EstomatoNet: A 5-year experience of an oral medicine telediagnosis service.

OBJECTIVE: EstomatoNet is an online service driven by primary health care professionals to support diagnosis and decision-making for oral lesions. This study aimed to describe the experience of the service, depicting use cases and its impact on the referral to specialised services. MATERIALS AND METHODS: Patient/applicant demographics and information related to their oral lesions and/or complaints were retrieved from the service's cloud-based platform. The differential diagnosis provided by the applicants, their level of satisfaction and the teleconsultant's opinion in terms of diagnosis and management were also reported. The teleconsultant's suggestion was cross-referenced with the data from the regulation system to verify the avoidance of referral. RESULTS: Out of 2,002 teleconsultations, most patients were women (55.1%) and 50.1% were aged between 20 and 59 years. Applicants (96.5%) generally considered the service very satisfying/satisfying. Potentially malignant disorders were reported in 19.6% of cases and 7.7% were suspected to be malignant. The referral of 37.3% of patients was avoided after the suggestion of keeping the patient in the primary health care system (k = 0.234; p < 0.001; 62.2% agreement). CONCLUSION: The use of EstomatoNet for oral mucosal lesions improves support for primary health care professionals in the management of lesions and reduces referral to specialised services.

The role of the dentist in the diagnosis and management of patients with oral mucosal diseases / El papel del dentista en el diagnóstico y tratamiento de pacientes con enfermedades de la mucosa oral

Based on a few case reports of oral mucosal diseases a number of questions is raised about the role of dentists-general practitioners in the diagnostic procedure and management of patients with such diseases. For instance, aredentists prepared to prescribe topical corticosteroids and should dentists be taught how and when to take a biopsy?And how about palpation of the neck? A strong recommendation is made to take clinical pictures for proper docu-mentation and, if needed, for telediagnostic procedures.Another issue relates to the communication between dentists and dental specialists when dealing with patientswith oral diseases. In case of a patient suffering from burning mouth syndrome or any other type of chronicorofacial pain, the question is raised whether dentists-general practitioners are prepared to manage such patients.Furthermore, there is a call for structuring the collaboration between dentists-general practitioners and dentalspecialists, including oral and maxillofacial surgeons.(AU)