Sickle Cell Anemia: Considerations
On Periodontal Tissue
Gerardo Viadas, RDAEF
What is Sickle Cell Anemia?
It’s related with RBC’s of the body.
Not all RBC’s are doughnut
shaped
Some RBC’s are sickle shaped or
moon shaped.
Crescent shaped RBC’s do not
flow with ease via blood vessels.
Sickle shaped RBC’s tend to clump
together obstructing normal
blood flow causing excruciating
pain.
Sickle shape RBC’s carry abnormal
hemoglobin and lack sufficient
oxygen.
Sickle Cell Anemia In Dentistry
• Studies have shown that there is not a direct link
between sickle cell anemia and periodontitis.
• However, sickle cell anemia does cause abnormal
blood flow. Avascularity in certain periodontal
tissues does cause certain dental conditions a
dental hygienist should be aware of. Conditions
like:
• Trabeculation of alveolar bone
• Osteomyelitis
• Osteonecrosis
Trabeculation Of Alveolar Bone
Bone density is lost in
patients with sickle cell
anemia.
Poor blood flow (avascularity)
within the bone.
Patients with a history of
sickle cell anemia should
have their periapical
radiographs evaluated
thoroughly for an increase in
trabeculation.
Trabeculation in patients with
sickle cell anemia means that
their normal bone trabeculae
increases in size hence
making the bone less dense.
Osteomyelitis
Osteomyelitis is a bone
infection caused by a
bacteria (generally
staphylococcus aureus).
Poor blood circulation is a
major contributor of this
condition.
Osteomyelitis if not cured
can lead to bone death.
Dental hygienists should be
aware of ulcerated tissue,
epithelialized soft tissue,
malodor, and exposed
bone.
Osteonecrosis
Literally translates to
“bone death”.
Ischemia and or
avascularity contributes to
this condition.
Sickle cell anemic patients
must be properly assessed
prior to a tooth extraction
and or implants.
References
Zieve, David (2008). Sickle Cell Disease. clarian.org. http://www.clarian.org./ADAM/doc/In-DepthReports/10/000058.htm
Simon, Harvey (2009). Sickle Cell Anemia. health.nytimes.com. http://health.nytimes.com/health/guides/disease/sicklecell-anemia/complications.html
Benoist, H. M., et al. (2008). Periodontal Conditions In Young Sickle Cell Anemia Senegalese Patients.
http://lib.bioinfo.pl/meid:43298
Hollar, A. Margaret (2009). The Hair-on-End Sign. radiology.rsna.org. http://radiology.rsna.org/content/221/2/347.full
Faber, T.D., et al. (2005). Fourier Analysis Reveals Increased Trabecular Spacing In Sickle Cell Anemia.
http://jdr.sagepub.com/cgi/content/full/81/3/214
Ankyloglossia