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Minja IK, Wilson EM, Machibya FM, Jonathan A, Cornel F, Ruggajo P, Makani J, Balandya E. Dental Caries in Children with Sickle Cell Disease and Its Association with the Use of Hydroxyurea and Penicillin Prophylaxis in Dar Es Salaam. Pediatric Health Med Ther 2024; 15:121-128. [PMID: 38533196 PMCID: PMC10964788 DOI: 10.2147/phmt.s443139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/08/2024] [Indexed: 03/28/2024] Open
Abstract
Purpose This comparative study sets out to report dental caries status among individuals with Sickle Cell Disease (HbSS) against those with sickle cell trait (HbSA) and those without the disease (HbAA) as controls. The study further assessed the impact of penicillin chemoprophylaxis and hydroxyurea use on dental caries among Sickle Cell Disease participants. Methods This was a comparative cross-sectional study in which 93 children aged 30 to 60 months were recruited. There were 60 participating children who had SCD (HbSS), 17 with SCD trait (HbAS) and 16 were without SCD or SC trait (HbAA). A questionnaire was used to record sociodemographic details including mean age in months and sex and on haemoglobin genotype for all the participants. Specifically, for the participants with HbSS, information on their whether they are taking hydroxyurea (HU), and penicillin chemoprophylaxis was recorded. To assess the prevalence of dental caries, clinical examination of all primary maxillary and mandibular teeth to determine the presence or absence of dental caries lesions was also recorded. Results A total of 1197 teeth from 93 children were examined, whereby, 45 (2.4%) of them had dental caries. The participating children with HbAA genotype (6.6%, N=21) had more dental caries than their HbSS counterparts (2.0%, N=24), while none of the participants with HbAS exhibited dental caries. Among the participants with HbSS, males and those who use HU were 3.79 and 3.07 times more likely to have dental caries than their counterparts, female and non-users of HU, respectively. Conclusion Dental caries was observed to be low among participants with HbSS when compared to those with HbAA. More research utilizing more robust methodologies is recommended.
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Affiliation(s)
- Irene Kida Minja
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- The Sickle Pan African Research Consortium (SPARCO) – Tanzania Site Project, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Evarist Mulyahela Wilson
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- The Sickle Pan African Research Consortium (SPARCO) – Tanzania Site Project, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ferdinand M Machibya
- Department of Orthodontics, Pedodontics and Community Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Agnes Jonathan
- The Sickle Pan African Research Consortium (SPARCO) – Tanzania Site Project, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Fortunata Cornel
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Paschal Ruggajo
- The Sickle Pan African Research Consortium (SPARCO) – Tanzania Site Project, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Julie Makani
- The Sickle Pan African Research Consortium (SPARCO) – Tanzania Site Project, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Emmanuel Balandya
- The Sickle Pan African Research Consortium (SPARCO) – Tanzania Site Project, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Cherry-Peppers G, Fryer C, Jackson AD, Gu X, Ford D, Glascoe A, Smith D, Liu M, Dunmore-Griffith J, Robinson-Warner G, McIntosh C, Sonnier J, Slade L, Rizkalla A, Mundey S, Dawson N, Fleurinord M, Edmonson B, Ford C, Griffith J, Peppers G, Muttanahally K, Mncube-Barnes F, Watkins-Bryant T. Sickle cell disease: Contributing factors and radiological assessments. J Natl Med Assoc 2023:S0027-9684(23)00064-0. [PMID: 37495445 DOI: 10.1016/j.jnma.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/09/2023] [Accepted: 05/13/2023] [Indexed: 07/28/2023]
Abstract
Sickle Cell Disease (SCD) is genetically described as an autosomal blood disorder resulting from the presence of a mutated form of hemoglobin. Morbidity, frequency of crisis, degree of anemia, and organ systems involved vary considerably per patient. Dental health professionals and other specialists commonly request comprehensive medical consultations prior to performing complex periodontal, endodontic, and surgical procedures. In order to have successful dental outcomes and minimize posttreatment dental complications, relevant disease indicators are noted. This review is to raise awareness of the impact of oral diseases in patients with sickle cell disease and to emphasize the importance of full medical disclosure, radiographic interpretation, and a well-documented medical history, and a well-written consultation which can guide treatment planning and greatly improve the course of dental treatment.
