Oral and Maxillofacial Pathology, Radiology, and Medicine

Chair: Denise Trochesset, DDS
Clinical Professor, Oral and Maxillofacial Pathology, Radiology and Medicine

oral medicine, microscope, and CBCT radiology icons

Overview

The Department emphasizes the responsibility of the dentist to see problems affecting the oral region in the context of overall health status. The department’s curriculum includes assessment of patients’ overall health status and its impact on oral health care, identifying problems affecting the teeth and supporting structures, understanding and identifying oral mucosal and salivary gland disorders, orofacial neurological and chronic pain disorders, oral manifestations of systemic diseases and dental management of patients with complex medical problems and disabilities.

 

ACADEMICS

Predoctoral Curriculum: OMPRM

Preclinical Radiology

In this radiographic technique preclinical laboratory course, the student is scheduled to spend a total of 4 hours in learning the fundamentals associated with the discipline of dental radiography. This instructional experience is designed to provide the student with the practical skills and knowledge necessary to manage the digital radiographic computer system, and to expose digital periapical and bitewing radiographs while following the acceptable infection control and radiation health and safety protocols.

 

General Pathology

This course covers the molecular, cellular, tissue, and organ changes that underlie disease. The general pathology component of the course covers cellular responses to injury, cell death, immunology, inflammation, wound healing, immunopathology, developmental and genetic disorders, neoplasia and an introduction to oral precancer and environmental and radiation induced pathology. The fundamental elements of how the body reacts to disease are explored and examples are given to show the link between pathology and the oral cavity.

 

Introduction to Oral and Maxillofacial Radiology

The first part of this course provides the fundamental knowledge in Radiology as it relates to x-ray generation, image formation, imaging systems, radiobiology, and radiation protection. The students will be introduced to different radiographic modalities (e.g., intraoral radiographs, panoramic images, extraoral radiographs, and advanced imaging systems) as well as the radiographic anatomy of intraoral radiographs, panoramic images and cone beam CT scans. The second part of the course (i.e., after the first exam) focuses on the interpretation of radiographic imaging and radiographic appearances of common dental findings such as caries, periodontal disease, inflammatory diseases, and dental and developmental anomalies.

Body and Disease I and II

Body and Disease I and II is a course jointly run with the Department of Molecular Pathobiology. This course emphasizes basic mechanisms in systemic physiology, pathology, and therapeutics and the integration and implications for dental practice. This course is divided into vertical integrated units (VIUS) by organ system. Each VIU contains sessions for discussion giving students the unique opportunity to incorporate medicine directly into a dental context and to create a framework that they can learn to apply to their patients and beyond. The physiology component of the course presents, sequentially, key physiological concepts related to the organ systems of the body, including reference to relevant basic anatomy and histology. The systemic pathology focuses primarily on prevalence and incidence and pathogenesis (cause and effect relationships) or mechanisms of disease. These mechanisms are taught not only within an individual system (e.g., cardiac) but also between systems (e.g., cardiac and pulmonary). The course thus covers common diseases within the range of the major organ systems: cardiovascular, hematology, pulmonary, endocrine, gastrointestinal, infectious diseases, reproductive pathology, renal, skeletal, neuropathology, and common diseases of the skin. The pharmacology / therapeutics component of the course describes the mechanisms of action of principal classes of pharmacological agents, discusses the impact of pharmacokinetic parameters on the onset, duration, intensity and termination of drug action, as well as proper usage, possible interactions with other medication / factors and commonly encountered adverse effects. A special focus is placed on the indications of drugs used in dentistry, the non-dental indications for drugs most commonly used by other health providers and the impact of commonly used drugs on the dental treatment of patients. Faculty and physician guest lecturers present the most current concepts in their field. The application of pathologic principles to dental treatment, particularly of medically complex patients, is discussed, and oral manifestations related to systemic disease are included in clinical cases. There is a significant emphasis on case-based learning.

