Oral manifestations of nutritional deficiencies

Oral manifestations of nutritional deficiencies

• 1.
  Oral Manifestations of NutritionalDeficiencies Dr. Arsalan Wahid Malik M. Phil (Oral Pathology) Dip.(Orthodontics) ِ‫ح‬َّ‫ر‬‫ال‬ ِ‫من‬ْ‫ح‬َّ‫ر‬‫ال‬ ِ‫هللا‬ ِ‫م‬ْ‫س‬ِ‫ب‬ِ‫ميم‬
• 2.
  Cause/Reasons: • Reduced intake •Faulty absorption or metabolism • Increased excretion
• 3.
  Deficiency Systemic effectsOral effects Vitamin A Xerophthalmia Leukoplakia, Hyperkeratosis of oral epithelium Thiamin B1 Neuritis, Cardiac failure, Beriberi None Riboflavin B2 Dermatitis Angular stomatitis, Glossitis Nicotinamide (Niacin B3) Pellagra, CNS, Diarrhoea, Dementia Glossitis, Stomatitis, Gingivitis Vitamin B12 Pernicious anemia Glossitis, Aphthae Vitamin C Scurvy Gingival swelling, Bleeding Folic acid Macrocytic anemia Glossitis, Aphthae, Atrophy of lingual papillae Vitamin D Rickets, Osteomalacia Hypocalcification of teeth, Malformation
• 4.
  Pregnancy: • During pregnancythe hormonal changes effects a previously existing chronic gingivitis which have been symptom free and unrecognized Causes:  Elevated estrogen and progesterone levels  Birth control pills
• 5.
  Pregnancy: Oral manifestations: • Gingivahyperplasic with purple color • Bleeding from pockets • Food stagnation • Secondary infections • Halitosis • “pregnancy tumor” Treatment: • Maintenance of oral hygiene • Excision of Epulis
• 6.
  Gingival hyperplasia inpregnancy
• 7.
  Management consideration during pregnancy: •Hypotension if laid in supine position so dental treatment in sitting position • Nausea and vomiting • Pregnancy hypertension • Iron/folic acid deficiency
• 8.
  Hazards to fetusfrom dental treatment: • X-ray • Respiratory depression due to sedatives, diazepam and opioids all these cross placenta • Aspirin causes neonatal hemorrhage • NSAID in high dosages causes pulmonary hypertension • Steroids causes fetal adrenosuppresion
• 9.
  Safe drugs: • Paracetamol •Metronidazole
• 10.
  Diabetes Mellitus: • Hyperglycemiadue to deficiency of insulin • Type-1 • Type-11 • Glucose concentration in blood ( mg/100ml) Normal Diabetic • Fasting 100 120 • 2-hr after glucose 120 180 Complications: • Diabetic nephropathy • Diabetic retinopathy • Diabetic neuropathy
• 11.
  Diabetes Mellitus: General signs/symptoms: •Polyuria • Polydipsia • Loss of weight • Tiredness
• 12.
  Diabetes Mellitus: Oral manifestations: •Dry mouth • Increased susceptibility to infections • Periodontal diseases • Glossodynia • Burning mouth syndrome • Sialosis • Lichen planus
• 13.
  Diabetes gingivitis
• 14.
  Scurvy: • Ascorbic aciddeficiency • Old aged patients • Vitamin C - synthesis of collagen
• 15.
  Scurvy: Clinical features inscurvy: • Hyperplasic gums • Swollen gingival false pocketing • Tiredness • Malaise • Bleeding gums
• 16.
  Scurvy: Investigations: • Blood examinations Treatment: Ascorbicacid