Lesson of the Week: Value of opinion by oral physician in diagnosing Wegener's granulomatosis

Adequate and appropriate oral biopsy by an oral physician may help diagnose potentially life threatening systemic disease

It has long been appreciated that the mouth is the mirror of the rest of the body. Many systemic diseases have oral symptoms, which often coincide with widespread evidence of disease. In some cases, however, oral symptoms may be the sole presenting sign of systemic disease. This may cause difficulty in diagnosis, yet little attention is paid to examination of the oral cavity in medical undergraduate training. It is therefore important that patients with oral lesions are referred to specialists in oral medicine for diagnosis, investigation, and management. We report on a patient in whom the diagnosis and treatment of a potentially life threatening systemic disease was delayed owing to poor appreciation of the clinical importance of oral lesions.