 

Oral and Maxillofacial Pathology and Radiology

This course provides an overview of oral pathology including the clinical, microscopic and radiographic presentation of oral diseases and pathogenesis. Soft tissue lesions including oral premalignant and malignant lesions, infectious diseases, soft tissue tumors and salivary diseases as well odontogenic cysts and tumors, non-odontogenic bone diseases and bone tumors are discussed covers with emphasis on etiology, clinical presentation and management. Diagnostic procedures and treatment of oral disease will be introduced in relationship to the clinical and radiographic presentation and pathogenesis. 

Care of the Medically Complex Patient

This course will build upon prior course knowledge that was presented in General Pathology, Body and Disease courses, as well as other basic science courses. It will focus on the clinical presentation and natural history of selected medical disorders, as well as present the scientific evidence available in how to manage and approach the selected medical disorders. The practical information needed to arrive at a medical risk assessment in order to develop management strategies in the delivery of dental care will be reviewed. The course will focus on how to obtain and interpret desired information through medical and other consultation; recognition of oral consequences / manifestations of selected medical illnesses; the relevant practical pharmacology of the management of common medical problems and its impact on oral/dental disease and therapy; drug mechanisms, interactions and adverse effects of commonly prescribed medications and how to incorporate evidence-based decisions into the dental treatment plan.

 

Clinical Pathologic Correlations

This course builds upon prior course knowledge that was presented in General Pathology, Body and Disease I and II, and Oral and Maxillofacial Pathology, as well as basic science courses. The course provides an integrative approach to the diagnosis and management of patients presenting with pathology of the oral soft and hard tissues. Students are expected to use foundational knowledge to develop a differential diagnosis, determine the most likely diagnosis based on patient presentation, demographics and current evidence and develop a management of the disease or disorder. The course is predominantly case based and includes written description of clinical/radiographic findings.

 

Orofacial Pain-Neurosensory Disorders

This course builds upon foundational knowledge of somatosensation, nociception, and the complex interaction between neural and immune systems following tissue injury. Emphasis is placed on practical concepts that illustrate how to interpret clinical manifestations of integrated somatosensory neurobiology. Neuropathic pain is extensively examined with emphasis on neuroplasticity and the origins of perception. These applied concepts of a dynamically-maintained CNS become the foundation for understanding chronic pain as well as pain that persists in the absence of tissue injury. Extensive use of cases then explores the presentation, diagnostic features and criteria, and contemporary therapeutics for selected chronic musculoskeletal, neuropathic and mixed orofacial neurosensory / pain disorders. Throughout the course the unique experience of suffering and the biopsychosocial factors that influence it are explored.

Oral Medicine, Diagnosis, and Radiology Clinic

This clinical rotation spans the third year and takes place in the Patients’ Admissions Clinic. It builds on foundation knowledge presented by courses across the department. Students will show proficiency in collecting and recording patient information to include chief complaint, vital signs, medical, dental and social histories, as well as category, side effects and interactions of medications. Reviewing these segments of the patient record, students will show competency in developing a medical risk assessment based on the patient’s oral health needs. Ability to develop an appropriate medical consult is also assessed. Proficiency in performing and recording the findings of an extraoral and intraoral examination to include variations of normal, anomalies, as well as pathology is also a part of this course skill set. Radiographic proficiencies of prescribing, acquiring and interpreting diagnostic radiographs will be demonstrated. Students will be expected to recognize and develop a simple differential diagnosis for common oral mucosal lesions or conditions.
 

Senior Comprehensive Care

This course will draw upon the senior dental student's knowledge and skill across all clinical disciplines and upon her/his understanding of evidence-based and biomedical-dental-based principles, to demonstrate in a variety of interactive, clinical scenarios a capacity for comprehensive patient assessment, diagnosis, and interdisciplinary treatment planning. The course will be concentrated in the fall semester to facilitate early assessment of comprehensive care critical thinking as well as preparation for national board examination. The format will include summary and strategy sessions that also involve an interactive case session that will require consideration inside and outside the classroom. The course will concentrate on the review and practice of diagnosis criteria, radiology interpretation skills, hard and soft tissue findings, dental management of medically complex patients, pharmacology, evidence-based dentistry and critical thinking skills. An additional course section for Geriatrics is included in this course to complete the learning experience.

