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Oral & Maxillofacial Pathology, Radiology and Medicine

Chair, Joan A. Phelan, DDS, Professor of Oral and Maxillofacial Pathology, Radiology and Medicine

Associate Chair, Miriam R. Robbins, DDS, MS, Clinical Associate Professor of Oral and Maxillofacial Pathology, Radiology and Medicine

Overview:
The educational program of the department is comprised of a broad range of didactic and clinical activities that includes didactic and clinical courses to undergraduate dental students, a didactic course to dental hygiene students and both didactic courses and microscopic experience for post-graduate students.  Many faculty members have advanced graduate and clinical specialty training, providing a core of clinician-scientists whose leadership in research and education position them at the cutting edge of clinical dentistry and research.

The department’s undergraduate dental curriculum includes courses in all four years.  The goal is to develop the dental student’s knowledge and skill in comprehensive patient evaluation and diagnosis in preparation for treatment planning so that they develop treatment plans that address existing problems as well as disease prevention and health promotion.  The department’s curriculum is integrated with those of other departments in the College of Dentistry and 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 and oral manifestations of systemic diseases.

The Oral Diagnostic Pathology Laboratory, New York University College of Dentistry’s oral biopsy service is part of the department.  The laboratory provides histopathology examination and diagnosis of cases submitted from the dental center clinics and by private dentists in the community.  The laboratory also serves as a resource for research projects developed by the faculty of the College.

The department’s research programs are vibrant and represent the keen interest of the department faculty in the generation of new knowledge that expands the breadth and depth of dentistry.  Departmental faculty are investigators in a broad range of research that includes topics such as diagnostic technologies for early detection or oral cancer or precancer, trials to develop new medications for oral mucosal disorders, oral manifestations of HIV infection, epidemiology and new treatments for chronic pain disorders and bioethical issues in medicine and dentistry.

Curriculum

First Year
Patient Interaction, Health Screening and Record Taking
This course introduces the student to the scope of dental medicine and the overall goals of health care provided by the dentist. It builds on information presented during earlier courses: (1) Dentistry as a Science and a Profession and (2) Epidemiology and Health Promotion. The course reviews the overall goals of health care provided by the dentist and begins a detailed study of the elements of a patient’s health history and physical examination that form the basis for a comprehensive approach to diagnosis, risk assessment, disease management, and health promotion. Emphasis is placed on how information is organized and recorded in a patient’s record (chart). Using case histories the course systematically explores all aspects of the patient evaluation process as they are presented in the NYU College of Dentistry Patient Chart and discusses how patient information contributes to an understanding of a patient’s (oral) health care problems and needs. It identifies circumstances that require the doctor to seek additional information and actively explore strategies for acquiring the information sought. This course continues the process of fostering students’ decision-making skills based on an understanding of epidemiology and critical thinking in the practice of dentistry. This course concludes with student-driven and student-presented analyses of patients actively receiving care at the College of Dentistry.

Second Year
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, inflammation, wound healing, immunopathology, developmental and genetic disorders, neoplasia and an introduction to oral precancer, hemodynamic disorders, nutritional disorders, aging, and environmental and radiation induced pathology. The infectious diseases component of this course includes the properties of bacteria, viruses, fungi, and protozoa and the virulence factors that enable them to cause disease in humans. This component of the course covers the major infectious diseases in humans including the identification of the organisms that cause these diseases, the prevention of transmission of infectious diseases, and treatment with antimicrobial agents. Microbiology and pathology of infectious diseases are integrated in the infectious diseases component of this course.

Systemic Pathology
Systemic pathology, a course jointly run with the Department of Basic Science and Craniofacial Biology, focuses primarily on mechanisms of disease and includes common diseases of the major organ systems. Physicians introduce major and current concepts in the lectures. The application of these pathologic principles to dental treatment, particularly of medically complex patients, is also an important component of the course and is taught in smaller, interactive seminars with a significant emphasis on critical thinking and case-based learning. Oral manifestations related to systemic disease are included in the seminar cases. Clinical cases are also presented to the entire class as clinical conferences. The foundation knowledge taught in systems pathology applies to the clinical disciplines.

History and Physical Examination

This course builds on the freshman course Patient Interaction, Health Screening, and Record Taking and is designed to take dental students through a comprehensive process of data collection for any new patient (adult or child), ranging from chief complaint, medical history and review of systems, the steps necessary to make a medical risk assessment, social and dental/oral history, and the steps of a physical examination. In the process, students also learn how to recognize and report signs of abuse.

Radiology
The first part of this course provides the fundamental knowledge in radiology as it relates to X-ray generation, image formation, imaging systems, and radiobiology and radiation protection. With this course as a base the student applies this knowledge to their preclinical mannequin and clinical experience. The second part of the course prepares them for the course in Diagnostic Radiology with topics that include expanded intraoral radiographic anatomy and the theory and interpretation of panoramic, extraoral, CT, and MRI images.

