‘National Oral pathologist day’ is celebrated on February 25. This day was instituted by the Indian Association of Oral and Maxillofacial pathologists to honor Dr.Harnath Manishankar Dholakia, who is the first post-graduate teacher in Oral pathologists of the country by dedicating his birthday.
Oral pathology (oral and maxillofacial pathology/head and neck pathology) is a specialized field of dentistry dealing with the diseases of the oral cavity and its associated structures (i.e., teeth, tongue; bony tissue [maxilla and mandible]; joint [temporomandibular joint]; lymph nodes; nerves; structures in neck and blood vessels of the ear, nose, and throat [pharynx and larynx]). The qualified doctors of this domain are called oral and maxillofacial pathologists. Oral pathology deals with the diagnosis of developmental anomalies, cysts, benign tumors, cancer, salivary gland pathology &various infection which includes bacterial, fungal & viral.
As per the Dental Council of India (DCI), Oral pathology and microbiology are one of the recognized branches of dentistry. Therefore, oral pathology is not only a branch of dentistry but also of pathology and, in turn, related to medicine. Like other branches of pathology including neuropathology, nephropathology, hematopathology, pediatric pathology, dermatopathology, and oncopathology, Oral pathology is also a recognized branch of pathology, and this fact has already been acknowledged by the Royal College of Pathologists, United Kingdom.
The branch of Oral pathology started in India way back in the 1950s, with postgraduation in the 1960s. As per the DCI in 2018, there are 559 MDS seats in the department of oral pathology and microbiology in 174 dental colleges, respectively, across India. The major reason for doing MDS for any BDS graduate is to hone up their skills and become a specialist. Furthermore, awareness about oral pathology among professional medical colleagues and the general public should be created.
All oral pathologists need to understand their potential strengths. Of all the dental specialties, oral pathology is the foundation subject on which the science of dentistry stands, and this branch is unique in many aspects. It is the only branch of dentistry representing the confluence of basic sciences and clinical dentistry, covering the subjects of hematology, biochemistry, immunology, serology, microbiology, oncology, histopathology, and cytopathology. It is a well-known fact that the prevalence of oral cancer along with other head and neck pathologies is very high in India.
Oral cancer is the third most common cancer and accounts for 30% of all malignancies in India. Furthermore, 7.8% of the global cancer burden is contributed by India. Various fellowship courses/postdoctoral certificate courses in head and neck oncopathology, laboratory medicine, and molecular pathology can be started by the Indian Association of Oral and Maxillofacial Pathologists, which can further form a board by the name of the Indian Board of Oral and Maxillofacial Pathology for granting fellowships. National Accreditation Board for Testing and Calibration Laboratories (NABL) accreditation of oral pathology laboratories in dental colleges and private practice can be done. Quality management programs for NABL accreditation can be done by budding oral pathologists, which, in turn, will help them by acquiring the post of quality manager in diagnostic pathology laboratories. Awareness among the general public and professional medical colleagues can be done through means of government bodies by including MDS (oral pathology) as one of the qualifications for eligibility in cancer centers and diagnostic laboratories.
Oral pathologists can be employed as a consultant, laboratory administrator, and quality manager in diagnostic laboratories; onco-histopathologist in cancer hospitals and oral cancer centers; consultant in dermatology clinics and editor/project in-charge in journal or book publishing industry. The research laboratories can be made mandatory in dental colleges, which will further increase avenues for oral pathologists as oral pathology is one of those unique specialties where research is an integral part of oral pathology. Oral pathologists should be allowed to teach general pathology and general microbiology classes in academics which will further increase job opportunities.
Dental/oral anatomy and histology and forensic odontology can also be made as separate departments to increase vacancies. Further, oral pathologists can set up and run their own pathology laboratories/diagnostic centers and practice oral pathology and routine general pathology. To mention, there is mushrooming of pathology laboratories that are run by unauthorized qualified or unqualified lab technicians at the majority of places in India which depicts a tremendous lack of qualified and authorized workforce in the field of pathology across the nation. Oral pathologists can practice their specialty as per the DCI MDS curriculum and DCI code of ethics. Recently, NABL has considered MDS (oral pathology) as an authorized signatory for cytopathology and histopathology cases pertaining to the oral and maxillofacial region and hematology cases prescribed by only dental professionals.
Oral pathology as a super specialty seldom makes a cut as a preferred choice of postgraduation and career due to several challenges being faced in the present scenario. The fast-increasing rates of oral cancer and manifestations of other systemic diseases to oral and maxillofacial regions require and will be definitely benefitted from the nurturing of the field of oral pathology. Finally, competency is someone’s subjective dedication and ability, not based on qualifications only. It is rightly said “survival of the fittest,” so competent people will survive. Therefore, by becoming competent in the subject, making necessary changes in the oral pathology curriculum, and incorporating proposed solutions, the grace of the oral pathology can be maintained as well as grooming.
References:
- Nagpal B. Delineating the scope of oral pathology and microbiology: Present scenario and future prospects. Journal of oral and maxillofacial pathology: JOMFP. 2019 Jan;23(1):5.
- Govindarajan S, Muruganandhan J, Raj AT. Oral pathology in India: Current scenario and future directions. World J Dent. 2017;8:429.
Image Courtesy; freepik.com
