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Retired dental professor provides 35,000 oral pathology images for UM database

March 17, 2014


Database team: (Front row, from left to right) Clayton Fisher, University of Michigan School of Dentistry adjuct clinical lecturer; Dr. Erika Benavides, UM School of Dentistry clinical assistant professor; Dr. Jack Gobetti, retired UM professor; Dr. Theodora Danciu, assistant professor and director, UM Oral Pathology Biopsy Service; Vidya Ramaswamy, curriculum specialist; (back row, from left to right) dental students Matthew Van Beek, Brandon Veremis and Renee Tripon.
Ann Arbor, Mich.—A patient has an ulcer on the lip. Is it a cold sore? A canker sore? Or something worse?

"Many oral diseases look very similar while some of these entities don't always manifest the same way," said Dr. Theodora Danciu, a clinical assistant professor of dentistry and director of the Oral Pathology Biopsy Service at the University of Michigan School of Dentistry.

In an effort to help their dental students, during their studies and long after they've graduated, identify the various diseases that appear in the oral cavity, Dr. Danciu is launching a UM dental school database of clinical oral pathology images.

"With oral pathology, I found it's very important for students to have a lot of case exposure to help them identify diseases," she said. "The images will give students more visual information and ultimately provide better care to patients."

Dr. Danciu is also hopeful students will not only refer to the database, but also contribute, during and after their time at UM, to help it grow.

So far, the creation of such an extensive database is out to a good start.

UM School of Dentistry's own Dr. Jack Gobetti is allowing the school to archive and use more than 35,000 clinical oral pathology images he photographed during his 38 years of teaching.

"Dr. Gobetti's images are a treasure to be valued by generations of faculty and students and that will facilitate keen diagnostic skill development critical for effective patient care," said Dr. Laurie K. McCauley, dean of UM School of Dentistry.

The collection, Dr. Gobetti said, chronicles more than 200 diseases—from cold sores and anemia to HIV.

"So many diseases show up in the oral cavity," he said. "It surprises people but mouths can only express diseases in so many ways. The collection allows people see the tiniest of differences."

Many images in the Gobetti collection include case histories chronicling a patient's struggle with a particular disease.

For example, Dr. Gobetti said, he followed, for 20 years, one of his patients who had lichen planus. The disease was stress-related.

"When her son went to Vietnam, there was nothing I could treat her with that would make it go away," Dr. Gobetti said. "Each slide in the collection is part of a story. You gain a better appreciation of a disease when you're able to follow it for a long time."

Dr. Gobetti estimates teaching about 4,000 dental students in his time at UM dental school. Even though he retired seven years ago, his collection will be used to teach many more.

Dental students will digitize the images. None of the Gobetti images are yet in the database, which currently has about 300 images.

Unlike oral pathology images easily found through Google searches, all content in the database will be screened and controlled by faculty.

All images, including those from the Gobetti collection, will be organized by disease type and will include information such as summaries of findings, treatment plans and how patients responded, Dr. Danciu said.

In addition, Dr. Danciu's students are involved in all levels of creating the database—from taking the pictures to analyzing the diseases in the photographs.

The database is funded by grants, which were received in April 2013, from the Roberts Family Foundation and the Center for Research on Teaching and Learning from the University of Michigan.