Oral Manifestations of Systemic Disease I

• Which lymph nodes should you always examine extra-orally?

  Remember extra-oral examinations begins the moment the patient walks through the door.

  
  

  1. Submental

  2. Submandibular

  3. Cervical chain

  4. Supraclavicular

  5. Occipital

  6. Post auricular

  7. Pre auricular

  
• Which areas should you always examine intra-orally?

  -Gingiva

  -Mucosa

  -Lips

  -Vestibule

  -Hard palate

  -Floor of mouth

  - Ventral and lateral border of the tongue

  
• Why might teeth be abnormally coloured?

  - Tetracycline used in odontogenesis might make them yellow, brown or grey

  
  

  - Fluorosis (opaque white or brown patches)

  
  

  - Severe long term/childhood jaundice (yellow or greenish)

  
  

  - Porphyria, a rare hereditary disorder of Hb metabolism (purplish red colour)

  
  

  - Dentinogenesis & osteogenesis imperfecta, hereditary conditions influencing mineralised tissues can manifest in mouth (purplish/brownish discolourations)

  
• What is dental hypoplasia?

  When enamel has not formed properly/correctly
• When might dental hypoplasia occur and what would the classic manifestations of ongoing disease be?

  In congenital syphilis

  
  

  Once the child is born, the manifestations would include notched & peg-shaped permanent incisors & molars may also be deformed (Moon's molars)

  
• What can cause enamel/dental hypoplasia (1)?

  1. Severe childhood fevers

  - Horizontal grooves or pits

  -Especially in the incisors

  
  

  2. Severe fluorosis

  - Rough pitting, white/brown

  - Opacities

  
• What can cause enamel/dental hypoplasia (2)?

  1. Severe rickets

  - Grooving or pitting of the enamel

  - Due to low vitamin D so calcium absorption is affected

  
  

  2. Hypoparathyroidism

  - Ectodermal defects (grooving/pitting of enamel)

  
• Which systemic conditions can abnormal loss of tooth surfaces reflect?

  1. Erosion (due to intrinsic or extrinsic acids)

  
  

  2. Attrition - bruxism

  
  

  3. Abrasion - components of diet

  
  

  (Look at picture)