Current Concepts in Dentistry Day 4

Course description

Clinical Assessment of Oral Lesions

Tuesday, Nov. 12, 2024
Presented by Charles Shuler, BSc, DMD, PhD

Changes from the expected appearance of the oral hard and soft tissues are not uncommon.  The clinician must recognize the change and engage in a process to determine the definitive diagnosis.  Traditionally oral pathology has been taught in dental schools by presenting either clinical or histologic images and asking the student to recall their diagnostic names.  In clinical practice alterations in the oral soft and hard tissues rarely resemble the images from either dental school classes or oral pathology textbooks.  The objective of this course is to guide the participants to develop an approach to evaluate lesions of the soft tissues of the oral cavity by assessing key features of the lesions with reference to the anatomy/histology of the intraoral site.  This approach builds on dentists’ strengths resulting from their experiences in clinical care of patients to provide a more comprehensive strategy to develop a differential diagnosis for an oral lesion. 

The importance of developing a differential diagnosis will be stressed in this course in order to ensure that important conditions are not overlooked when evaluating a patient.  In contrast to the expectations in a dental school oral pathology courses it is not necessary to reach the final diagnosis of any clinical oral lesion the first time the lesion is observed but rather to consider the range of possible diagnoses and establish a process to determine the final diagnosis. Procedures that lead to a definitive diagnosis will be discussed and the rationale for selecting a particular procedure presented.  It is important that getting the diagnosis “right or wrong” when a lesion is first recognized at the chairside or in the clinic should not be the goal.  The goal should be to initiate a process that considers all the possible diagnoses and proceed along a course that is most beneficial for your patient.

The course approach will use specific clinical cases observed in general dental practice to demonstrate the process for generating the differential diagnosis and determining the proper course of action to reach a final diagnosis.  The steps involved in generating a thorough assessment of the lesion will be presented so that a broader range of potential conditions may be considered.  The result of this course will be a new strategy to approach the assessment of oral lesions that will result in a more extensive set of differential diagnoses. 

Learning Objectives

• Recognize the changes in oral soft tissues representative of pathologic changes
• Evaluate the lesions in a standardized format based on using clinical examination strengths generated in practice
• Develop a process for generating a differential diagnosis based on the anatomy and histology of the site
• Appreciate the application of additional procedures to reach a definitive diagnosis and determine an approach to treatment
• Apply the process to clinical cases to reinforce this new approach to the evaluation of oral lesions

About the presenter

Charles Shuler, BSc, DMD, PhD is a professor of oral pathology in the Department of Oral Biological and Medical Sciences, Faculty of Dentistry at the University of British Columbia (UBC). He was the dean of the Faculty of Dentistry at UBC for 10 years and he finished his second five-year term in 2017. Dr. Shuler is engaged in active research on education outcomes and teaching oral pathology/medicine.

Prior to being appointed at UBC, he was a faculty member at the University of Southern California (USC) for 18 years. At USC he served as the director of the University of Southern California Center for Craniofacial Molecular Biology holding an endowed chair position as the George and Mary Lou Boone Chair Professor of Craniofacial Molecular Biology. He also served as the director of the graduate program in craniofacial biology and associate dean for student and academic affairs at the USC School of Dentistry. Dr. Shuler received his BSc in Biochemistry from the University of Wisconsin, his DMD from Harvard School of Dental Medicine, his PhD in Pathology from the University of Chicago, and his oral pathology education at the University of Minnesota and the Royal Dental College in Copenhagen, Denmark.

He has been active in assessing and managing clinical oral pathology patients with soft and hard tissue lesions. He has had an active research program funded by national granting agencies that focused on evaluating the molecular regulation of the soft and hard tissues of the secondary palate to better understand the etiology of craniofacial birth defects and pathologic changes of the tissues. He currently mentors a study club on clinical oral pathology that reviews cases recognized by general dentists in British Columbia.