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Affiliation(s)
- Gail Cherry-Peppers
- Associate Professor, Director Oral Diagnosis and Radiology, Howard University College of Dentistry, Howard University College of Dentistry.
| | - Cheryl Fryer
- Associate Dean Academic Affairs, Howard University College of Dentistry.
| | | | - Xinbin Gu
- Associate Dean for Research, Chair, Research Committee, Howard University College of Dentistry.
| | - Debra Ford
- Senior Associate Dean for Academic Affairs, Howard University College of Medicine.
| | - Alison Glascoe
- Comprehensive Care, Chair, Howard University College of Dentistry.
| | - Dawn Smith
- Chair, Department of Dental Hygiene, Howard University College of Dentistry.
| | | | | | - Gillian Robinson-Warner
- Assistant Professor, Department of Restorative Dentistry, Howard University College of Dentistry.
| | - Crystal McIntosh
- Associate Professor, Chair, Department of Periodontics, Howard University College of Dentistry.
| | - Jezelle Sonnier
- Assistant Professor, Department of Restorative Dentistry, Howard University College of Dentistry.
| | - Lisa Slade
- Director, Department of Endodontics, Howard University College of Dentistry.
| | - Adel Rizkalla
- Assistant Professor, Department of Restorative Dentistry, Howard University College of Dentistry.
| | - Shakeya Mundey
- Assistant Professor, Comprehensive Care, Howard University College of Dentistry, Washington, DC.
| | - Nyree Dawson
- Assistant Professor, Department of Dental Hygiene, Howard University College of Dentistry.
| | - Manouchka Fleurinord
- Research Student Committee, Howard University College of Dentistry, Ashleigh Bellamy Research Student Committee, Howard University College of Dentistry.
| | - Baron Edmonson
- Research Student Committee, Howard University College of Dentistry.
| | - Courtney Ford
- Summer Research Project, Howard University College of Dentistry.
| | - Jillian Griffith
- Summer Research Project, Howard University College of Dentistry.
| | - Gretchen Peppers
- Research Committee Coordinator, Howard University College of Dentistry.
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Prevalence of orofacial alterations in patients with sickle-cell disease: Systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:642-660. [PMID: 36858858 DOI: 10.1016/j.oooo.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/18/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The aim of this study was to identify the prevalence of orofacial alterations in sickle-cell disease (SCD) and to compare it with the general population. STUDY DESIGN This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The search was conducted on PubMed, Embase, Scientific Electronic Library Online, Web of Science, Cochrane Library, gray literature, and references of the included articles. RESULTS A total of 770 records were found, and 28 studies were selected. In SCD, the prevalence of decreased bone density was 57% (95% CI: 35%-80%), with Q: P < .01 and I2 = 95%; for stepladder pattern was 30% (IC: 13%-47%), Q: P < .01 and I²: 93%; for delayed eruption was 20% (95% CI: 6%-34%), with Q: P < .01 and I2 = 86, Q: P < .01 and I2 = 99%; and for malocclusion, 66% (95% CI: 39%-92%), Q: P < .01 and I2 = 98%. A high risk of bias was observed in relation to the sample size of the studies. A limited number of articles compared the prevalence of orofacial alterations in patients with SCD and healthy individuals. CONCLUSIONS Decreased bone density, malocclusion, orofacial pain, tooth necrosis, eruption delay, periodontal disease, and neuropathies may be present in patients with SCD with variable prevalence.
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Staphylococcus aureus Infection Initiates Hypoxia-Mediated Transforming Growth Factor-β1 Upregulation to Trigger Osteomyelitis. mSystems 2022; 7:e0038022. [PMID: 35852344 PMCID: PMC9426532 DOI: 10.1128/msystems.00380-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Little is unknown about the regulatory mechanisms underlying the pathogenesis of osteomyelitis induced by Staphylococcus aureus. Hypoxia-inducible factor-1α (HIF-1α) and transforming growth factor β1 (TGF-β1) were both upregulated in S. aureus-infected MC3T3-E1 cells and osteomyelitis patients. HIF-1α directly targets the hypoxia-responsive elements (HREs) of TGF-β1 mRNA to induce its expression. Silencing HIF-1α and TGF-β1, as well as treatment of hypoxia inhibitor IDF-11774, consistently elevated OPN and RUNX2 expression and alizarin Red S (ARS) and alkaline phosphatase (ALP) staining levels in MC3T3-E1 cells with S. aureus infection. S. aureus infection increased HIF-1α expression and serum TGF-β1 concentration in a mouse model of osteomyelitis. Hypoxia inhibitor IDF-11774 treatment reduced serum levels of interleukin (IL)-6, IL-1β, and C-reactive protein. Upon S. aureus infection, hypoxia was activated to trigger TGF-β1 upregulation through direct targeting of HRE on TGF-β1 mRNA by HIF-1α, eventually leading to osteomyelitis symptoms in terms of osteogenesis and mineralization deficiencies as well as elevated inflammation. This study hereby suggests a novel signaling cascade involving hypoxia/HIF-1α/TGF-β1 in osteomyelitis pathogenesis, which could potentially serve as a target for therapeutic measures. IMPORTANCE The pathogenesis of osteomyelitis induced by Staphylococcus aureus remains unclear. To develop therapeutic approaches for osteomyelitis, it is important to understand the molecular mechanisms of its pathogenesis. Our results suggests that hypoxia/HIF-1α/TGF-β1 signaling is involved in osteomyelitis pathogenesis. Thus, these findings highlight the potential of this signaling components as therapeutic targets for the treatment of osteomyelitis.