Introduction to Patient Care-Clinics
This course builds on the preclinical skills learned during the sophomore-year Simulation course and allows students to gain hands-on clinical experiences performing various procedures that are not ideally suited to simulation, yet are required before promotion to the junior clinics. These experiences include head and neck examination, various diagnostic tests, impressions and other prosthodontic techniques, periodontal probing and scaling, fabrication of a pediatric sports mouth guard, and administering local anesthesia.

Diagnosis and Treatment of Oral Diseases
This course is an integrated course and includes a series of units each focusing on a different area of diagnosis and management of oral diseases.  The introduction to the diagnosis and management of oral mucosal and salivary gland diseases is taught by the faculty of the Department of Oral and Maxillofacial Pathology, Radiology and Medicine.

Third Year
Care of the Medically Complex Patient
This course builds upon prior course knowledge that was presented in Systemic Pathology and Diagnosis and Management of Oral Diseases as well as basic science courses.  The course focuses on the clinical presentation and natural history of selected medical disorders and reviews the practical information that is needed in order to arrive at a medical risk assessment and develop appropriate management strategies in the delivery of dental care.

Oral and Maxillofacial Pathology and Radiology

This course builds on the foundation knowledge of pathologic processes that was presented in D2 General Pathology, Infectious Diseases and Systemic Pathology.  The course provides an overview of oral pathology including the clinical and radiographic presentation of oral diseases and pathogenesis. Diagnostic procedures and treatment of oral disease are introduced in relationship to the clinical and radiographic presentation and pathogenesis.

Applied Clinical Pharmacology and Therapeutics
This course complements lectures in the Care of the Medically Complex Patient course and specifically addresses the pharmacologic management of common medical disorders.  The course focuses on the pharmacology of commonly prescribed drugs in the practice of dentistry.  The course also includes an overview of the process of clinical trials that must be achieved before a drug can be prescribed by the dentist.

Orofacial Pain-Neurosensory Disorders
This course focuses on the biology, pathology and psychology of chronic orofacial pain, with an emphasis on the diagnostic criteria and general treatment options available for patients with chronic neurosensory/pain disorders.

Second and Third Year Clinics
Oral Medicine, Diagnosis and Radiology Clinic
Radiology Clinic. The student spends approximately 24 hours in the Admissions and Radiology Clinic where she or he evaluates patients for the purpose of acquiring clinical skills in the selection, prescription, execution, and interpretation of an appropriate radiographic examination.

New Patient Admissions Clinic:
In this clinic assignment, students learn to evaluate the patient's chief complaint, medical status and collect the data needed to develop an appropriate treatment plan.  The goal of this clinical experience  is to develop the dental student’s knowledge and skill in comprehensive patient evaluation and diagnosis so that they develop treatment plans that address existing problems as well as disease prevention and health promotion, including assessment of patients’ overall health status and its impact on oral health care.

Fourth Year
Interdisciplinary Seminars
This highly interactive, case-based conference emphasizes comprehensive patient evaluation, critical thinking, problem-solving, and treatment planning skills and knowledge essential for senior dental students as they approach graduation and transition into private practice or advanced dental education. Using interactive, computer- and classroom-based learning environments, students actively, comprehensively, and critically evaluate four patient cases with a wide range of health problems. Prior to each interactive seminar students are required to complete computer-based, self-instructional modules for each case.

Fourth Year Clinics

Oral Medicine, Diagnosis and Emergency Clinics
Emergency Clinic
Students have approximately 24 hours of formal training and patient care in the Dental Emergency Clinic in addition to their ongoing experience in providing emergency dental services during their general patient care experiences in the group practices. During this rotation students gain experience in quickly and efficiently assessing urgent emergent dental and other oral problems.

New Patient Admissions Clinic:
In this clinic assignment, students learn to evaluate the patient's chief complaint, medical status and collect the data needed to develop an appropriate treatment plan.  The goal of this clinical experience  is to develop the dental student’s knowledge and skill in comprehensive patient evaluation and diagnosis so that they develop treatment plans that address existing problems as well as disease prevention and health promotion, including assessment of patients’ overall health status and its impact on oral health care.

Senior Honors Programs
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 intra-oral 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 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.

Chronic Facial Pain Honors Program
This Clinical Concentration program provides the participant with the opportunity to gain experience in the diagnosis and management of the patient with orofacial pain -one of the most challenging problems faced in dental practice and one with great impact on the patient’s quality of life. The program includes regular seminars 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 Honors Program
This Clinical Concentration program provides the participant with the opportunity to gain experience in the diagnosis and management of the patient with complex medical histories and special needs. It is designed to give students who are interested in pursuing residency programs after graduation exposure to the types of patients generally treated in a hospital setting. Additionally, it will prepare students to treat patients with medical problems in private practice. The program includes regular seminars and intensive "hands-on" clinical experience under the supervision of well-trained attending faculty. Participants will be responsible for an assigned roster of patients and will have the opportunity to provide comprehensive dental treatment while receiving training in the management of physically, mentally and medically disabled patients. Students will receive credit for procedures performed during the clinic sessions towards graduation requirements.