Oral Medicine/Diagnosis Clinic

Through this course, the student will broaden his/her diagnostic skills, the understanding of treatment of medically complex patients, and radiographic interpretation skills. Students will build on their D3 oral medicine clinical experiences in the following ways: further experience in diagnosis of new patients during the Oral Diagnosis rotation, radiographic interpretation exercises, radiographic technique skills assessments. Based on the patient's pre-existing systemic status and the dental needs, the student will implement appropriate strategies to minimize chances of systemic complications from the therapy of oral diseases and further practice the identification of relevant interaction and side effects of medications.

 

Clinical Management of Special Needs Patients

In this course, the student applies the knowledge and skills previously acquired in didactic and clinical courses to the management of patients with congenital, developmental and acquired disabilities, undergoing oncology treatment and with medical complexity. Students will adapt the foundational knowledge to address the dental treatment needs of these unique populations of patients and development management skills to allow for optimal and safe dental care. The student will enhance skills for developing a medical management plan based on patient’s oral health needs and if needed, write a medical consult accurately.

 

Oral Medicine and Orofacial Pain Clinic

Students are assigned rotations to the Oral Medicine and Orofacial Pain Clinic, where they will evaluate patients by conducting a thorough history and physical exam, review of diagnostic data, and create a differential diagnosis and a list of treatment plan options. Students will also be evaluating follow-up patients for monitoring of disease progression. Additionally, students will engage in didactic learning through case presentations and journal article reviews as well as in depth discussions on the diagnosis and management of oral mucosal diseases and orofacial pain disorders.
 

 

Honors & Electives Programs: OMPRM

Oral & Maxillofacial Radiology Honors Program

The honors in Oral & Maxillofacial Radiology is a one-half-day session per week throughout the academic year clinical experience in which the D3 student will gain additional training in the practice of Oral & Maxillofacial Radiology. Students will be exposed to radiographic normal anatomy and interpretation of conventional and advanced imaging systems and gain experience on interpretation of complicated radiographic findings and reading and interpreting cone beam CT scans. This course will focus on the interpretation of different types of head and neck imaging, especially cone beam CT and advanced imaging. The students will understand the technique and indications of different types of radiographs, proper and systematic evaluation of different types of radiographs and accurate description of the radiographic findings and adequate differential diagnosis and appropriate follow-up.

 

Oral & Maxillofacial Pathology Diagnostics Honors Program

This course allows D3 students the ability to see and learn the pathologic findings of common oral lesions. Students learn to recognize histopathologic characteristics of neoplastic, infectious and reactive lesions of the head and neck. Weekly microscopic sessions with boarded oral and maxillofacial pathologists help students correlate basic science with clinical practice. This course is especially applicable to students who have an interest in attending specialty training in oral surgery, endodontics, periodontics and oral medicine/oral pathology.

Oral Medicine and Pathology Honors Program

This program is dedicated to the diagnosis and management of patients with a wide range of oral lesions. Students will develop their diagnostic skills, learn how to manage chronic oral mucosal diseases with a number of pharmacologic therapies, take intraoral photographs and perform various diagnostic tests including mucosal biopsies. Microscope sessions provide students with the opportunity to review the microscopic appearance of the tissue they have removed by biopsy. Students will learn the process involved in presenting in a "grand rounds" format with two of their most interesting patients. This will include learning how to put together a PowerPoint presentation with digitized pictures, how to perform a Medline search, and how to critically review the scientific literature.

 

Orofacial Pain Elective

This clinical concentration program provides the participant with the opportunity to gain experience in the diagnosis and management of the patient with orofacial pain — including some of the most challenging disorders faced in practice resulting in great impact on the patient’s quality of life. The program includes regular and intensive "hands-on" clinical experience under the supervision of well-trained attending faculty. Participants will receive training which specifically addresses relevant craniofacial anatomy and neurophysiology as well as diagnostic classification criteria / systems and the full spectrum of medical, procedural, physical, and behavioral therapeutic modalities.

