Oral and maxillofacial conditions
Dr Imran Rafi, Chair of RCGP Clinical Innovation and Research
The 2015 President of the British Association of Oral and Maxillofacial Surgery (BAOMS) Professor Peter Brennan, together with his team which includes specialist trainees, has co-authored a unique book that will be distributed, using his President’s fund, to every general practice in the UK free of charge.
Professor Brennan is a distinguished NHS consultant Oral and Maxillofacial Surgeon working at Portsmouth Hospitals NHS Trust since 2002. He is also Honorary Professor of Surgery and Head of the Academic Department of Surgery, at the University of Portsmouth. Peter has co-authored over 400 papers and is an editor of four widely respected text books.
The book provides a useful oversight of the common as well as not-so-common presentations on oral and head and neck conditions that we face in primary care. It starts with a good discourse on how to do an effective oral and head and neck examination. From swellings in the mouth and oral mucosal lesions, to neck lumps, skin lesion and dental presentations, the book provides a logical account of the diagnostic conundrums we face and provides algorithms, particularly around red flag symptoms that warrant urgent referral such as managing oral non-healing ulcers. The authors ask the reader to take an ‘Ask, Look and Do’ approach in managing such conditions.
The book, which is illustrated with clinical cases, covers conditions that we should all be mindful of and warn patients about, such as the risk of osteonecrosis of the jaw following treatment with bisphosphonates, and knowing when to refer patients acutely for oral and maxillofacial conditions that are likely to lead to rapid airway obstruction.
Problematic conditions such as burning mouth syndrome are also discussed together with presentations such as atypical facial pain and TMJ dysfunction. It is reassuring to know that for some of these conditions it is very difficult even for experts to make a definitive diagnosis.
The book also contains a recap of the conditions that need urgent suspected cancer referrals, reinforced by algorithms which clearly lay out management options and help the reader decide whether a referral needs to be urgent or non-urgent and to the relevant practitioner.
With each pack sent to every GP practice in the UK, there are 5 A2 sized wall posters which contain easy to follow algorithms of presentations such as oral ulceration, neck lumps, skin lesions, facial pain, and TMJ symptoms, with red flag symptoms and signs to help and promote rapid referral when necessary.
The book will also be made available online in July 2016 for every GP and additional hard copies are available if needed at cost price. To find out more until then, please visit the BAOMS website.
Professor Peter Brennan