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Oral Manifestations
Hematologic Disorders

Anemia
 
Iron, B12, or folate deficiency can all result in anemia and changes in the oral mucosa.
 
Oral manifestations include mucosal pallor, angular cheilitis, and atrophic glossitis or “bald tongue”.

Leukemia
 
May present with gingival hypertrophy, petechiae, ecchymoses, or
oral ulcers.
 
Gingivitis: Inflammation of the gums.
Gingivitis and
Mucositis: Inflammation of a mucous membrane.
mucositis can develop secondary to chemotherapy or infection.
 
Chemotherapy or radiation therapy for other malignancies can also result in gingivitis and mucositis.

Langerhans Cell Histiocytosis
 
Alveolar bone invasion by histiocytes most commonly occurs in the mandible and may result in:
   
1.
 Pain, loose teeth, and jaw fractures.
   
2.
 X-ray appearance of teeth "floating in air" due to radiolucent areas in the bone.
   
3.
 Precocious
Exfoliation: The shedding of a superficial layer of a tooth.
exfoliation of primary teeth (early tooth loss).
 
Histiocytosis can also cause gingivitis and oral ulcers.
 
 
Many systemic conditions are known to adversely affect the mouth or teeth, and these patients require additional oral care and management.
 
Oral findings may be the only presenting symptom for leukemia and histiocytosis.
 
Early tooth loss, especially mandibular molars, should prompt consideration of Langerhans cell histiocytosis.
 
Xerostomia may occur in SLE, Sjogren's Disease, and Diabetes Mellitus.
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