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Wu HW, Rahim N, Mbadiwe N, Khayat S, da Fonseca MA, Peters E, Hsu LL. Vaso-occlusive Pain Crisis Mimicking Mandibular Abscess in an Adolescent with Sickle Cell Disease. J Pediatr Hematol Oncol 2022; 44:e450-e452. [PMID: 35200222 DOI: 10.1097/mph.0000000000002274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/15/2021] [Indexed: 11/26/2022]
Abstract
In people with sickle cell disease (SCD), oral abscesses are concerning clinical conditions and carry a high risk of postoperative sickle cell complications. We present an unusual case of a 14-year-old girl with SCD whose initial presentation of facial swelling, headaches, jaw pain, and paresthesia mimicked an odontogenic abscess. She was diagnosed with vaso-occlusive crisis in the mandibular bone and successfully managed noninvasively. This is among the youngest cases of paresthesia in the lower lip in SCD, which provided a clue that postponing invasive aspiration or biopsy was possible under empiric antibiotics and close observation.
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Affiliation(s)
| | | | | | | | | | | | - Lewis L Hsu
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Illinois at Chicago College of Medicine, Chicago, IL
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Kumar PR, Karunakaran A, Sivaprasad KK, Philipose L. Comparison of dentofacial findings in sickle cell anemia patients and controls among a tribal population in Kerala – A cross-sectional study. THE SAINT'S INTERNATIONAL DENTAL JOURNAL 2022. [DOI: 10.4103/sidj.sidj_15_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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Orofacial Manifestation and Dental Management of Sickle Cell Disease: A Scoping Review. Anemia 2021; 2021:5556708. [PMID: 34721900 PMCID: PMC8556080 DOI: 10.1155/2021/5556708] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/13/2021] [Accepted: 09/15/2021] [Indexed: 11/19/2022] Open
Abstract
Aims Sickle cell disease (SCD) is an upcoming global health problem with rapid progress in therapy especially since 2017. However, systematic reviews found no clinical trials on the dental treatment of sickle cell disease (SCD). This article aims to outline the oral features of the sickle disease and discuss oral management strategies that can serve as guidelines for dental professionals. Material and Methods. A comprehensive literature review was conducted using PubMed, Google Scholar, and Web of Science. The search strategies were developed to cover publications from January 2010 to March 2020. With the help of keywords, multiple abstracts were identified. These abstracts were further reviewed, which included the information about the SCD manifestation, particularly about the oral health features. Based on all these articles and clinical experience, a narrative review was constructed, which summarizes all the aspects of the oral manifestation in people with SCD. Results The results of this study demonstrate that there is distinct evidence available, indicating the developmental enamel defect leading to hypoplasia and increasing susceptibility to dental caries. Another important result of this review found that people with SCD have a vaso-occlusive crisis in the microcirculation in the dental pulp leading to symptomatic and asymptomatic pulpal necrosis without any signs of odontogenic pathology in an apparently healthy tooth. The study also found that early detection, intervention, and prevention are crucial for improving oral health care, and involving a multidisciplinary approach plays an important role in managing people with SCD. Conclusion Patients with sickle cell disease have chronic overall health problems. The hematological disorder becomes their main concern and impaired oral health becomes secondary, increasing the risk for dental caries at the most. This paper broadly describes the oral manifestations of SCD, additionally; this paper also provides recommendations for better dental management of patients with SCD. Patients with SCD are often misjudged and, due to lack of knowledge and guidelines, dental providers are not able to provide adequate care. This paper attempts to highlight the essential measures to provide better dental care.
