Washington State Physicians’ Perceptions of Oral Medicine

Abstract

Background and AimsOral Medicine (OM) is the dental specialty devoted to the diagnosis and non-surgical treatment of complex oral and maxillofacial conditions. Oral medicine provides care for oral conditions typically not adequately addressed by their dentist, otolaryngologist or oral surgeon, as evidenced by frequent referrals to OM from these specialties. Physician education and training around oral and maxillofacial conditions is limited, potentially leading to missed diagnoses and fragmented care for patients with these conditions. To improve interdisciplinary collaboration, referral pathways, and medical education of oral conditions, it is important to understand physicians' awareness of OM. Therefore, this study aimed to assess levels of awareness and knowledge as well as referral practices and barriers, among medical physicians in Washington State with regard to the OM specialty. MethodsThis cross-sectional electronic survey study was conducted using REDCap©. The survey was distributed to 23,336 licensed physicians in the state of Washington. Twenty-two questions captured five domains including demographics, awareness of and knowledge about OM, referral patterns and barriers. Quantitative data analysis was conducted using descriptive statistics. Open-ended responses were summarized. ResultsFive hundred eligible physicians completed the survey. Two hundred and sixty-eight (53.6%) participants reported prior awareness of OM. Nearly half of the participants (n=239, 47.8%) had >20 years of clinical experience, with family medicine (n=219, 43.8%) and internal medicine (n=164, 32.8%) comprising the specialties with the greatest number of participants. Nearly all (n=251, 93.7% and n=244, 91.0%) participants who were aware of OM correctly identified oral complications of cancer therapies and oral premalignant conditions, respectively, far fewer participants aware of OM (n=175, 65.3%) correctly identified medication related osteonecrosis as part of the OM scope of practice. Just more than half (n=166, 62.0%) of aware participants reported referring to OM providers. One hundred and thirty-five(50.4%) of these physicians made fewer than five referrals annually. Perceived barriers to collaboration included lack of awareness of OM (n=157, 58.5%), limited availability of OM providers (n=143, 53.3%), insurance issues (n=115, 42.0%), referral networks or systems (n=116, 43.2%), and perceived overlap with ENT and Dermatology (n=109, 40.6%). ConclusionThis study highlights critical gaps in medical physicians’ awareness and knowledge of OM, which may reduce access to adequate care for patients with oral conditions. Targeted educational initiatives, integration of OM content into medical curricula, and clearer referral pathways with increased availability of OM providers are possible methods to enhance physician knowledge of OM referrals and ultimately improve patient care. These findings support national efforts to increase medical-dental collaboration and emphasize the oral-systemic health connection, promoting a less segmented healthcare model.