Times of India
12 December 2010
By Revathi Ramanan
Chennai, India

The age–old custom of the doctor asking you to open your mouth wide to take a close look might probably hold more significance than you imagine. Diseases like leukemia, HIV–AIDS and viral infections can be diagnosed at an early stage through an oral examination, thereby improving prognosis of diseases, according to experts who gathered in Chennai for the first international conference of the Indian Association of Oral and Maxilofacial Pathologists (IAOMP).

A lot of diseases have oral manifestations. The oral cavity is part of many important processes such as respiration, digestion and speech, and hence it is the first to be affected by diseases, they explained. “Take the example of HIV–AIDS,“ said IAOMP secretary Dr K Ranganathan, “Instead of conducting blood tests for everyone in high risk groups, we can do oral examination. If there is yeast infection in the mouth, the patient should be recommended for a blood test to confirm the presence of the virus.“

While swelling of gums and prolonged pain may be an indication of leukemia, several sexually transmitted diseases could cause lesions on the tongue. Oral inspection may not yield conclusive diagnosis of deadly diseases, but in a country like ours, where blood tests may not be possible on a large population, it serves as an efficient screening process.

Experts Feel Dentists Are Not Trained Enough
In a new finding that can change the way ailments are diagnosed, experts claim that many diseases like leukemia, HIV–AIDS and viral infections can be diagnosed at an early stage through an oral examination. “The mouth has largely been ignored while doing diagnostic tests for various diseases. Mouth can tell a lot about diseases of several organs,“ said Dr Carl Allen, professor of oral and maxillofacial pathology at the Ohio State University.

“Misdiagnosis of many infectious diseases could be avoided by just examining the oral cavity of the patient. Early signs of cancer are usually found in the mouth. Early diagnosis can prevent it from spreading. There are times when the patient has an oral condition for a long time but come to an oral pathologist very late by which time the cancer is beyond control,“ said Dr Allen, adding that oral manifestations precede symptoms in other parts of the body.

However, the field of oral pathology in India, though more advanced now, still has a long way to go, felt IAOMP president Dr V Ramesh. “We have only about 1,500 oral pathologists in the country, and a majority of the medical schools do not include oral pathology in their curriculum. This needs to change,“ he said.

The experts felt that most physicians and dentists were not trained enough to send patients with an oral condition to oral pathologists, resulting in wrong diagnosis. “Most people visit a general physician when they have an oral condition when they should be visiting an oral pathologist. About 99% of patients I get are referred to me by other doctors rather than the patient coming on their own,“ said Dr Allen.