Bridging Medicine and Dentistry Through Clinical Pathology: A Call for Integration

Despite remarkable progress in both medicine and dentistry, clinical collaboration between these 2 disciplines remains relatively limited. ¹ However, such separation may no longer be sustainable in this era of global aging and increasing multimorbidity. Fragmented care pathways often result in delayed diagnoses, redundant treatment, and missed opportunities for early intervention. ² As a clinician formally educated in both medicine and dentistry, I have firsthand experience of how this disconnect between the two fields impedes fully comprehensive patient care.

Several structural factors are responsible for this disconnect. Medical and dental education systems are often designed independently. As a result, their separate institutions, curricula, and accreditation processes foster siloed thinking and impact clinical practice.^3,4 Globally, differences in medical and dental insurance reimbursement models, record-keeping systems, and organizational cultures continue to impede integration, making interdisciplinary collaboration the exception rather than the norm.^5,6

Clinical pathology offers a promising foundation for integrating medicine and dentistry. The oral cavity serves as a diagnostic crossroad where systemic and oral health conditions intersect.^7,8 Many systemic diseases manifest as oral symptoms in the early stages. For example, diabetes often coexists with periodontitis in a bidirectional relationship, complicating the management of both conditions. Other systemic disorders, including hematologic, autoimmune, and infectious diseases, may also present with oral symptoms that serve as early warning signs. Conversely, dental pathology, particularly chronic oral inflammation, has been associated with higher risk of cardiovascular disease, poor pregnancy outcomes, and cognitive decline.^9-11 For example, recent studies have suggested emerging associations between oral health and systemic conditions. In particular, the relationship between oral microbiome composition and systemic diseases is a topic of ongoing discussion.^12,13

The relationship between internal medicine and dental pathology has been widely documented in leading clinical and biomedical journals.^13-15 The complex association between systemic diseases and oral health continues to be uncovered through an accumulating amount of research.^16,17 This journal considers it a priority to clarify the mechanisms of these diseases, particularly from a pathological perspective, and will continue to focus on this area of research.

Despite its potential, clinical pathology remains a relatively underutilized tool for medical–dental collaboration. One major limitation lies in the education and training processes. Many universities still teach pathology separately in medical and dental schools, often with different emphasis and depth. As a result, dental students have minimal exposure to systemic pathology, while medical students, in contrast, usually overlook the diagnostic significance of oral findings. Interprofessional case discussions are also rare, leaving few opportunities for collaborative training. These early missed opportunities have long-term repercussions on collaborative clinical reasoning. Recent studies suggest that these educational and structural gaps have yet to be fully addressed. For example, Fatahzadeh et al reported that oral medicine–centered interprofessional case conferences markedly enhanced students’ understanding of the mouth–body connection; however, such experiences remain uncommon in preclinical curricula. ¹⁸ Alqutaibi et al and Khabeer and Faridi also reported a lack of comprehensive interprofessional education frameworks and inconsistent integration across institutions.^19,20 To address these issues, clinical pathology education could be provided to medical and dental students, preferably through integrated classes. One illustrative example is medication-related osteonecrosis of the jaw (MRONJ), which can occur when systemic antiresorptive therapies (eg, bisphosphonates) administered for cancer or osteoporosis result in necrotic lesions in the maxillofacial region. ²¹ The diagnosis and management of MRONJ require coordinated involvement of physicians, oral medicine specialists, oral pathologists, and oral and maxillofacial surgeons, reflecting the close interplay between systemic treatments and oral disease processes in routine clinical practice. ²² In addition to clinical pathology, the oral health disciplines (eg, oral medicine, oral pathology, and oral and maxillofacial surgery) play an important role in linking systemic and oral health.^7,8,18,23

While integrated clinical pathology education is important for strengthening medical–dental collaboration, practical models of broader medical–dental educational integration already exist. Hospital-based oral medicine programs and combined MD–DDS residencies, with joint rotations and joint case studies, demonstrate that interdisciplinary training is feasible and effective.^18,24,25 These efforts, aligned with Interprofessional Education Collaborative (IPEC) competencies, provide a practical framework for interprofessional strategies in addressing oral and systemic health.^26,27 Furthermore, policy measures such as joint accreditation and uniform competency standards can strengthen medical–dental collaboration and help integrate these practices into medical and educational infrastructures.^27-29 Together, these educational and policy frameworks foster interdisciplinary consultation, facilitate early disease detection, and support the use of oral indicators as diagnostic and prognostic tools for systemic diseases with oral manifestations. ¹⁵

Recent technological advances are shaping the direction of this field. ³⁰ Increasing attention to computational pathology, digital slide analysis, and AI-driven diagnostics aligns well with the requirements of interdisciplinary care.^31,32 Digital pathology platforms enable the seamless sharing of annotated slides between institutions, specialties, and countries. Telepathology further supports real-time remote consultations among physicians, dentists, and pathologists.^33-35 Machine learning algorithms can be trained to detect patterns in oral lesions that correlate with systemic conditions, thereby enabling the incorporation of predictive analytics into routine practice. ³⁶ To ensure the appropriate application of these technologies, clinicians should view digital pathology and AI-assisted diagnostic tools as complementary resources that complement expert interpretation, with ongoing evaluation to ensure accuracy, reliability, and ethical use.^37,38 As diagnostic tools continue to evolve, molecular pathology, including genomic and proteomic profiling, further improves diagnostic accuracy and aids in the discovery of biomarkers associated with both oral and systemic disease processes.^39,40

In conclusion, coordinated efforts across shared clinical pathology-based education, responsible digital integration, and interprofessional collaboration are increasingly important for strengthening the connection between medicine and dentistry. By advancing these shared initiatives, more comprehensive and patient-centered care can be promoted, offering a coherent framework for future collaboration between medicine and dentistry.