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Rationale for the Oral Medicine Referral Service. Dental management of medically compromised patients is becoming a routine and increasingly important part of dental practice. Several factors contribute to this phenomenon. First, the population continues to age. Many older patients have multiple medical conditions. Second, as medical care becomes more effective and cost issues are emphasized, many patients are being treated on an ambulatory basis to avoid hospitalization. Consequently, these individuals are in the community and readily seek dental care. Third, the sophistication of medical treatment is prolonging life. And fourth, the level of and access to available dental care has improved, resulting in more patients (regardless of medical status) wanting dental treatment. Therefore, behavior disorders and diseases of the mouth as manifestations of systemic disease are seen at an increasing rate, and require prompt and adequate care by experienced specialists.
In addition, oral cancer continues to be a serious problem. An estimated 29,500 new cases of oral cancer, mainly squamous cell carcinoma involving the tongue, oropharynx and floor of the mouth, are diagnosed annually in the United States. Unfortunately, the survival curves of oral cancer have plateaued over the past two decades, causing approximately 9,000 deaths each year in this country and the fifth lowest five-year survival rate, a rate which exceeds that for cervical cancer, malignant melanoma and Hodgkin's disease. As there is rarely a second chance for a cure of oral cancer, early diagnosis and initial approach to therapy is critical.
The Oral Medicine Clinic of Boston University School of Dental
Medicine provides the highest level of diagnosis and medical management of
oral diseases as described here.