Oral Manifestation of Anaemia

 

G. Nithya Karpagam,  Jothi Priya

Saveetha Dental College,162, P.H. Road, Chennai, Tamilnadu 600077

 

ABSTRACT:

Aim: the main aim of this study is to find out the causes that leads to oral manifestation of anaemia. Objective: This procedure was done in 100 patients affected with oral anaemia. Background: Anaemia is due to decreased RBC and decreased oxygen binding activity and cause haemoglobin deficiency and it carries oxygen to capillaries and leads to excessive bleeding and take long period of time and the most common cause leads to orofacial lesions, soreness, discolourisation. And people who consume alcohol there is poor absorption due to lack of vitamins and minerals.it cause sickle cell anaemia and stem cell problem.

 

 

 

 

INTRODUCTION:

Many systemic diseases have oral manifestations that must be properly recognized if the patient is to receive appropriate diagnosis and referral for treatment. (1) These disease often include various types of anaemia that were recognized by the presence of oral lesions. Anaemia is caused due to decrease in the normal amount of circulating haemoglobin. Iron deficiency is the most common cause of anaemia throughout the world.(2) (3) Oral manifestation of iron deficiency anaemia include angular cheilitis and atrophic glossitis. (4) In megalo-blastic anaemia oral signs and symptoms includes glossitis, recurrent oral ulcer, oral candidiasis, diffuse erythematous mucositis and pale oral mucosa.(5) (6) Iron deficiency anaemia affect women more than men. (7) Patients with iron deficiency anaemia have the following symptoms like fatigue, weakness, light-headedness, shortness of breath, palpations etc. Oral symptoms includes tenderness or burning sensation of the oral mucosa.(8) Fanconisanaemia which is a type of anaemia also leads to oral problems.

 

There are few reports about oral manifestation of fanconisanaemia. Schofield and Abbot described a case of a woman with microcephaly extreme gingival inflammation and recession.(9). Schofield and Worth reported a case of a lady with severe generalized periodontitis, gingival inflammation and recession associated with bad hematologic condition. The patient also had ulceration on tongue which was diagnosed as carcinoma.(10) Joho and Marechaux described a case of a woman with macroglossia and generalised microdontia with enamel hypoplasia which may be caused by fanconis anemia.(11) The aim of this study is to create awareness in adolescents and to find out the main cause that leads to oral manifestation of anaemia.

 

METHODS AND MATERIALS:

A survey based questionnaire was done to assess about the oral manifestation of anaemia. A total of 19 questionnaire were filled . The data is collected using paper and pen method. The questionnaire contains question regarding the health of their oral cavity which is given below. After data collection statistical analysis was done.The answers were marked according to the current status of the participant in the current situation.

1.     Gender:  Male/Female.

2.     Which age group you belong to?

a)17-18  b)18-19  c) 19-20.

3.     Do you think your gums have paled in colour?

a)yes  b) no.

4.     Are you feeling hard to chew hard food than that of before?  a) yes  b) no.

5.     Are you experiencing unusual tooth fall? a)yes b)no.

6.     Do you think your mouth bears a stingy smell all day?  a)yes  b)no

7.     Are you suffering from bleeding gums? a)yes b)no.

8.     Do you sore all time? a) yes b) no.

9.     Do you bite your tongue often that extremely painful?  a)yes  b)no.

10.  Do you notice any colour changes in your tongue?

 a) yes b) no.

11.  Have your tongue changed tender than before?

 a)yes  b)no.

12.  Are you expecting wounds in your tongue?

a)yes b)No.

13.  Has it become hard for you to maintain stress?

a)yes  b)no.

14.  Often do you feel fatigue? a)yes b)no.

15.  Do you have hypo or hyper salivation?

 a)yes  b)no.

16.  Do you feel burning sensation in your mouth?

a)yes  b) no.

