Oral Medicine and Hospital Dentistry

Oral medicine specialists do not offer general dental care for most people. Rather, this dental specialty treats a wide range of conditions that affect the oral and maxillofacial region, such as:

• Chronic dry mouth (or xerostomia) and other salivary gland diseases.
• Diseases that affect the lining inside the mouth, cheeks, and lips. These include autoimmune skin diseases and rheumatologic diseases like Sjögren’s syndrome, rheumatoid arthritis, lupus, and scleroderma.
• Issues related to cancer -- particularly oral, head and neck, and blood cancers -- and cancer treatments that can contribute to tooth decay, bone deterioration, jaw stiffness, pain, and other problems.
• Mouth and facial pain.
• Oral lesions and ulcers that can be caused by herpes viruses, yeast infections, anemia, and vitamin deficiencies.

Oral Clearance
You may need to see an oral medicine specialist to receive “oral clearance” before major surgery. This means a specialized dentist will determine if you have any active infections, need a tooth pulled, or have other oral concerns that must be resolved before undergoing procedures such as heart surgery (especially valve repairs and replacements), bone marrow transplant, or organ transplant. 

Hospital Dentistry
If you have severe heart disease, a ventricular assist device, a bleeding disorder, or a weakened immune system, you may need to receive dental care in a sterile environment like an operating room to reduce your risk of infection. 

Usually, your provider or general dentist will refer you for an oral medicine appointment. At your first visit, an oral medicine specialist will meet with you to discuss your needs, medical history, and symptoms. Then they will examine your mouth, neck, and head and may take X-rays to learn more about your oral health. Then you’ll discuss next steps, including any additional tests or biopsies that may be needed, and one or more of these recommended treatment options.

Medicated Ointments 
Prescription steroid or numbing gels and creams help heal oral lesions and relieve pain. 

Injections 
Some injections deliver medications to areas that are resistant to topical treatments, while others -- like Botox and trigger point injections -- can relieve joint stiffness and muscle spasms.

Minor Dental Procedures 
These are used to remove non-cancerous lumps and bumps.

Oral Cancer Screenings 
Routine follow-up appointments aim to identify pre-cancerous and cancerous growths early so they can be treated quickly.

Experts in Oral Medicine and Hospital Dentistry
Our oral medicine specialists are fellowship-trained and board-certified, which requires years of additional training. We treat a high volume of patients each year, including some of the most frail and susceptible to infection. Our dental hygienists have specialized experience treating medically complex patients in a hospital setting. We collaborate with other Duke specialists to ensure your care is tailored to your unique needs.

Patient Coordinator to Help You Navigate Care
Our patient coordinator is your connection to your oral medicine specialist and helps schedule your appointments, coordinate your visits, and plan dental procedures. It’s their job to make your treatment journey easier by guiding you through it step by step. They answer all of your questions along the way.