Oral education is inadequate
Manjulika Das, Calcutta
Medical students receive inadequate education on
common oral diseases, and their diagnoses of oral disorders are poor,
research in the British Journal of Oral and
Maxillofacial Surgery claims (2005;43:
61-4).
Only half of the UK medical schools that responded
teach oral pathology. And only 28% of medical staff could diagnose cases of
oral diseases properly, compared with 89% of dentists.
Researchers investigated whether UK medical students,
doctors, and dentists could appropriately diagnose, investigate, manage,
and refer common diseases of the mouth. Diseases included geographic
tongue, primary herpetic gingivostomatitis, squamous cell carcinoma,
Stevens Johnson syndrome, HIV associated Kaposi’s sarcoma, and oral
hairy leukoplakia. The researchers were led by Patrick McCann of the
department of oral and maxillofacial surgery at York District Hospital.
They gave clinical photographs, short medical
histories, and a questionnaire to 48 emergency department doctors and 22
dental staff affiliated to Glasgow hospitals. The questionnaire asked about
the diagnosis, investigations, and management of oral conditions and asked
for comments on the necessity for referral.
The researchers also sent anonymous questionnaires to
29 UK medical schools and 16 UK university dental schools to assess the
teaching of oral anatomy, pathology, and prevention of diseases. They also
contacted 24 postgraduate medical deans to find out if they offered
qualified staff any postgraduate courses in oral diseases.
“The most likely reason for the poor performance
is lack of training,” explains McCann. Oral anatomy is taught at an
early stage in the medical course, which is why students lack a useful
working knowledge of the oral anatomy of a living person. “It is
important that a physician should be able to recognise oral malignancy at
an early (and therefore treatable) stage. This is particularly relevant
because of patients’ selective attendance for dental care,
particularly primary care,” the researchers argued.
Ashok Kumar Maity, head of the dental surgery
department of Calcutta National Medical College, India, however, said,
“One shouldn’t expect a dentist to perfectly diagnose common
medical problems like gastrointestinal obstruction or vesicovaginal
fistula. Similarly it’s not a big problem if medical staff fail to
diagnose a common oral disease.”
studentBMJ 2005;13:89-132 March ISSN 0966-6494
