OROFACIAL MANIFESTATIONS OF
SYSTEMIC DISEASES
Dr. Mary Mwacharo
INTRODUCTION
• The oral cavity is the gateway to the body
• It is a mirror that reflects what is happening in
the body
• Lesions occur in oral cavity and the maxillofacial
complex caused by systemic diseases or
conditions
Introduction cont’
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Haematological disorders/diseases
Gastrointestinal diseases
Connective tissue disorders
Nutritional disorders
Endocrine disorders
Drug induced conditions
JUSTIFICATION
• Orofacial signs and symptoms may be the 1st
clinical presentation of a systemic disease
• Early diagnosis results in early intervention
• Manifestations must be recognised to avoid
wrong treatment being administered
• Management must focus on correcting the
disorder as well as the oral manifestations
• Prevent complications during dental procedures
Haematological disorders
• Aplastic anaemia: multiple haemorrages in oral
cavity , oral ulcers, oral candida infection,
subconjunctival haemorrage
Leukemias: monocytic, lymphocytic,
myeloid
Haematological disorders cont
• Disorders of haemostasis: mixed group of
disorders with abnormal tendency to
haemorrage or thromboembolism
• Manifest as petechiae, prolonged post extraction
bleeding, spontaneous gingival bleeding or after
mild trauma, conjunctival haemorrage
Gastrointestinal diseases
• Oral cavity is the portal of entry to the GI tract
• Many conditions affecting the GIT manifest in
the mouth
• Gastro-oesophageal reflux disease (GERD).
Regurgitation of gastric contents reduces oral pH
< 5.5 resulting in dissolved enamel
• Enamel erosion also occurs in anorexia/bulimia
Enamel Erosion
Connective tissue disorders
• Sjogren’s syndrome: autoimmune disorder,
mainly affecting women above 50yrs:
keratoconjunctivits, xerostomia, angular
stomatitis
Connective tissue disorders
Scleroderma: diffuse sclerosis of skin, GIT,
heart muscle, lungs, kidneys.
Oral signs: difficulty in opening mouth due to
pursed lips, decreased tongue mobility, salivary
hypofunction
Nutritional deficiencies
Iron deficiency anaemia: pallor of
mucosa/conjunctiva, atrophic glossitis,
angular stomatitis
Nutritional deficiencies cont’
Vit C deficiency: petechiae and echymosis in
mucosa, erosive bleeding gums, early tooth
loss in children
Endocrine Diseases
• Diabetes mellitus: oral infections such as
candidiasis, altered taste, gingivitis,
xerostomia
Endocrine diseases
• Addison’s disease/adrenal insufficiency:
hyperpigmentation of skin, oral mucosa
tongue,
Drug induced conditions
• Gingival hyperplasia caused calcium channel
blockers for hypertension
• Drug induced ulcers may be triggered by
systemic or locally delivered medicines
• NSAIDs, cytotoxics, nicorandil etc
Conclusion
• Wide array of disorders have manifestations
in oral cavity
• Many manifestations are non specific for
particular conditions
• Clinician must be alert to possibility of
concurrent or latent disease
• Take detailed history of patient and thorough
examination
• Refer patient for appropriate treatment
where necessary