The specialty of Oral Medicine deals with the diagnosis and non-surgical management of patients with chronic / recurrent, benign conditions of the oral mucosa and facial pain. These conditions are often intractable and related to systemic disease requiring multi-disciplinary care.
Referrals for children, adolescents and adults are accepted from primary and secondary care.
The Oral Medicine service is delivered on two sites within NHS Lothian:
- Edinburgh, Mid- and East Lothian patients – Oral Medicine at the Edinburgh Dental Institute. On SCI Gateway access is via Lauriston (Oral Health).
- West Lothian patients – refer to Oral Medicine at St John’s Hospital, Livingston, where patients are managed by the Oral & Maxillofacial Surgical team.
All those suspected of having cancer must be referred to Oral & Maxillofacial Surgery at St John’s Hospital.
The conditions managed include: - Recurrent oral ulceration
- Herpes labialis
- Angular cheilitis
- Chronic Oral candidiasis
- Geographic tongue
- Oral white patches
- White sponge naevus
- Vesiculobullous disorders
- Suspected drug reactions
- Temporomandibular joint (TMJ) disorders
- Acute or chronic facial pain of non-odontogenic origin
- Burning mouth syndrome
- Medical Salivary disorders, including dry mouth, Sjögren’s syndrome and excess salivation
- Oral facial granulomatosis
- Suspected orofacial allergic disorders
- Oral lesions in immunocompromised patients.
Associated specialties are:
- ORAL SURGERY– deals with the diagnosis and management of pathology of the mouth and jaws that requires surgical intervention, but where cancer is not suspected.
- ORAL & MAXILLOFACIAL SURGERY (OMFS) – the diagnosis and management of benign and malignant diseases affecting the mouth, jaws, face and neck. The team at St John’s Hospital delivers the only OMFS service for NHS Lothian and does so for patients of all ages, including children.
Who to refer:
Please see above for details of conditions managed.
Who not to refer:
- Anyone suspected of having oral cancer – who should be referred to Oral and Maxillofacial Surgery at St John’s, Livingston. For further details please see OralMaxillofacialSurgery.aspx
- Those requiring surgical treatment, or likely to need a biopsy.
How to refer:
Urgent Suspicion of Cancer
All such referrals should be directed to Oral and Maxillofacial Surgery, St John’s Hospital via SCI Gateway.
Routine and Urgent referrals via SCI Gateway:
Edinburgh, Mid and East Lothian patients – refer to Lauriston, Oral Health Oral Medicine.
West Lothian patients – refer to Oral Medicine, St John’s Hospital, Livingston.
Emergency referral to Oral Medicine
If a GP or a dentist needs to access an emergency referral for a patient, please contact:
- Edinburgh, East- or Midlothian: Oral Medicine at the Edinburgh Dental Institute – 0131 536 4566 (same route as Oral Surgery).
- West Lothian: Oral and Maxillofacial Surgery – via St John’s Hospital switchboard.
- Oral Health Management of Patients at Risk of Medication-related Osteonecrosis of the Jaw (SDCEP)
- Management of Dental Patients taking Anticoagulants or Antiplatelet Drugs (SDCEP)
- Antibiotic Prophylaxis (SDCEP)
- British Association of Oral and Maxillofacial Surgeons
- British Association of Oral Surgeons
- The British Society for Oral Medicine (BSOM): this website has produced patient information leaflets for a number of oral conditions.
- British Association of Dermatologists: patient information leaflets available.
- International Association for the Study of Pain: patient resources available.
- Guide for Commissioning Oral Surgery and Oral Medicine (NHS England)
Primarily for dentists:
- Guidelines for Selecting Appropriate Patients to Receive Treatment with Dental Implants: Priorities for the NHS (Royal College of Surgeons)
- Conscious Sedation in Dentistry (SDCEP)
- British Association of Oral Surgeons (BAOS)
- Management of Acute Dental Problems (SDCEP)
- Guide for Commissioning Oral Surgery and Oral Medicine (NHS England)
- Dementia friendly dentistry: good practice guidelines.
- Management of Acute Dental Problems (SDCEP)