The Clinical Practice of Oral Medicine in South Africa: a description of referral sources and diseases managed in a private and public health facility

The Clinical Practice of Oral Medicine in South Africa: a description of referral sources and diseases managed in a private and public health facilityOral medicine is a specialised discipline within periodontics in South Africa, focused on the diagnoses and management of oral mucosal diseases. Limited awareness may lead to underutilisation of oral medicine services. This study describes referral patterns, investigations, and disease profiles in public and private OM clinics in Gauteng. A retrospective review of patient records was conducted for a private oral medicine clinic (2016–2018) and a public oral medicine clinic (2021–2022). Data included demographics, referral sources, prior consultations, investigations, and diagnoses. A total of 522 patients were analysed (private: 309; public: 213). Most were female (private: 70.2%; public: 63.9%) with mean ages of 53 and 52 years. Dental practitioners were the main referral source (private: 69.3%; public: 65.3%), while medical referrals were limited (private: 22%; public: 10.8%). Patients often consulted multiple clinicians before oral medicine referral. Incisional biopsy was the most frequent investigation. Immune-mediated diseases predominated in both settings, while public clinics managed more benign growths, oral potentially malignant disorders, and infections. Oral medicine services are primarily accessed through dental referrals, with minimal medical engagement. Diagnostic delays and demographic disparities highlight the need for improved awareness, streamlined referral pathways, and equitable access.