Oral Medicine lies between medicine and dentistry, bridging the gap between them. It is the specialisation of dentistry that deals with systemic disorders which affect the oral cavity, and facial pain, playing a role in every clinical practitioners’ day to day work. This work is always challenging, innovating, and satisfying, with little room for boredom.
There are opportunities to work in Oral Medicine at every level. Historically, Oral Medicine has gone from solely dental to dual medical and dental qualification and now mostly dental only, but also some medical only career paths. Many people interested in becoming specialists in Oral Medicine still choose to do a full 4-year or 3-year medical degree or 4-year dental degree as this specific knowledge and experience is useful in their future career.
Oral Surgery and Maxillofacial Surgery
The specialties of Oral Surgery and Maxillofacial Surgery (OMFS) are closely intertwined; usually OMFS departments will staff a mixture of both Oral and OMFS surgeons. Oral Surgery encompasses the diagnosis and treatment of pathology of the oral cavity and jaws that requires surgical intervention – oral surgeons will have undertaken a dental degree.
Oral and Maxillofacial Surgery (OMFS) is a medical specialty and requires both medical and dental degrees. OMFS surgeons undertake a wider variety of more complex treatments involving the head, neck and oral cavity. Clinicians will often work closely with Orthodontic and Oral Medicine colleagues. A Dental Core Training post in an Oral and Maxillofacial Surgery department will provide experience within OMFS and Oral Surgery.
Oral and Maxillofacial Pathology
Oral and Maxillofacial Pathology (OMFP) is a division of cellular pathology which is performed by specialist dentists. OMFP dental specialists typically work within general cellular pathology departments in hospitals alongside medically qualified histopathologists. OMFP is the specific branch of pathology which is concerned with the assessment and diagnosis of diseases occurring in the head and neck, with particular focus and interest in the oral and maxillofacial region.
OMFP dental specialists receive biopsies from a variety of sites such as from the skin, oral mucosa, sinonasal mucosal, soft tissue, dental cysts, bone, and teeth, reflecting the truly diverse nature and complex anatomy of this fascinating region. Biopsies vary from incisional to surgical resection material and are submitted by a wide range of clinical dental and medical specialties.
Orthodontics is the dental specialty concerned with facial growth, development of the dentition and occlusion. It involves the assessment, diagnosis, interception and treatment of malocclusions and facial irregularities. Orthodontic services in the UK are delivered in both primary and secondary care settings.
Most orthodontic work is carried out with removable and fixed appliances in the NHS. However, many new appliances are being used as technology advances, with removable aligner systems becoming increasingly popular in the private sector. Orthodontics in secondary care assesses and treats patients who have more complex malocclusions and may require a multi-disciplinary approach to their care involving other specialties.
Paediatric Dentistry is the practice, teaching, and research into the comprehensive and therapeutic oral healthcare for children from birth to adolescence, including care for children who have intellectual, medical, physical, psychological and/or emotional problems. It covers most aspects of oral healthcare including restorative care, minor oral surgical procedures, and interceptive orthodontics.
Paediatric Dentists work closely with General Dental Practitioners and other specialities within dentistry such as Orthodontics, Oral Surgeons, and Restorative Dentists. There is also a need to work with Paediatricians, Surgeons, and Anaesthetists as part of a team caring for children with complex medical problems. All paediatric patients may require liaison with other agencies, such as Health Visitors and Social Workers, in safeguarding children.
Dental and Maxillofacial Radiology
Dental and Maxillofacial Radiology is a specialty recognized by the General Dental Council aimed at acquiring and interpreting diagnostic imaging of the structures of the head, neck, and teeth. It is one of the smaller dental specialties but is one of the most vital as every dentist will look at a radiograph every day.
All dental specialties rely on the interpretation of the radiographs to help diagnose and treat patients, but sometimes more specific radiological tests are needed to answer a clinical question. Radiologists require specialised knowledge of the physics of imaging as well as the manipulation of digital image data, keeping the specialty on the forefront of science and technology.
Restorative Dentistry involves the study, diagnosis, and integrated management of diseases of the oral cavity, the teeth and supporting structures. It encompasses the dental restorative ‘mono-specialties’ of Endodontics, Periodontics and Fixed and Removable Prosthodontics, including Maxillofacial Prosthodontics and Implant Dentistry. Restorative Dentists use knowledge and skills in all these specialties, working with other clinical colleagues in the management of cases requiring specialist complex, multi-faceted care.
Most specialists in Restorative Dentistry work as Consultants or Honorary Consultants in University Teaching Hospitals, District General Hospitals and Community Dental Services. Specialists in Restorative Dentistry can also provide services in Private Specialist Practices.
Special Care Dentistry
Special Care Dentistry is the newest dental specialty, recognised by the GDC in 2009. Special Care Dentists care for adolescents and adults with disability or impairment such as sensory disabilities, mental health issues, or emotional impairments like dental phobia. Patients with additional needs are treated in all fields of dentistry, but most of these patients are managed by the Community Dental Services or Hospital Dental Services.
A week managing patients with additional needs can be hugely varied, from domiciliary care, providing sedation or working under general anaesthesia. Patients often need longer appointment times to manage their additional needs and anxiety, or patients may even require specialist equipment such as wheelchair recliners or hoist transfers.
Dental Public Health
Dental Public Health professionals are either dentists employed as consultants or employed having followed a training programme in dental public health. They provide a specific service which includes the assessment of the oral health and dental needs of the population.
Working in public health involves promoting oral health and preventive dental measures, developing, and ensuring implementation of local oral health and oral health promotion strategies, providing advice and information to the public and media on dental issues, and working collaboratively with key stakeholders in the NHS to influence health policy relating to dental health.
Members can download our career guide to find out more about specialisation.