22nd April 2024

Oral Manifestations of Systemic Diseases

Endocrine Disorders

Poorly controlled diabetes can lead to periodontal disease, xerostomia (dry mouth), burning mouth syndrome, impaired wound healing, and increased susceptibility to infections such as oral candidiasis. These conditions can be attributed to the altered host response, impaired immune function, and changes in saliva composition associated with the disease. Patients with hypothyroidism may experience macroglossia (enlarged tongue), delayed tooth eruption, and altered taste sensation. These oral findings are thought to be connected with metabolic changes and reduced salivary flow rate in hypothyroidism.

Hematologic & Nutritional Disorders

Oral manifestations of anaemia (both iron and vitamin B12 deficiency) may include pale mucosa, glossitis (inflammation of the tongue), angular cheilitis (cracks and sores at the corners of the mouth), and oral ulcerations. These oral signs result from reduced oxygen-carrying capacity and tissue hypoxia associated with anaemia. Leukaemia can present with oral manifestations such as gingival enlargement, oral petechiae, spontaneous bleeding, oral ulcers, and increased susceptibility to infections. These oral findings can occur due to leukemic infiltration of oral tissues, impaired platelet function, and compromised immune response.

Autoimmune, Gastrointestinal & Immunologic Disorders

Sjögren’s syndrome is an autoimmune disorder characterised by dry mouth and dry eyes. The oral manifestations classically include xerostomia, dental caries, oral candidiasis, and mucosal ulcers. These symptoms are a consequence of decreased salivary gland function and can significantly impact oral health and quality of life.

Crohn’s disease can have oral manifestations that include orofacial granulomatosis, which is characterised by lip swelling, facial swelling, oral ulcers, and gingival hyperplasia. These manifestations may precede gastrointestinal symptoms and can aid in early diagnosis.

Oral manifestations of the disease are common in individuals with HIV/AIDS and can include oral candidiasis, oral hairy leukoplakia, periodontal disease, aphthous ulcers, Kaposi’s sarcoma, and salivary gland dysfunction. These manifestations often indicate a compromised immune system and can serve as markers for disease progression.

References

• Hietanen, J., & Salo, T. (2017). Oral manifestations of hypothyroidism: a review and case report. Acta Odontologica Scandinavica, 75(1), 1-6
• American Diabetes Association. (2003). Consensus Development Conference on Diabetic Complications: Oral Health Consensus Statement. Diabetes Care, 26(2), 593-598
• Bánóczy, J., & Jáhn, A. (2006). Oral manifestations of gastrointestinal diseases. Orvosi Hetilap, 147(25), 1187-1194