17.  Do you feel difficult while swallowing the food? a)yes  b)no.

18.  Do you have shortness of breath? a)yes  b)no.

19.  Do you have any oral ulcer? a)yes  b)no.

 

RESULTS:

PALED GUMS

           

 (Table 1)

HARD TO CHEW FOOD

 

(Table 2)

UNUSUAL TOOTH FALL

 

(Table 3)

 

MOUTH BEARS STINGYMELL

 

(Table 4)

 

BLEEDING GUMS

 

(Table 5)

FEELING SORE

 

(Table 6)

TONGUE BITING

 

(Table 7)

 

COLOUR CHANGE IN TONGUE

 

(Table 8)

TENDERNESS IN TONGUE

 

(Table 9)

WOUNDS IN TONGUE

 

(Table 10)

 

HARD TO MAINTAIN STRESS

 

(Table 11)

 

FEELING FATIGUE

 

(Table 12)

 

HYPO OR HYPER SALIVATION

 

(Table 13)

BURNING SENSATION IN MOUTH

 

(Table 14)

 

DIFFICULTY IN SWALLOWING THE FOOD

 

(Table 15)

 

SHORTNESS OF BREATH

 

(Table 16)

 

PRESENCE OF ORAL ULCER

 

( Table 17)

 

DISCUSSION:

The research was done in anaemic patients. The people suffering from anaemia are more prone to oral disease. From the research it was concluded that 68% of patients has paled gums as they lack sufficient red blood cells in the body and about 69% of the patients bears stingy smell in their mouth. It is found that 54% of the patients has bleeding gums due to lack of Haemoglobin or red blood cells. Pernicious Anaemia is a type of vitamin B12 anemia. It is required for the synthesis of red blood cells in the body. Absence of this causes bleeding gums, shortness of breath etc. Colour changes in the tongue was observed in about 58% of the patients. Glossitis is the inflammation of the tongue which is caused by iron deficiency Anaemia. Systemic control attention should be given to these patients especially dental care and prevention from the beginning of the medical therapy. In addition effective protocols should be implemented.

 

CONCLUSION:

The survey which was done on oral manifestation of anemia will lead to paleness of gums, bleeding gums, glossitis etc. It also cause poor breath, oral ulcer, shortness of breath, burning sensation in the mouth etc. From the survey it is found that women are more frequently affected by anaemia than men due to chronic blood loss associated with excessive menstrual flow. Early and proper diagnosis of these problems could make a difference to the prognosis of many condition and to a greater extent to the patients life.

 

REFERENCES:

1.     Long RG, Hlousek L, Doyle JL. Oral manifestations of systemic diseases. Mt Sinai J Med 1998 Oct-Nov;65 (5-6):309-15.

2.     Massey AC. Microcytic anemia. Differential diagnosis and management of iron deficiency anaemia. Med Clin North Am 1992 May ;76(3):549-66.

3.     Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and maxillofacial Pathology. Philadelphia: W.B. Saunders Company; 1995 . pp.169,602-3.

4.     V.S.S. Pierro, L.C. Maia, L.G. Primo, F.D. Soares. Case report: The importance of oral manifestations in diagnosing iron deficiency in childhood. European Journal Of Paediatric Dentistry.2/2004.

5.     DeRossi SS, Raghavendra S. Anemia. Oral surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(2):131-41.

6.     Red-blue lesions. In: Regezi JA, Sciubba JJ, Jordan RC.Oral Pathology: clinical pathologic correlations. Philadelphia: aunders; 2007.p. 107-25.

7.     Yang-Che Wu, Yi-Ping Wang, Julia Yu-Fong Chang, Shih-Jung Cheng, Hsin-Ming Chen, Andy Sun. Oral manifestations and blood profile in patients with iron deficiency anemia. Journal of the Formosan Medical Association (2014) 113,83-87.

8.     Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and maxillofacial pathology.3rd ed. Philadelphia: Saunders Elsevier; 2009.p.4 11.827-9.

9.     Schofield IDF, Abbot WG (1978). Review of aplastic  anaemia and report of a rare case (Fanconi type).  JCDA 3:106-108.

10.  Schofield IDF, Worth AT (1980). Malignant mucosal change in Fanconis anemia. J Oral Surg 38:619-622.

11.  Joho JP, Marechaux SC (1979). Microdontia: a specific tooth anomaly: report of case. J Dent Child 46:483-486.

 

Accepted on 04.06.2016           © RJPT All right reserved

Research J. Pharm. and Tech 2016; 9(10):1766-1769.