As discussed here, oral manifestations can be the presenting symptom for many systemic diseases, and thus a careful medical and social history is critical to. There are a variety of diseases and conditions that can cause tongue problems, discoloration, and soreness. Other systemic diseases that can cause the tongue to form aphthous ulcers are. Pdf mouth as a mirror of systemic diseases researchgate. Cardiovascular disease, diabetes, oral microorganisms, oralsystemic connection, preterm low births. Periodontal diseases have been linked to a variety of conditions with systemic implications. Jan 24, 2014 systemic diseases linked to gum disease. We report a case of raynauds phenomenon affecting the tongue in a patient with scleroderma, diagnosed three years after onset of symptoms. Geographic tongue is more common in people with allergic diseases such as atopy, asthma.
Clues suggesting systemic disease may be found in the mouth and adjacent structures see introduction to the approach to the dental patient and table oral findings in systemic disorders. Indeed, an early diagnosis can play a decisive role in improving the quality of treatment strategies as well as quality of life. Cardiovascular diseases bacterial plaque from the oral cavity can make its way into a persons bloodstream through the open area of infection and blood flow just under the gumlines. Amyloidosis of the tongue, either isolated or part of the systemic disease, is rare and its features resemble those of a tumor. Likewise, systemic diseases can have an impact on oral health. Dapsone, often employed for the treatment of dh and sometimes for pemphigoid may rarely cause blue discolouration of the tongue secondary. Oral manifestations of systemic disease 24 general dentistry novemberdecember 2017 or absent, and the oral mucosa may be dry, red, and wrinkled. Systemic disorders and the mouth dental disorders merck. Conditions such as leukoplakia, oral thrush, and oral lichen planus may cause a white tongue while kawasaki syndrome, scarlet fever, and geographic tongue may cause the tongue to appear red. Systemic disease as a risk indicator for oral or general health problems.
A hairy tongue may be an indication of epstein barr virus infection and is usually seen in those infected with hiv. Furthermore, any change of the tongue colour, form, mobility, coating may be indicative of a disease. Here are links to pages about the dermatological manifestations of noninfectious internal diseases. Taste buds are distributed along the dorsal surface of the tongue. Pdf a tongue lesion as a sign of a systemic disease. Geographic tongue genetic and rare diseases information. Ramesh parajuli msotorhinolaryngology,head and neck surgerydr. The skin may reflect signs of systemic diseases, useful for diagnosis, or suffer from a complication of disease or its treatment. Abstract a semidiagrammatic illustration of the normal anatomy of the oral structures is presented, and changes of these structures, particularly those of the tongue, that result from some important systemic and local disorders are demonstrated. Tongue necrosis caused by systemic vascular diseases. Systemic diseases can influence oral health, and oral health has an impact on overall health.
The oral cavity is the window to the body and is often the area where systemic disease first presents itself. Raynauds phenomenon affecting the tongue of a patient with. The tongue may be affected as part of oral disease or as a signs of systemic diseases. Pdf on aug 1, 2010, vishal mehrotra and others published mouth as a mirror of systemic diseases find, read and cite all the research you need on researchgate. Systemic diseases and oral health pocket dentistry. The oral cavity, along with the tongue, are sites of neoplasms, reactive processes, and infections, and may be a harbinger of systemic diseases. It is a disease difficult to identify due to its nonspecific symptoms and manifestations. This article provides a guide for recognizing the oral manifestations of select systemic diseases.
However, sometimes your symptoms might occur due to an underlying ailment that requires medical treatment. Linear gingival erythema has specific characteristics that include spontaneous bleeding petechiae on the attached gingiva and alveolar mucosa and a band of erythema at the gingival margin which one of the following statements is true. The plaque then travels through the arterial system and can become lodged in arterial plaque, or find its way into. Oral manifestations of systemic diseases are common and diverse. Jan 26, 2016 introduction tongue is a muscular organ situated in the floor of mouth. Tongue diagnosis introduction tongue is generally known as the organ of taste. A dentist should consult a physician when a systemic disorder is suspected, when the patient is taking certain drugs eg, warfarin, bisphosphonates, and when a patients ability to withstand general. The oral cavity might well be thought of as the window to the body as oral manifestations accompany many systemic diseases.
