Physician Spotlight: Dr. Dudley E. Felix

BY SHARON H. FITZGERALD

Physician Spotlight: Dr. Dudley E. Felix

Dr. Dudley E. Felix and students.
On the shelf of Dr. Dudley E. Felix in Nashville are several books by the late Lester William Burket, who was a dentist, professor and chair of the Department of Oral Medicine at the University of Pennsylvania. In the 1970s, Felix studied under Burket, whom many experts credit as a founder of the specialty of oral medicine. Burket signed one of those books for Felix, and it's a prized possession of Meharry Medical College associate professor.

With the likes of Burket as a mentor, it's no wonder that Felix today is a flag-bearer for the field, which still labors to obtain official designation as a specialty by the American Dental Association. Felix is the only oral medicine specialist at Meharry and one of the very few in the area. While Meharry doesn't offer a degree in oral medicine, Felix says, "I think Meharry needs specialists like myself. There is so much interest now about the unity between the medical and the dental professions. We who have gone into oral internal medicine and diagnosis are right in the middle of the two."

A native of Great Britain, Felix grew up in London and received his licentiate of dental surgery (LDS) from the Royal College of Physicians and Surgeons in Glasgow, Scotland, in 1967. Friends encouraged him to come to the United States, where he earned his Doctor of Dental Surgery (DDS) degree in 1978 at Howard University in Washington, D.C. It was at the University of Pennsylvania where he completed his post-doctoral studies in oral medicine, with instruction is internal medicine, oral pathology and diagnosis, physical and laboratory diagnosis, and radiology.

Felix is a member of the American Academy of Oral Medicine, which defines the specialty as "concerned with the oral healthcare of medically compromised patients and with the diagnosis and non-surgical management of medically related disorders or conditions affecting the oral and maxillofacial region." Oral medicine specialists are experts in salivary gland disorders, oral mucosal diseases and orofacial pain that doesn't respond to standard medical or dental treatments. A patient who has difficulty swallowing, for example, might be referred to Felix, who has a private practice on Charlotte Avenue in addition to his teaching duties.

Felix says oral medicine specialists study the upper anatomy — the head, the mouth, the teeth, the throat, the neck and even the upper back. That's why they are called upon occasionally to make a "differential diagnosis" when standard diagnoses fail. Oral specialists also handle complications caused by medical therapies such as radiology and are more familiar with oral disorders caused by aging, immunosupression and substance abuse.

"Sometimes diagnosis is difficult. The medical person is confused, and the dental person is confused, so it's sent to the medical-dental specialist to put things together and come to a decision," he says. "Sometimes we are also the first to recognize a serious condition in a patient."

Felix recalls just such a time when a 15-year-old girl was referred to him with gum problems. The diagnosis? Leukemia, and he sent her immediately to a pediatric oncologist at the Vanderbilt-Ingram Cancer Center. Felix has written about that case, and his work as been published in both medical and dental journals.

Oral medicine specialists also are in a position to recommend special protocols for patients with diabetes, thyroid disease, bleeding disorders, hypertension, hepatitis, emphysema and even congestive heart failure. In fact, Felix says medicine is waking up to the connections between oral health and both cardiovascular and gastrointestinal health.

In addition, patients with oral herpes, aphthous ulcers, lichen planus, candidiasis, pemphigus, pemphigoid, erythema multiforme and other diseases of the skin and mucous membranes may be referred to an oral medicine specialist.

Felix lectures at both the Meharry School of Dentistry and at Tennessee State University, where he says most students don't see a problem with blurring the line between medicine and dentistry. "The demand at this time for this kind of combination is great. Sometimes the students ask many questions that are medically related, and the students are trying to correlate that with the dental information they have," he explains. "This is what I am trying to do — and what I have been doing for years — to teach these students the medical aspect and the dental aspect and correlate both together."

Felix adds that his dental students "just don't want to be localized to teeth. I teach them the entire human being, all of it, with an accent on oral internal medicine."

In addition to Pennsylvania, other institutions of higher education that are making a mark in oral medicine include Harvard, New York, California at San Francisco and Kentucky.