The Clinical Practice of Oral Medicine in South Africa: a description of referral sources and diseases managed in a private and public health facility
1
Periodontics and Oral Medicine, University of Pretoria, Tshwane, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1609
ABSTRACT
INTRODUCTION:
Oral Medicine (OM) is a specialised discipline within periodontics in South Africa, focusing on the diagnosis and non-surgical management of oral mucosal diseases and related conditions (1). Despite its clinical relevance, OM remains under-recognised among healthcare professionals, potentially leading to delayed diagnosis and inappropriate management (2,3). This study describes referral patterns, diagnostic investigations, and disease profiles in public and private OM clinics in Gauteng.
METHODS:
A retrospective review of patient records was conducted for a private OM clinic (July 2016–June 2018) and a public OM clinic (July 2021–June 2022). Data included demographics, referral sources, prior consultations, investigations, and diagnoses. Descriptive statistics were applied.
RESULTS:
A total of 522 patients were analysed (private: n=309; public: n=213). Most patients were female (private: 70.2%; public: 63.9%) with mean ages of 53 and 52 years, respectively. White patients predominated in private practice (91.6%), while African patients comprised 39.9% of the public cohort. Dental practitioners were the main referral source (private: 69.3%; public: 65.3%), while medical referrals were limited (private: 22%; public: 10.8%), consistent with international findings of low OM awareness among physicians (4,5). Patients often consulted multiple clinicians before OM referral (median: private 2; public 1). Incisional biopsy was the most frequent investigation. Immune-mediated diseases were the leading diagnostic category in both settings (private: 40.3%; public: 20.8%), while public clinics managed proportionally more benign growths, oral potentially malignant disorders (OPMD), and infections.
CONCLUSIONS:
OM services in South Africa are primarily accessed through dental referrals, with minimal engagement from medical practitioners. Diagnostic delays and demographic disparities highlight the need for improved interdisciplinary awareness, streamlined referral pathways, and equitable access to OM care. Strengthening education and integration of OM into healthcare systems could enhance early diagnosis and patient outcomes (6).
Oral Medicine (OM) is a specialised discipline within periodontics in South Africa, focusing on the diagnosis and non-surgical management of oral mucosal diseases and related conditions (1). Despite its clinical relevance, OM remains under-recognised among healthcare professionals, potentially leading to delayed diagnosis and inappropriate management (2,3). This study describes referral patterns, diagnostic investigations, and disease profiles in public and private OM clinics in Gauteng.
METHODS:
A retrospective review of patient records was conducted for a private OM clinic (July 2016–June 2018) and a public OM clinic (July 2021–June 2022). Data included demographics, referral sources, prior consultations, investigations, and diagnoses. Descriptive statistics were applied.
RESULTS:
A total of 522 patients were analysed (private: n=309; public: n=213). Most patients were female (private: 70.2%; public: 63.9%) with mean ages of 53 and 52 years, respectively. White patients predominated in private practice (91.6%), while African patients comprised 39.9% of the public cohort. Dental practitioners were the main referral source (private: 69.3%; public: 65.3%), while medical referrals were limited (private: 22%; public: 10.8%), consistent with international findings of low OM awareness among physicians (4,5). Patients often consulted multiple clinicians before OM referral (median: private 2; public 1). Incisional biopsy was the most frequent investigation. Immune-mediated diseases were the leading diagnostic category in both settings (private: 40.3%; public: 20.8%), while public clinics managed proportionally more benign growths, oral potentially malignant disorders (OPMD), and infections.
CONCLUSIONS:
OM services in South Africa are primarily accessed through dental referrals, with minimal engagement from medical practitioners. Diagnostic delays and demographic disparities highlight the need for improved interdisciplinary awareness, streamlined referral pathways, and equitable access to OM care. Strengthening education and integration of OM into healthcare systems could enhance early diagnosis and patient outcomes (6).
| eISSN: | 2654-1459 |
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