The Sunday News
Health Promotion, Kimberly Nyathi
OVER the next few weeks, my main focus will be some common general and systemic diseases that have distinctive oral manifestations that may sometimes initially manifest orally before the main symptoms of the disease itself manifest.
Anaemia
Blood consists mainly of
(1) Red Blood Cells (erythrocytes) whose main role is to carry oxygen to the body cells and tissues and remove carbon dioxide from the cells and tissues by means of a pigment called haemoglobin.
(2) White Blood Cells (leukocytes): whose main role is immune response.
(3)Platelets (thrombocytes): main function is blood clotting.
Anaemia is a disease and syndrome in which there is a general decrease in the red blood cell mass, either due to a decrease in the total number of red blood cells, a decrease in the concentration of haemoglobin or both.
Causes and types
Iron deficiency
— Caused by chronic (longterm) bleeding, pregnant or breastfeeding women whose daily iron requirements are increased, children or adolescents in the rapid growth phase, people with a generally low dietary iron intake.
— Oral manifestations:
(1) Pain during swallowing
(2) Cracks and fissures at the corner of the mouth
(3) Pallor of skin
(4) Smothered and painful tongue, atrophied (visibly smaller) tongue papillae (taste buds).
(5) Usually susceptible to fungal infection.
Megaloblastic Anaemia
— Vitamin B12 (Cobalamin) deficiency: Mostly in alcoholics, vegeterians, malnourished people with kidney failure cancer.
— Pernicious Anaemia (Addison-Bierner Anaemia): An autoimmune disease in which the body produces antibodies against cells that produce a compound that is necessary for Vitamin B12 absorption.
Oral manifestations:
(1) Sore, burning and enlarged tongue that is a beefy red colour.
(2) Small shallow ulcers on the tongue (aphthous ulcers).
(3) Lingual Ppillae (taste buds) become smooth and reduce or shrink.
(4) Pain during tongue movement and enlarged tongue.
— Vitamin B9 (Folate) deficiency: poor diet, poor absorption in the small intestine due to irritable bowel disease, gluten intolerance and alcoholism are the main causes.
Hemolytic Anaemia
— Due mainly to the premature destruction of red blood cells.
Sickle Cell Anaemia
— An inherited form of Anaemia in which red blood cells become rigid, sticky and sickle shaped.They get stuck in blood vessels and slow down the blood flow.
Aplastic Anaemia
— It is due mainly to the body’s inability to produce new red blood cells (which are produced in the bone marrow).
Oral manifestations:
(1) Oral mucosa is pale and dry.
(2) Fissures and cracks at the corner of the mouth
(3) Back of tongue is smooth and painful.
(4) Sometimes mild ulceration
Generally patients with anaemia are at an increased risk for:
(1) Periodontitis (gum disease)
(2) Oral mucosa lesions and pale appearance of oral mucosa
(3) Gossitis: tongue inflammation which manifests as
— glossodynia: pain of the tongue
— glossopyrosis: burning of the tongue
— swelling of tongue
— smooth appearance of the tongue
Above-mentioned are only the oral manifestations, however, anaemia is a hematological disease and has many other systemic symptoms that may differ slightly in their onset due to the causal factor.
Role of dentist
— A dentist can only treat the oral manifestations of anaemia, if your dentist suspects that you may have any of the above as a result of any type of anaemia you will be referred to a physician.
— Regular visits to the dentist (every six months)with or without any complaints may help in prevention of any systemic disease also because the mouth is the mirror of the body.
A healthy you is a happy you.
Kimberley Eve Nyathi
Final year BDS student
Lviv National Medical University
