22 - Systemic disease and the mouth Flashcards
What are the common reasons for dental manifestations of systemic disease in children?
- congenital conditions or infections
- illness or metabolic disorder
- pigmentation from substance in the blood
Give an example of a congenital condition or infection that has a dental manifestation.
- syphilis
- TORCH infection
- ectodermal dysplasia
What is a TORCH infection?
T - toxoplasmosis
O - other ie syphilis, Hep B
R - rubella
C - cytomegalovirus (CMV)
H - herpes simplex
Give an example of an illness or metabolic disorder that has a dental manifestation.
- severe childhood illness
- cancer treatment
Give an example of pigmentation from substances in the blood that have a dental manifestation.
- bilirubin (jaundice)
- tetracycline (antibiotics)
How does ectodermal dysplasia present orally?
- hypoplasia
- hypodontia
- can have affect on salivary glands
What are Hutchinson’s incisors?
- caused by syphilis infection
- permanent teeth are peg like
What presentation can perinatal illness have?
- calcification across teeth is affected
- seen at different stages of development
What is porphyria?
- rare metabolic disease that allows porphyrins to build up in the blood
- teeth are discoloured red/brown
How does high levels of bilirubin present orally?
- teeth are discoloured yellow/green
- must be significant jaundice for several years
How does tetracycline staining present?
- dark band across teeth if antibiotic is taken for a long period during tooth development
- these antibiotics are not recommended for children
How can systemic disease present with oral mucosal changes?
- giant cell granuloma
- oralfacial granulomatosis
- RAS
- dermatoses (lichen planus)
- immune deficiency
- drug reactions
What are giant cell granulomas?
- osteoclast related lesions that can be seen on radiograph
- can form due to irritation
- parathyroid function should be checked
What is the result of hyperparathyroidism?
- loss of cortical bone
- PTH is released in excess to raise serum calcium by activating osteoclasts
- can be seen in oral radiographs by the loss of lamina dura
How does Addison’s disease manifest orally?
- pigmentation of the mucosa
- caused by raised ACTH which stimulates melanocytes to cause reactive melanosis