CLINICAL ORAL PATHOLOGY CONSULTS IN A US DENTAL SCHOOL: A RETROSPECTIVE ANALYSIS OF UTILIZATION AND EFFICACY

Volume 128, Issue 1, July 2019, Page e87
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Introduction

Chairside clinical oral pathology consultations are frequently provided in most dental schools; however, the outcome and efficacy of those consults remains largely unanalyzed. We designed a retrospective study to assess the utilization of consults by Oral and Maxillofacial Pathology (OMP) providers at the UF College of Dentistry (UFCOD).

Materials and Methods

With IRB approval, the clinical record system (AxiUm) at the UFCOD was searched from January 1, 2011 until July 1, 2017 for oral pathology consultations. The following information was collected for these consults: year of consult, requesting clinic, reason/clinical impression, presumptive diagnosis, recommended plan of action, and outcome (follow up).

Results

A total of 418 consults were included in this study, of which 11 were repeat consults on the same lesion on different occasions. The most frequent clinics requesting consults were in decreasing order: undergraduate DMD clinics, followed by faculty practice, graduate prosthodontics, graduate periodontics clinic, with other clinics requesting consults infrequently. The most common reasons consults were requested in descending order were: white lesions, ulcerations, nodules, pigmented lesions, swellings/enlargements, and erythematous lesions. Radiographic consults were uncommon in our study as at UFCOD, these are usually assigned or re-assigned to oral radiology. The disposition of the consults resulted in the following recommendations: 35% for observation/re-evaluation (ORE) in original clinic, 24% referred for biopsy, 19% treatment in original clinic followed by ORE, 12% referral to specialty clinic for treatment, and 10% multiple recommendations/lesions. In terms of outcome, biopsy and referral compliance was relatively reasonable, however ORE remained problematic.

Conclusions

This study illustrates the scope and difficulties associated with clinical consults in dental school and identifies areas of potential improvement.

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