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Letters: Medical education

September 03, 2012

I am writing in response to your article, "Dentistry Meets Medicine at Stanford University" (June 4 ADA News). My compliments to Drs. Hema Patel, Sabine Girod and Allen Wong for their lecture series for medical students. In the European Union, medical students are required to spend clinical clerkship time in a dental facility as part of their elective requirements during medical school.

During the past 30 years of clinical practice in oral and maxillofacial surgery, one of the most rewarding experiences I have had has been teaching third- and fourth-year medical students about the relationship of dentistry to medicine and vice versa. I have been a clinical instructor for the last five years for the Hope Medical Institute of Newport News, Va., working in affiliation with the medical universities of Silesia and Lublin in Poland.

Medical students spend dental elective time in my office learning through practical experience and at Adventist Hinsdale and LaGrange Hospitals in Illinois, where they also participate in other medical clerkships. Although they only spend a week in this elective clinical rotation, many positive experiences have been had. For example, last April a 93-year-old patient was referred by his general dentist for evaluation and routine extraction of tooth #29 which had abscessed. The patient lived alone and was not under medical care. When his vital signs were taken, bruises and ecchymosis were noted on his arms and legs, when questioned further the patient revealed he was having frequent falls for no known cause. The vital signs revealed a heart rate of about 40. I immediately thought that either this patient was Michael Jordan or he might need a pacemaker. Prompt referral into the medical system and emergency pacemaker placement may have saved his life.

Teaching the medical students has sharpened my attention to physical diagnosis and a patient’s physical status as well as dental status. There is a lot to be said for medical education in the U.S.; however, in this instance, the EU may have a leg up on the U.S. medical education with respect to dental exposure as part of their clinical medical education.

Stephen G. Marshall, D.D.S.
Westchester, Ill.