Oral and Maxillofacial Medicine – Winner of the Royal Society of Medicine and Society of Authors Book Award in the category of ‘New Authored Book’
Oral and Maxillofacial Medicine is that area of special competence in dentistry concerned mainly with diseases involving the oral and perioral structures, especially the oral mucosa, and the oral manifestations of systemic diseases. The specialty, in some countries termed ‘stomatology’, deals not only with oral disease but also with perioral lesions, and is increasingly known as ‘oral and maxillofacial medicine’. Furthermore, apart from the obvious close relationships with oral pathology (oral and maxillofacial pathology) and with oral surgery (oral and maxillofacial surgery), there is a close relationship with special care dentistry and hospital dentistry.
This book attempts to present for those interested in oral medicine and hospital dentistry, the basics of the specialty of oral medicine in a useful and digestible format; by offering the information in a range of modes and levels of detail and offering practical guidance to diagnosis, therapy and sources of information for patient and clinician, both on the Internet and elsewhere.
The first section reviews the fundamental principles of the history, examination and investigations and principles of management. In the absence of randomized controlled trials, many of the therapies suggested are unable to be thoroughly evidence based. Hopefully, future multicentre studies will rectify this deficiency. The second section discusses the more common symptoms and signs in oral medicine.
The third section covers in some detail the most common and important conditions seen in oral medicine. This section also includes synopses of a number of eponymous and other conditions relevant to oral medicine; if a specific condition is not found there, the reader is referred to the index, since it may well be located elsewhere in the book.
The fourth section is a discussion of the important areas of HIV infection and iatrogenic diseases. The other relevant oral manifestations of systemic disorders are tabulated in Appendix 1: further detail can be found in Medical Problems in Dentistry (Scully and Cawson: Elsevier, Edinburgh, 2004).
Agents used in the treatment of patients with oral diseases are outlined in Appendix 2. Only a limited number of these are prescribed by dental practitioners, but practitioners may have to cope with questions from patients about their treatment, or to recognize or deal with treatment complications. Further details can be found in textbooks such as Basic Pharmacology and Clinical Drug Use in Dentistry (Cawson, Spector and Skelly: Churchill Livingstone, Edinburgh, 1995).
An attempt has been made to present the material in such a way as to highlight the more important conditions – important because of frequency or seriousness – and to guide the reader through didactic and problem-oriented approaches. However, it is impossible to position every subject in a perfect location, not least because few conditions affect only one site (e.g. even erythema migrans can have lesions in sites other than on the tongue), some affect even more than one tissue (e.g. ectodermal dysplasia affects skin, salivary glands and teeth) and several have a range of clinical presentations (e.g. lichen planus and cancer can both present with white, red or ulcerative lesions, and can be symptomless or cause extreme discomfort). Cross-referring between sections will help the user get full value from the content.
The book is not intended to give all the details of the various investigative and therapeutic modalities, since these are covered in other texts by the author, or in pharmacopoeias. The book offers illustrative examples of the more common and important conditions, but cannot provide the more comprehensive selection of illustrations such as can be found in atlases such as Oral Diseases (Scully, Flint, Porter and Moos: Dunitz, London, 2004).
Much of my work could not be done without the support of my family (Zoe and Frances) and my work colleagues who help with information collection, particularly John Evans, Avril Gardner, Lesley Garlick and Karen Widdowson, to whom thanks are due. I thank Jose-Vicente Sebastian Bagan and Isaac van der Waal, and also my nephew, Dr Athanassios Kalantzis, for their helpful, friendly and constructive comments on the text.
Finally, I would be delighted to receive any comments about this text, in the hope that I can improve further in the future.