 

Special Patient Care Elective Program

This clinical concentration program provides the participant with the opportunity to gain experience in the diagnosis and management of patients with medical complexities and developmental, intellectual, behavioral, physical, and mental/cognitive disabilities. The program provides the student exposure to the types of patients whom they may encounter during their hospital-based general practice residency. Additionally, it will prepare students to manage and treat patients with medical issues in private practice. The program includes intensive "hands-on" clinical experience under the supervision of well-trained attending faculty along with a discussion of cases. The students will be responsible for an assigned roster of patients and will have the opportunity to provide comprehensive dental treatment throughout the academic year as their schedules allow. The students will be encouraged to engage in scholarly activity, including publications and presentations at the annual meetings of the Special Care Dentistry Association (SCDA) and American Dental Education Association (ADEA). Credit for procedures performed during the clinic sessions will be awarded toward graduation requirements.
 


 

Patient Admissions (Suite 1A)

Faculty from the Department welcome new patients to the professional and caring environment of the Patient Admissions suite. Initial visits include a medical history/medication review and a comprehensive head and neck examination, which includes a cancer screening. X-rays will also be assessed at this visit and taken if needed.

Information for PATIENTS »

Information for Students:

Second, third- and fourth-year students will be assigned 6-10 days of rotation each year.

You will gain hands-on clinic experience in reviewing the patient’s chief concern, acquiring vitals, collecting a thorough medical history, list of medications and social history. You will receive training in how to manage medically complex patients and request consultation from other health professionals.  Additionally, you will acquire skills in performing a comprehensive extra-oral and intra-oral exam, assess findings and determine the need for referral.  Imaging skills will include prescribing, acquiring and interpreting radiographs. 

There are usually 14-18 dental students in the clinic with 3 – 5 faculty per session.

Approximately 32 – 36 patients are seen in the Admissions Clinic every day.

 

Oral Medicine/Pathology

Mondays & Wednesdays
345 E. 24th Street, Suite 2S, New York, NY 10010

Phone: (212) 998-9743
Fax: (212) 995-4767

We provide care to patients with a range of complaints including, but not limited to:

  • abnormal swellings involving the head and neck (jaw/oral region),
  • oral sores or lumps and bumps inside the mouth,
  • severe dry or burning mouth or other neurosensory disorders, and
  • abnormal/pathological x-ray findings unrelated to common dental issues.

After a complete history and oral exam, we use imaging, perform tissue biopsies and other chairside diagnostics, and manage a wide range of patients with oral mucosal diseases, salivary gland disorders and other diseases affecting the jaws and oral structures. Our faculty are trained in the specialties of Oral Medicine or Oral and Maxillofacial Pathology.

Information for PATIENTS »

Information for Students:

The rotation is four consecutive days, Monday though Thursday, from 9:00 am to 6:00 pm. You will be in the Oral Medicine clinic for two days and the Orofacial Pain clinic for two days.

You will see patients with various types of pathologies that you learned about in your didactic courses.

You will work on patients hands-on and learn to take a good medical history, perform a comprehensive extra-oral and intra-oral exam, make an appropriate clinical or differential diagnosis, write prescriptions, and learn to perform soft tissue biopsies.

There are usually eight senior dental students in the clinic with two faculty per session.

Approximately 15 to 20 patients are seen in the Oral Medicine clinic per day on Monday or Wednesday.

Information for Faculty:

Please fill out an internal referral form for oral medicine. Then the student or resident can bring the patient or the patient can come straight to the oral medicine clinic (1A) and schedule an appointment directly with the patient service representative.

Certainly. Please either call (212) 998-9743 to make an appointment, visit the clinic on the first floor, or e-mail one of the oral medicine faculty.

Yes, you are always welcome to participate in the care of your family member.

There are usually 8–9 senior dental students per weekly rotation.


