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Oral Manifestations, continued

Other systemic diseases with oral manifestations include:

  • Diabetes Mellitus
    Patients with diabetes have increased risk for dental caries, oral candidal infections, and xerostomia. Diabetic sialadenosis presents as diffuse, nontender, bilateral parotid enlargement. Patients with poorly controlled diabetes experience greater periodontal attachment loss compared with patients without diabetes and those with well-controlled diabetes. Treatment for periodontitis may improve glycemic control, but additional studies are needed to confirm these findings.
Xerostomia: Abnormal dryness of the mouth due to insufficient saliva production.
  • HIV
    Vertical transmission of HIV is far less common in the U.S. with maternal and infant antiretroviral therapy. In children who do become HIV infected, oral candidiasis and gingivitis are the most common soft tissue oral lesions. Oral candidiasis may be the presenting infection in HIV in newly infected adolescents. Oral hairy leukoplakia occurs in 20% of asymptomatic HIV-infected adults and can also occur in children (3%). Triggered by EBV infection.
Leukoplakia: A condition commonly considered precancerous in which thickened white patches of epithelium occur on the mucous membranes especially of the mouth.
  • Peutz-Jeghers Syndrome
    Peutz-Jeghers Syndrome is an autosomal dominant condition characterized by multiple hamartomatous polyps of the GI tract with hyperpigmented maculae of the skin and oral mucosa. Multiple, small hyperpigmented maculae develop on the lips and buccal mucosa, beginning in infancy.

  • Wegener’s Granulomatosis
    Wegener’s Granulomatosis is a form of vasculitis that involves the respiratory tract and kidneys. It can cause swollen, red, granular gingival lesions, known as “strawberry gingivitisâ€�.Ulceration of the gingival lesions is pathognomonic for Wegener’s disease.
 
 
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 hystiocytosis.
 
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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