New Clinic for Hard-to-Diagnose Oral Diseases

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New Clinic for Hard-to-Diagnose Oral Diseases
September 15, 2003
University of Illinois Medical Center at Chicago
September 15, 2003 ÇƒÓ A new clinic has opened at the Medical Center specializing in some of the most difficult oral conditions to diagnose and treat: from burning mouth syndrome and temporomandibular disorders to unexplained headaches and persistent sores in the mouth.
The only one of its kind in the area, the Oral Medicine/Orofacial Pain Center will be a community resource, offering clinical consultation and non-surgical treatment in a field where there are few experts.
"Previously, physicians and dentists encountering these difficult and unusual oral diseases had nowhere to refer patients. Now, in one place, we have a staff of clinicians who are experts in evaluating, diagnosing and treating these conditions," said Charles Greene, director of orofacial pain studies and clinical professor of oral medicine in the UIC College of Dentistry.
Oral medicine covers a wide range of disorders, including oral mucosal diseases, oral manifestations of other diseases, orofacial pain and movement disorders, and orofacial sensory disorders.
Oral mucosal diseases, which affect the lining of the mouth, include infections, immunological conditions, premalignant conditions and cancer.
Joel Epstein, head of oral medicine and diagnostic sciences in the College of Dentistry and director of the interdisciplinary program in oral cancer in the Cancer Center, studies methods for early detection of oral cancer. He said that the clinic offers patients new diagnostic tools and therapies that are not readily available in the community.
"We can increase survival rates if the cancerous lesion is detected at an early stage or if the lesion is discovered and treated before it becomes malignant," Epstein said.
Epstein also treats, and studies, oral complications of cancer therapy and bone marrow transplants.
"The single most debilitating side effect of radiation therapy in patients with head and neck cancers is the destruction of tissue lining the mouth and salivary glands," Epstein said. "Ninety percent of patients develop severe irritation, including open sores on the tongue and inside of their mouths, and extreme throat pain, which often results in difficulty eating, drinking and speaking."
Oral manifestations of other diseases -- another focus of the clinic --include symptoms such as dry mouth and mouth infections that come with diseases like diabetes, leukemia or even arthritis.
Orofacial pain problems range from ordinary dental discomfort to severe neurological conditions. These pains can arise from muscles, nerves, oral tissues, salivary glands and other structures in the head and neck.
The most common type of orofacial pain, after toothaches, is due to temporomandibular joint disorders. Often the first signs are clicking and popping sounds when the jaw is opened or closed. Other symptoms include pain or discomfort when chewing, facial pain, tooth pain, trouble sleeping, muscle stiffness in the neck and shoulders and certain kinds of headaches.
While these disorders are common, most symptoms are temporary and fluctuate over time. An estimated 5 to 10 percent of the U.S. population, however, requires professional treatment.
"Conservative management techniques ÇƒÓ including behavior modification, physical therapy, medication, jaw exercise and orthopedic appliances ǃÓare effective in the majority of these cases," Greene said. "But accurate diagnosis is crucial."
Orofacial sensory disorders include strange tastes and smells and unusual tooth pain, according to Miriam Grushka, associate professor of oral medicine and diagnostic sciences.
One prominent orofacial sensory disorder, called burning mouth syndrome, affects 40 percent of post-menopausal women. Typically, there is no visible abnormality in the mouth to account for the burning, dryness and altered taste that mark the condition.
The faculty members staffing the new oral medicine/orofacial pain clinic will collaborate closely with physicians in otolaryngology, gerontology and hematology at the University of Illinois Medical Center at Chicago, as well as dentists in the UIC College of Dentistry specializing in oral and maxillofacial surgery, periodontology, endodontics and prosthodontics.
Patients can be seen either in the practice at the renowned Craniofacial Center or, as a lower-cost alternative, in the College of Dentistry's Oral Medicine Clinic. At the college, residents and students will be involved in assessing and managing patients under faculty supervision.