How can we reduce diagnostic errors related to oral lesions in healthcare centers?

Document Type : Letter to Editor


Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran


Diagnostic error is an important problem in healthcare centers. This definition includes any failure in making possible differential diagnosis; specialty referral and timely treatment. The most frequently misdiagnoses were hyperkeratotic lesions, focal inflammatory hyperplasia, periapical cyst/granuloma and cancerous lesions.

The most incorrect diagnosis made by general dental practitioners was atrophic candidiasis, followed by mucous membrane pemphigoid, atrophic and erosive forms of lichen planus, squamous cell carcinoma. One of the main reasons for these diagnostic errors is the lack of sufficient information about non-dental issues among dentists and physicians, including lesions of the oral mucosa.

The next reason is inadequate awareness of oral health and related specialties such as oral medicine among healthcare providers. Only 60% of medical practitioners were aware of the oral medicine specialty, and more than half of those had never referred patients to an oral medicine specialist. Nevertheless, it has been noted that 83.3% of physicians who referred patients to oral medicine specialists had a satisfactory experience.

Oral Medicine is a specialized field of dentistry that by the definition of the American Academy of Oral Medicine is responsible for the diagnosis and non-surgical management of conditions affecting the oral mucosa, salivary gland diseases, orofacial pain, and the dental treatment of patients with underlying medical disorders.

Recently, the definition of Oral Medicine has been expanded by the World Dental Parliament in 2016. The new definition encompasses three key domains: disease and condition status, psychosocial status, and physiological function.

This updated definition moves beyond the traditional focus on the presence or absence of disease alone. It now includes the consideration of a patient's psychosocial well-being and physiological functioning. This promotes a more holistic, patient-centered approach, where the patient's values and preferences are also taken into account.


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