Oral Manifestations of Systemic Disease

Question 1

what is acromegaly?

Answer 1

disease of excessive growth hormone production

Question 2

what are the facial features of acromegaly?

Answer 2

facial features are said to become coarser
- might see dentures no longer fitting
- tongue or lip enlargement
- teeth become spaced

Question 3

what are the oral presentations of anaemia?

Answer 3

• Angular cheilitis
• Depapillation of the tongue
• Erythema/inflammation of the tongue (‘glossitis’)
• Oral ulceration of the aphthous and other forms
• Oral candidosis
• Oral dysaesthesias
• Mucosal pallor

Question 4

what are the oral presentations of haematinic deficiencies?

Answer 4

• Aphthous ulceration
• Recurrent/persistent oral candidosis
• Burning Mouth Syndrome or oral dysaesthesias
• B12 deficiency may also present with transitory red patches that can be very sore inside the mouth (although it is much less common than aphthous ulceration secondary to B12 deficiency

Question 5

what are the oral presentations of Leukaemia?

Answer 5

• May present in the mouth as inappropriate bleeding and unexpected degrees of oedematous swelling e.g. unexplained intraoral bruising, excessive bleeding on brushing
• Oral ulceration due to neutropenia may occur
• Gingival hypertrophy may occur and tends to ulcerate
• Lymphadenopathy in the neck may be present

Question 6

what can form granulomatous disease?

Answer 6

foreign bodies
bacterial infections (TB)
orofacial granulomatosis (linear sulcal ulcers, gingival inflammation, mucosal tagging, fissuring of the tongue

Question 7

what are the oral manifestations of TB?

Answer 7

long standing oral ulceration
gingival hypertrophy

Question 8

how would you carry out a review of systems (GI system) if no underlying medical conditions were found? what questions could you ask?

Answer 8

1) have you lost weight unintentionally lately?
2) is there any change in bowel habits?
3) are you struggling to swallow/vomiting/regurgitating food?

Question 9

what information do you need to make a good diagnosis?

Answer 9

• age
• gender
• ethnicity
• symptoms
• signs
• full medical and social history (including review of symptoms)
• management strategies already tried and the response to it

Question 10

what information do you need to make a good diagnosis?

Answer 10

• age
• gender
• ethnicity
• symptoms
• signs
• full medical and social history (including review of symptoms)
• management strategies already tried and the response to it