Oral Medicine in Primary Dental Care: A Narrative Review of Recognition, Management and Referral of Oral Mucosal, Neoplastic, Orofacial Pain and Medication-Related Conditions

Author

Dr. Althaaf Khan


Abstract

 General dental practitioners are usually the first, and often the only, health professionals to examine the oral mucosa, which places them at the centre of early recognition of oral disease. This narrative review aimed to summarise current evidence on the recognition, initial management and referral of common oral medicine conditions encountered in primary dental care. Relevant literature, including systematic reviews, meta-analyses, consensus statements and clinical guidelines, was identified through searches of major biomedical databases and synthesised thematically. The review addresses oral potentially malignant disorders and oral squamous cell carcinoma, oral lichen planus, oral candidiasis and herpetic infections, recurrent aphthous stomatitis, temporomandibular disorders and burning mouth syndrome, and medication-related conditions including xerostomia and osteonecrosis of the jaw. The evidence shows that a systematic extra-oral and intra-oral examination, supported by a thorough medical and medication history, remains the most reliable tool for detecting disease in the dental setting. Conventional examination and scalpel biopsy remain the diagnostic standard, and adjunctive devices do not replace histopathology. No treatment has been shown to prevent malignant transformation of leukoplakia, so early detection, risk-factor counselling and structured follow-up are central. Delays in diagnosis and referral continue to contribute to advanced-stage oral cancer, including in South Africa. Most mucosal conditions can be managed safely in practice with simple, evidence-based measures, while a defined group of red-flag presentations requires urgent referral. Strengthening oral medicine competence in primary care, with clear referral pathways, is essential to improving patient outcomes.



Keywords

Oral medicine; primary dental care; oral potentially malignant disorders; oral cancer; oral mucosal diseases; referral



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References


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