Systemic Disease And The Mouth Flashcards
What are the two common dental manifestations of systemic disease?
Disruption to tooth structure formation
Disruption to tooth structure content
What is this?
Ectodermal dysplasia
Genetic disorder affecting tissues derived from ectoderm e.g. tooth enamel, oral epithelium, sweat glands, nails and hair, epidermis
What dental presentations may show in someone with ectodermal dysplasia?
Conical shaped teeth
Hypodontia
Microdontia
Altered eruption pattern
Thin enamel
What is a congenital infection? What typical dental presentation may there be?
Infection Picked up by unborn foetus or newborn infant e.g. congenital syphillis
- generally caused by viruses picked up by baby at any time during pregnancy / childbirth
- changes to incisors, making them more bulbous ‘Hutchinson’s incisors’
What is perinatal illness? Give an example
Illness affecting pregnant individual or child in the weeks just before or after childbirth
How may perinatal illness present dentally in a child?
Affect laying down of cementum and enamel of tooth, and possibly the calcification of the enamel of the tooth
Dark band = hypoplastic and hypomineralised enamel and dentine
Why may altered pigmentation of children’s teeth be present?
Metabolic disease - porphyria
- Affects amount of HAEM and HAEM products in blood. These can be incorporated into dental tissues
Bilirubin pigmentation
- perinatal jaundice
External pigmentation from substances - tetracycline
- linear band of grey affecting teeth
- tetracycline no longer indicated in children
What are giant cell lesions?
Sites of large multi-nucleated giant cells within affected tissues
Peripheral
- within soft tissues surrounding maxilla and mandible
Central
- within the mandible or maxilla bone
Characteristics and causes of giant cell lesion?
Benign, localised area of tissue destruction with large multinucleated giant cells
(Within bone = central)
(Within soft tissues = peripheral)
- response to local trauma / irritation
- excess parathyroid function stimulating osteoclasts leading to reduced cortical Bone
What dental implication can hyperparathyroidism also show?
Loss of lamina dura around apex of tooth and all round tooth
How can excess ACTH occur? What dental implications?
Adrenocorticotropic hormone
Cushings - tumour in pituitary causes excess ACTH
Addisons - not enough cortisol produced so ACTH is high to produce more
Widespread melanin pigmentation in oral mucosa, refer to GMP for investigation into pituitary issue
How does OFG typically present?
Perioral erythema
Perioral swelling / oedema
Lip swelling
Angular chelitis
Fissured ulcer in bottom of labial sulcus, not related to trauma
Difference between crohns and OFG? Good test for crohns?
OFG with abdominal pain / altered bowel habit = oral crohns
So abdominal pain and altered bowels
Often OFG symptoms on their own around 7/8 followed by crohns symptoms appearing thereafter
Good test for crohns?
Faecal calprotectin assay
- raised
Crohns growth chart
Abdominal pain
Endoscopy
What is thought to cause OFG?
Dietary allergens
- cinnamon
- chocolate
- benzoate (tomato and tomato products)
- sorbate
