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Dentists and primary care physicians: opportunities for closer collaboration.

As a medical student, I took an elective class in dental and oral health. I felt I had not received enough training in this area, and I was glad I chose the course. I came away with an aphorism about the physical examination: It doesn’t stop at the teeth. I bought and read a book about common oral conditions, learning about ranulas, geographic tongue, tori, erythroplakia, leukoplakia, and many others. I have maintained an interest in oral health over the years and, as a family physician, had many a happy patient who was pleased that I could address oral health conditions as well as other medical problems. Later in my career, when I became editor of the primary care journal, American Family Physician, I made sure that the content we provided to our more than 180,000 readers included topics on dental and oral health. The journal has published articles on common dental infections, dental emergencies, oral manifestations of systemic disease, common oral lesions and malignancies, and oral health in infants, older persons, and pregnant women. This issue presents a series of articles based on a collaboration between the General Dentistry and American Family Physician, an official publication of the American Academy of Family Physicians. These articles highlight some of the medical aspects of oral health, including Dr Kane’s examination of the impact of oral health on systemic health, Dr Pflipsen & Dr Zenchenko’s discussion of the interplay of nutrition and oral health, and Dr Gaddey’s review of oral manifestations of systemic diseases. We hope readers will find this information useful and applicable to their daily practice. In addition, I’d like to encourage my dentist colleagues to look for opportunities to expand their care of patients beyond oral health. Many already do so, but, for those who don’t, here are some ways to “think beyond the teeth.” The following is just a partial list of abnormal signs and symptoms that should prompt further evaluation.