 

Cone Beam Computed Tomography (CBCT)

Schedule an appointment for CBCT:
Cone Beam CT Imaging Service
345 E. 24th Street, Suite 1A, New York, NY 10010

Phone: (212) 998-9430
Fax: (212) 443-1347

Complete a Cone Beam CT Prescription »

Fully digitized radiology service provides intraoral, panoramic, and 3D imaging (cone-beam computed tomography) to patients of NYU Dentistry and those referred from outside providers. There are four (4) cone beam CT scan machines. Faculty from the Department of Oral & Maxillofacial Pathology, Radiology and Medicine also provide radiographic interpretation and radiographic consults on different types of radiographs.

Information for PATIENTS »

Information for Students:

The Office of Academic Affairs sends an email regarding the honors courses, including eligibility criteria, in the spring semester. After submitting your application, you will be invited for an interview and later notified if you are selected. Currently, two students per year are accepted.

The course will help to improve radiographic interpretation skills and knowledge of the technical aspects of cone beam computed tomography. This is very beneficial for students interested in a number of specialty residencies, including Oral and Maxillofacial Radiology, Oral and Maxillofacial Surgery, Periodontics, Endodontics, and Prosthodontics.

 

Orofacial & Head Pain

Tuesdays & Thursdays
345 E. 24th Street, Suite 2S, New York, NY 10010

Phone: (212) 998-9743
Fax: (212) 995-4767
 

The Orofacial and Head Pain clinic provides highly specialized diagnostic and treatment modalities for complex orofacial pain disorders. A large number of acute and chronic pain disorders are treated, including but not limited to:

  • temporomandibular disorders (TMD, TMJ),
  • musculoskeletal disorders,
  • neuropathic (nerve) disorders such as trigeminal neuralgia and post-traumatic neuropathies,
  • headache,
  • movement disorders (dystonia), and
  • sleep apnea.

Our specialty trained and board certified clinical faculty bring the highest level of multimodal treatment, care and pain relief for individuals dealing with these diagnoses.

Information for PATIENTS »  

Information for Students:

Requirements and responsibilities are outlined by your course director and will be emailed to you.

Yes, patient consult and follow-up visits will be conducted by students along with attending guidance.

Apply for the Orofacial Pain Elective in your D3 year.

Complete the in-house referral form in Axium, and then give your patient instructions to call 212-998-9743 to make an appointment.

Information for Faculty:

Complete the in-house referral form in Axium, and then give your patient instructions to call 212-998-9743 to make an appointment.

Every effort is made to reply to the in-house referral form in Axium. You may also call the clinic directly and ask to speak to an attending.

Yes, you may call the clinic to reach any of our orofacial pain faculty to discuss a patient.


 

Clinical Management of Special Needs Patients

Under the supervision of experienced faculty, fourth-year dental students attend to the dental needs of individuals with disabilities at the NYU Dentistry Oral Health Center for People with Disabilities. Among the patients presenting to the Center are individuals with intellectual, developmental, physical, mental, cognitive, and behavioral impairments along with patient undergoing complex medical therapy like transplants and oncologic care who require dental clearance before their treatment.

Information for PATIENTS »

Information for Students:

There are four full-time licensed dental assistants that assist with treatment throughout the day. In addition, all third-year students assigned to a concurrent 3-week rotation play a role in the assistance of care.

Yes, students have the opportunity to provide all dental treatment. Oral surgery, prosthodontics, endodontics, and restorative dentistry are just some of the many realms of procedure we do within the program. We complete all procedures within the scope of general dentistry.

Patients with all types of mental and physical disabilities and medically complex patients are seen in the program.

 

The facility provides several accommodations for patients: The rooms are larger than typical operatories and have soothing, adjustable, multi-colored lighting to help create a relaxing environment; one room accommodates the treatment of bariatric patients; a wheelchair tilt is affords patients the ability to receive care without transferring out of their wheelchair; the multisensory room is designed to accommodate patients who require sensory modulation.

Yes, once a medical and dental assessment of the patient's needs have been completed, options for sedation (ranging from mild to deep sedation) are considered.