Certainly the poorly controlled diabetic patient is more likely to have periodontitis. We report the case of a patient with amyloidosis who presented with a tongue lesion, weakness, nonspecific arthritis, and dyspnea on exertion that resulted in multiorgan system failure. It is important for oral health professionals to understand and recognize the impact of systemic diseases on oral health. Raynauds phenomenon affecting the tongue is a rare but recognised symptom in patients with connective tissue disease, but lack of awareness of its existence by the doctor may lead to a delay in diagnosis. Glossitis is a general term for tongue inflammation, which can have various etiologies, e. Oral mucosal necrosis caused by oral cancer and early adverseeventsrelated treatments operation, reconstruction, radiotherapy, etc. A number of oral manifestations of systemic disease have been covered previously5,6. This article emphasizes on the oral systemic disease connection which is now a rapidly advancing area of research. Pathways linking oral infection to secondary nonoral disease three mechanisms or pathways linking oral infections to secondary systemic effects have been proposed 6. Indicators of systemic disease in the oral cavity and tongue.
This can be obtained thanks to specific knowledge of oral manifestations of autoimmune. Studies have demonstrated an association between periodontal diseases and cardiovascular disease, stroke, respiratory infections, diabetes, osteoporosis, hiv, and adverse pregnancy outcomes. The possible systemic diseases which arise from oral microorganisms are hereby focused. Oral signs are frequently the first manifestation of autoimmune diseases. Di erential diagnosis of a tongue lesion and systemic disease is not very extensive and it includes infectious diseases such as herpes simplex. Impact of systemic diseases on oral health signs of several systemic diseases and conditions can be manifested in the mouth, which makes the oral cavity an important diagnostic tool for health professionals. Pdf on aug 1, 2010, vishal mehrotra and others published mouth as a mirror of systemic diseases find, read. Autoimmune diseases and their manifestations on oral. Apr 14, 2016 geographic tongue is a condition that causes chronic and recurrent lesions on the tongue that resemble psoriasis of the skin. Amyloidosis of the tongue, either isolated or part of the systemic disease. It is not linked to the use of tobacco but it has been reported as a rare side effect of lithium treatment. Systemic diseases such as diabetes can be risk factors, predisposing the patient to significant oral problems such as oral ulceration, stomatitis, infection, and poor wound healing.
One of the most interesting relationships in the oral systemic connection is the newly emerging twoway relationship between periodontal disease periodontitis and diabetes. Disorders of almost any body system can adversely impact upon the mouth. Systemic disease manifestations in the oral cavity osteopathic. This study aimed to explore a the association between periodontal health and bp in a large representative cohort, b the predictive value of diagnosis of periodontitis in undiagnosed raised bp and c whether age is a mediator of this relationship. The oral cavity and the tongue are sites of neoplasms, reactive processes, and infections and may be a harbinger of systemic diseases. Amyloidosis is the extracellular fibril deposition of a variety of proteins, many of which circulate as plasma ingredients. Autoimmune diseases and their manifestations on oral cavity. General practitioner, superficial tongue lesions, squamous cell. Systemic diseases associated with oral health oralucent. A tongue lesion as a sign of a system ic disease article pdf available in case reports in medicine 20169. A dentist should consult a physician when a systemic disorder is suspected, when the patient is taking certain drugs eg, warfarin, bisphosphonates, and. On examination, the oral cavity may exhibit manifestations of underlying systemic disease and serve as an indicator of overall health. Raynauds phenomenon affecting the tongue of a patient.
Oral mucosal injury caused by chemical burns and similar causes. It is characterized by pink to red, slightly depressed lesions with irregular, elevated, white or yellow borders. Whats relatively new is the belief that periodontal disease may have an influence on diabetes. Systemic diseases with oral findings include autoimmune, hematologic, endocrine, and neoplastic processes. The oral cavity is the site of much infectious and inflammatory disease which has been associated with systemic diseases such as diabetes, cardiovascular disease and preterm low births. Oral mucosal diseases with small blisters or multiple ulcers. The lesions may also occur in the mucosa of the mouth and labia.
