other countries, oral medicine physicians in the UK do not usually partake in the dental management of their patients. Currently, around thirty practising consultants and fifteen oral-medicine units in the United Kingdom, mostly within dental teaching hospitals.