INTRODUCTION
In 2012, Dr. Robert Marx and Dr. Diane Stern completed a 2-volume award-winning clinical text called Oral and Maxillofacial Pathology: A Rationale for Diagnosis and Treatment. Oral Pathology in Clinical Dental Practice is the progeny of that work. The original volumes were written primarily for oral and maxillofacial surgeons, whereas, the audience for Marx’s new book is practising dentists, dental hygienists or other health professionals who recognize an abnormality or pathologic condition during the client visit. The purpose of this book is to promote early identification of oral disease by providing a guide to certain conditions and suggestions for what path to take to benefit the client.
Robert E Marx is an award-winning professor of surgery and chief of the Division of Oral and Maxillofacial Surgery at the University of Miami, Miller School of Medicine. He is an educator, researcher, and surgeon known for his innovative treatments for pathologies of the oral and maxillofacial area as well as new techniques in reconstructive surgery. As a researcher he has made valuable contributions to our understanding of the relationships between smoking and carcinogenesis and the clinical applications of recombinant human bone morphogenetic protein and stem cell use. He was the first to identify bisphosphonate-induced osteonecrosis of the jaws. For the past 34 years, he has overseen the training of scores of residents and fellows.
ANALYSIS
The book has an appealing neutral blue hard cover with glossy pages. The title should pique the curiosity of the reader who is in clinical practice. It prompts questions such as: Would it be a useful reference book for my operatory; a quick reference book? Will I, in clinical practice, be able to use this book as an easy and quick guide to identify a suspicious lesion? Will it help me differentiate between lesions that are similar in appearance? What is the treatment? What is the possible prognosis for this client? For the most part, I would say the answer to these questions is “yes.”
After a cursory browse through the book, I was pleased to see the expected radiographs, histological images, and shocking photos at the top of each page with the lesion titles directly below. This layout allows the clinician to view the image for a comparison to what was found in the client’s mouth and read a succinct review. However, when I decided to test the ease of searching for a specific lesion, I first looked at the back of the guidebook for an alphabetical index: I found none. Lesion names are only listed on the first page of each chapter. That means, in order to find a particular lesion, let us say, lichen planus, the reader has to know to look for it in chapter 2, “Red and White Lesions.” This certainly would be within the ability of the dentist and dental hygienist, but I feel the book’s usefulness as a quick, easy reference guide would be strengthened if an index were included. Would a nurse or nurse practitioner have the ability to locate lichen planus in this guide with ease?
On the positive side, the 12 chapters are named in a logical manner and organized by lesion descriptors: colour, mass, location, radiographic viewing, and infectious disease. The chapters are as follows:
Recognizing Abnormalities and Pathological Conditions
Red and White Lesions
Masses Within the Soft Tissues of Oral Mucosa
Oral Mucosal, Facial, and Neck Masses
Infectious Diseases of Jaws and Oral Cavity
Radiolucent Lesions
Radiopaque and Mixed Radiolucent-Radiopaque Lesions
Radiopaque Lesions in Soft Tissue
Pigmented Lesions of Mucosa and Facial Skin
Lesions of the Facial Skin and Oral Mucosa
Exposed Bone Pathologies
Vascular Lesions of Oral Mucosa and Skin
Marx begins his reference guide with a well-written and emphatic reminder for the reader to use the 3-pronged approach to recognizing abnormalities and pathologies:
LISTEN – Chief complaint, history of present illness, and past medical history
LOOK – Oral exam and ask the client questions about the lesion
PLAN – What is my course of action? What is my referral action?
If you are like many who purchase reference books, you may have the good intention of using the book to its fullest, but only read the first chapter and refer to the rest of the book sparingly. I would applaud you for reading Marx’s introductory chapter. It alone would have suited the author’s purpose to promote early recognition of oral lesions and perhaps save a life.
Within each chapter, each page is dedicated to one lesion with standard subtitles. The nature of the disease, how it develops, its clinical features, and radiographic presentation (if pertinent) are presented in a concise manner for every lesion or condition. Further, a fair description of the differential diagnosis is given with a brief descriptor of the most common microscopic appearance. Lastly, the author gives suggestions as to the course of action, such as when to observe and for how long, when to refer and to whom, when to biopsy, and when to order tests and for what. The final heading is suggested treatment. One must realize that this a reference guide written in a concise manner. Clinicians who would like a fulsome narrative will have to search further in the literature or purchase the author’s earlier works.
CONCLUSION
As dental hygienists, we know that the importance of oral cancer screenings leading to the early recognition of an abnormality and subsequent referrals cannot be overemphasized. If you are looking for a quick reference book to oral pathology, I suggest using one that suits your organizational needs. While I prefer an index allowing for easy cross-referencing, you may find this book’s chapters to be organized well enough to assist you in recognizing a suspicious lesion and increasing your knowledge on the conditions/disease.
Rae McFarlane, MEd, RDH, works for the Interior Health Authority in Cranbrook, British Columbia, Canada. She is also a clinical assistant professor in the dental hygiene degree program, University of British Columbia, and has served as book review editor for this journal since 2014.