Liverpool Head & Neck Centre

Oral Medicine is a dental speciality concerned with the medical management of chronic disorders of the head and neck, particularly oral soft tissue pathology, salivary gland disease and facial pain.

The conditions managed by Oral Medicine specialists often require multidisciplinary input and therefore the team regularly works other medical and dental specialists to ensure a holistic approach to patient care.  Further information on the scope of Oral Medicine practice can be found here: https://bisom.org.uk/clinical-care/

Conditions Treated

Oral Dysplasia (“pre-cancer”)

Specialist input from Oral Medicine and Oral and Maxillofacial Surgery Consultants is available through the Oral Dysplasia Clinic, which is held once per month at Liverpool University Dental Hospital Oral Medicine Department. 

What is Oral Dysplasia?  Patients’ who develop a red or white (or mixed red and white) patch on the lining of their mouth should be referred (by their GP or Dentist) for specialist assessment, where a biopsy (sample) of the patch can be taken, with the aim of confirming the diagnosis.  In some cases, these patches contain abnormal cells and the patient is diagnosed with “oral dysplasia”.  Patients with oral dysplasia have a slightly increased risk of oral cancer hence it is known as a “potentially malignant disorder”; the risk of developing oral cancer depends on the severity of the dysplasia and treatment is available in many cases.  Patients with mild oral dysplasia are often simply kept under close surveillance, with a review appointment every 3-12 months.  If the patch/lesion changes in appearance, a further biopsy would be suggested.  In some cases, the patch is removed surgically, with the aim of reducing the risk of oral cancer development.  In cases where a cancer develops in a patient with oral dysplasia, the disease is often caught at the earliest stage when treatment with simple surgical or laser excision is possible with excellent prospects of full recovery.   

Other Oral Conditions (Oral Medicine)

  • Lichen Planus

  • Recurrent Oral Ulcers

  • Immunobullous (Blistering) Diseases

  • Infections of the Oral Mucosa (lining of the mouth)

  • Geographic Tongue

  • Salivary Gland Pathology (Dry Mouth)

  • Orofacial Granulomatosis

Further information can be found on all of these conditions via the British and Irish Society for Oral Medicine

Clinics

Liverpool University Dental Hospital

The hospital offers treatment on referral from primary or secondary care within its six specialist departments: Restorative Dentistry (Conservation, Prosthetics, Periodontology), Paediatric Dentistry, Orthodontics, Oral Surgery, Oral Medicine and Special Care Dentistry. Patients with latex allergy are treated in a latex-free suite.  There are operating theatres for day-case procedures for patients requiring treatment under general anaesthesia or intravenous sedation.  Further information can be found here:  Liverpool University Dental Hospital (rlbuht.nhs.uk).

Address: Pembroke Place, Liverpool L3 5PS

Contact:  0151 706 5000

Our Team

Dental Hospital - Oral Medicine

  • Dr. Bijaya Rajlawat, Consultant and Honorary Lecturer in Oral Medicine; Head of Department

  • Professor Anne Field, Consultant in Oral Medicine

  • Dr. Caroline McCarthy, Academic Clinical Lecturer in Oral Medicine

  • Dr. Daniel Finn, StR Oral Medicine

  • Dr. Majella Gregory, Speciality Dentist

Referral Information

Conditions managed:

  • Oral mucosal disease including oral lichen planus and immunobullous disorders.

  • Oral leukoplakia/erythroplakia or suspicious oral mucosal lesions (NB: if you strongly suspect oral cancer, please refer urgently to the Maxillofacial Unit, Aintree).

  • Recurrent aphthous stomatitis and other ulcerative conditions affecting the mouth.

  • Sore mouth, including Burning Mouth Syndrome (BMS).

  • Orofacial manifestations of systemic disease(s).

  • Candidal and viral infections if severe/recurrent.

  • Trigeminal neuralgia (suspected) – dental causes must first be ruled out (see guidelines for referral to Restorative Dentistry).

  • Soft tissue lesions (eg polyps) – if possible refer to OS/OMFS.

  • Orofacial pain, including atypical facial pain and oral manifestations of psychogenic disorders. Please note: (1) Patients with undiagnosed orofacial pain which may, or not, be dental in origin – should be referred directly to Restorative Dentistry with appropriate radiographs (will be copied and returned). (2) Patients with chronic facial pain are sometimes referred to the Oral Medicine clinic by GDPs, however many of these cases have already been seen and fully investigated by a number of other specialists in the past and the GMP has full details on file. It would therefore be helpful, if you could liaise with the patients GMP as referral to Oral Medicine may not be appropriate. Unless there are exceptional circumstances, we do not offer consultations to patients whose facial pain has already been managed in Pain Clinics elsewhere.

  • Xerostomia and salivary gland disorders. (1) Patients with OBJECTIVE evidence of oral dryness with: positive response to possible ‘Sjogren’s Syndrome’ questions (2) Patients with SEVERE oral dryness with no apparent underlying cause. Please see separate guidance on referrals to Oral Medicine for patients complaining of a dry mouth.

Referrals are not accepted for:

  • TMJ disorders

  • Periodontal disease, unless clinical presentation is part of generalised, oral mucosal disease (eg desquamative gingivitis secondary to oral lichen planus, or immunobullous disease)

  • Dental conditions or anomalies

  • Pain of dental origin

  • Cysts in jaws, bony anomalies

Referrals to the Oral Medicine Department should be sent to Dr Bijaya Rajlawat, Consultant in Oral Medicine

Urgent Advice – ‘Suspicious’ Oral Lesions

Patients presenting with a ‘suspicious’ oral lesion can be referred (mark ‘urgent’) on the Dental Referral Proforma. If you require immediate advice, please telephone 0151 706 5090 and ask to speak to a member of the Oral Medicine or Oral Surgery staff. (Back up telephone lines: 0151 706 5067 or 0151 706 5083.)