Oral cavity, oral manifestations, systemic diseases. In % of biopsy proven cases of amyloidosis, the head and neck area was a ected and the tongue was the most frequent site. Tongue cancer is a form of cancer that begins in the cells of the tongue. Oral mucosal necrosis caused by oral cancer and early adverse. The tongue is a complex organ involved in speech and expression as well as in gustation, mastication, and deglutition. The secondary functions of the tongue are to help swallowing and chewing the food.
Tongue diseases can be congenital or acquired, and are multiple in number. Evidently, systemic diseases have frequently been encompassing the oral cavity for a variegated number of. Aneurysm or aneurism, cerebral vasculitis, cutaneous vasculitis, leukocytoclastic vasculitis, livedoid vasculopathy, peripheral artery disease, know its causes, signs and treatment. Case report a tongue lesion as a sign of a systemic disease. Tongue exhibiting a relatively smooth, erythematous surface in a patient with iron deficiency anemia. Autoimmune disease may manifest as oral ulcerations, changes in the salivary and parotid glands, and changes in the tongue. A number of oral manifestations of systemic disease have been covered previ. Oral mucosal injury caused by chemical burns and similar. Oral manifestations oforal manifestations of systemic diseasessystemic diseases dr. Some of common systemic diseases or disorders include.
We report the case of a patient with amyloidosis who. Periodontitis is a common chronic inflammatory disease which could have an important impact on blood pressure bp. Jul 08, 2015 oral manifestations of systemic diseases 1. Oral manifestations of systemic disease american academy of. Considered according to a surgical sieve, some example conditions which can involve the tongue are discussed below. For this reason, dentists play an important role in the detection of emerging autoimmune pathologies. However, oral mucosal pigmentation associated with addisons disease develops and progresses during adult life and is usually accompanied by systemic manifestations including weakness, nausea and vomiting, abdominal pain, constipation or.
The tongue is an instrumental and vital part of our daily life it is often hailed as the strongest muscle in the body, as it is made up of a group of muscles that is attached to the floor of the mouth. Mar 22, 2016 amyloidosis of the tongue, either isolated or part of the systemic disease, is rare and its features resemble those of a tumor. Differentiate between potential systemic diseases associated with some specific oral conditions such as ulceration. Amyloidosis of the tongue is uncommon and its features resemble a tumor. The type of cells involved in your tongue cancer helps determine your prognosis and treatment. Therefore, it is extremely important to know that the oral mucosa plays a role in numerous systemic diseases, in some cases oral symptoms being the first manifestation of a disease. Have improved diagnostic skills in relation to the con. The type of cells involved in your tongue cancer helps.
Several types of cancer can affect the tongue, but tongue cancer most often begins in the thin, flat squamous cells that line the surface of the tongue. The upper surface contains the taste buds that act as. The main cause of tongue necrosis is not the systemic vascular diseases as follows. They may be the direct result of disease pathology, secondary infiltrative processes, or treatmentrelated adverse effects. Identify the different oral manifestations associated with specific systemic diseases. Crohns disease and ulcerative colitis, behcets syndrome, pemphigus vulgaris, herpes simplex, histoplasmosis, and reactive arthritis. For years its been apparent that diabetes exacerbates periodontal disease. Oral mucosal diseases with small blisters or multiple ulcers c. Geographic tongue is not an infectious disease nor it is related to systemic infections like hiv. Social interactions, selfesteem, dietary choices, and nutrition are enhanced by good oral health. Oral manifestations of local and systemic diseases. These are metastatic spread of infection from the oral cavity as a result of transient bacteremia, metastatic injury from the ef. Oral manifestations of systemic disease bdj team nature. Ramesh parajuli msotorhinolaryngology,head and neck surgery chitwan medical college teaching hospital, bharatpur10, chitwan, nepalchitwan medical college teaching hospital, bharatpur10, chitwan, nepal.
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