Anemia Iron, B12, or folate deficiency can result in anemia and changes in the oral mucosa. Oral manifestations include mucosal pallor, angular cheilitis, and atrophic glossitis or â€œbald tongueâ€� caused by atrophy of the lingual papillae. Atrophic glossitis triggers pain, tenderness, and burning.
Leukemia Leukemia may present with paleness of the oral mucosa, gingival bleeding, oral petechiae, painless gingival hyperplasia, and ulcerative necrotic lesions. Be especially concerned about spontaneous gingival bleeding in the absence of plaque, caries, calculus or trauma.
Oral manifestations can be the presenting clinical signs of leukemia at disease onset, especially with Acute Myelogenous Leukemia (AML). However, Acute Lymphocytic Leukemia (ALL) is the most common of the childhood cancers, so this is the most likely disease you will encounter.
Common oral effects from cancer treatment include:
Gingivitis and mucositis secondary to chemotherapy, radiation, or opportunistic infection
Preventive protocols to improve hygiene and prophylaxis against infection can minimize complications
Langerhans Cell Histiocytosis
Alveolar bone invasion by histiocytes commonly occurs in the mandible and may result in:
Pain, loose teeth, and jaw fracture.
X-ray appearance of teeth â€œfloating in airâ€� due to radiolucent areas in the bone.
Precocious eruption or exfoliation of primary teeth (early tooth loss).
Exfoliation: The shedding of a superficial layer of a tooth.
Histiocytosis can also cause gingivitis and oral ulcers