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Medicine Oral Medicine Preventive Dentistry

What are some of the clinical approaches to oral mucosal disorders?

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This summary is based on the Preface article published in the Dental Clinics of North America: Clinical Approaches to Oral Mucosal Disorders (October 2013)

Dr. P. Sollicito, DMD, FDS, RCSEd

Dr. Eric Stoopler, DMD, FDS, RCSEd

Oral health and disease are intimately related to general health status. Clinicians understand that the oral cavity does not exist in isolation, but as an integral component of the human body. The oral cavity and peri-oral region consist of various tissues that are not unlike other organ systems, including mucous membranes, nerves, ligaments, and bone. The oral cavity is perhaps more intricate than other areas because, in addition to those tissues, there is a complex dentition with its supporting structures. In addition, the oral cavity harbors saliva produced by major and minor exocrine glands, which has a profound impact on both health and disease.

Lesions affecting the oral cavity usually have a similar clinical appearance and there is often no single characteristic that differentiates oral soft tissue diseases. It is often extremely difficult to diagnose oral diseases based solely on clinical appearances … A detailed medical evaluation is essential for all complaints related to the oral cavity and peri-oral structures.

When querying a patient about oral lesions, it is imperative for clinicians to understand the various aspects of the condition … A detailed series of questions regarding the present illness includes appropriate symptom development. 

It is equally important to perform an accurate and expanded physical examination, which should be viewed in the context of a regional examination.

It is from this of information that the clinician will begin to formulate a differential diagnosis, which is, in part, based on prior fundamental knowledge and experience. A “final” diagnosis may need to be modified by the clinician as the patient is being managed for the presumed disorder.

Understanding appropriate patient evaluation, formulating a differential diagnosis, obtaining adjunctive diagnostic testing, and rendering a final diagnosis are all expected of today’s modern dentist.  Following the diagnostic approach as outlined gives the clinician the greatest chance of accurately diagnosing oral disease.

 

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