The Practice of Oral Medicine in South Africa

Oral medicine is a clinical discipline, practiced by periodontists, which concerns itself mostly with the non surgical management of oral mucosal diseases. Many of these diseases are rare and the discipline less well known – making it essential to identify the obstacles this discipline faces. The purpose of this study was to describe the private and academic practice of Oral Medicine. A self-administered, internet-based, questionnaire was distributed to South African periodontists which questioned the clinician’s competency, diseases managed, special investigations performed, referral sources, proportional time and monetary distribution of the discipline, and perceived barriers to the practice. Twenty-six periodontists completed the questionnaire. In comparison to periodontology and implantology, periodontists generally feel less competent, spend less time on, and receive less money from Oral Medicine. Lack of awareness of the speciality (55.6% - 59.3%) was identified as the biggest constraint, with only 11.2% of referrals received from medical doctors. Immune-mediated diseases (29.3%) and benign neoplasms (26.5%) are managed the most, and surgical biopsies (80.2%) are used most regularly to diagnose oral mucosal disease. Oral Medicine is still a lesser-known clinical speciality. Despite the heavy burden of HIV-related oral disease and oral mucosal malignancies, this speciality remains underutilised.