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Investigation of the relationship between periodontal and systemic inflammation in children with Sickle Cell Disease: A case- control study. Cytokine 2021; 149:155724. [PMID: 34653827 DOI: 10.1016/j.cyto.2021.155724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/26/2021] [Accepted: 09/30/2021] [Indexed: 11/20/2022]
Abstract
Periodontal diseases are chronic inflammatory diseases and tissue destruction increases with oxidative stress in periodontal tissues. Periodontal diseases are associated with systemic diseases such as diabetes, cardio-vascular diseases and rheumatoid arthritis by means of systemic inflammation. Sickle cell disease (SCD) is a chronic inflammatory disease in which vaso-occlusive crisis and endothelial dysfunction are present. It is not known whether the chronic systemic inflammation seen in SCD affect periodontal tissues. The aim of this study was to investigate the relationship between periodontal and systemic inflammation in children with SCD. Forty-three children with SCD and 43 healthy children were included in the study. Physical, dental and periodontal statuses were examined, blood and saliva samples were taken. Levels of pro-inflammatory and oxidative stress mediators in serum and saliva were evaluated. The periodontal findings of the groups were similar. The majority of the subjects in both groups had gingival inflammation. In SCD group, significantly higher serum high sensitive C-reactive protein (Hs-CRP), interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, total oxidant status (TOS), nitric oxide (NO) and salivary IL-6 were observed (p < 0.05). There were positive correlations between salivary IL-6 levels and serum Hs-CRP levels (r = 0.303, p < 0.05). In addition; it was determined that salivary IL-6, TNF-α and NO levels were increased 3-6 times in children with a history of painful crisis or acute chest syndrome compared to children who had never had a painful crisis or acute chest syndrome. Although, observed oral health status was similar in both groups, salivary cytokine levels were increased in children with SCD. The higher salivary cytokine levels may be associated with chronic systemic inflammation and vaso-occlusion observed in children with SCD.
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9
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Bjorklund ARB, Slusher TM, Faulman A, Howard CR, Odongkara B. Forehead Swelling and Fever in a 12-year-old Ugandan Boy. Pediatr Rev 2021; 42:203-205. [PMID: 33795466 DOI: 10.1542/pir.2019-0282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Tina M Slusher
- Hennepin Healthcare, Minneapolis, MN.,University of Minnesota, Minneapolis, MN
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10
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Orofacial manifestations of sickle cell disease: implications for dental clinicians. Br Dent J 2021; 230:143-147. [PMID: 33574535 DOI: 10.1038/s41415-021-2601-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/07/2020] [Indexed: 11/08/2022]
Abstract
Sickle cell disease is a multisystem disease associated with episodes of acute illness and progressive organ damage. It is one of the most common severe monogenic disorders worldwide and is now the fastest growing genetic disorder in the UK. Dental awareness of orofacial manifestation varies geographically due to the inheritance pattern and patient population affected by the disease. This article details the epidemiology, pathophysiology and the orofacial manifestations in light of current literature.
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Gusmini MADS, De Sa AC, Feng C, Arany S. Predictors of dental complications post-dental treatment in patients with sickle cell disease. Clin Exp Dent Res 2020; 7:11-19. [PMID: 33225591 PMCID: PMC7853884 DOI: 10.1002/cre2.335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/16/2020] [Accepted: 09/27/2020] [Indexed: 11/30/2022] Open
Abstract
Objective Our aim was to explore potential medical or dental indicators associated with dental complications and the utilization of emergency services in sickle cell disease (SCD), especially that clinical reports on adverse outcomes post‐dental treatment are scarce. Materials and methods A retrospective analysis of dental treatments of 47 eligible adults with confirmed SCD between May 2016 and October 2019. Logistic regression analysis was used whether clinical outcomes, course of dental treatment, and regularity of dental care are associated with dental complications after dental procedures and/or resulted in emergency care or hospital admissions. Results We identified a new, statistically significant association (p‐value = .01) between the number of prescription medications taken and complications (10%) after dental procedures. The most frequent dental procedures were tooth extractions (36%) and pain management (28%) during a non‐scheduled dental encounter (68%). The majority of cases did not participate in regular recall exams and periodical oral hygiene maintenance. Conclusions A higher number of prescription medications was associated with an increased risk of post‐dental complications in SCD patients. A thorough medical history, including a list of prescribed medications, and collaboration with the patient medical team are important to assess the risk of complications post‐dental procedures and the need for antibiotic prophylaxis according to the case complexity.
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Affiliation(s)
| | - Anny Clementino De Sa
- Department of General Dentistry, Eastman Institute of Oral Health, University of Rochester, Rochester, New York, USA
| | - Changyong Feng
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA
| | - Szilvia Arany
- Department of General Dentistry, Eastman Institute of Oral Health, University of Rochester, Rochester, New York, USA
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Evidence-based dental management in the new era of sickle cell disease: A scoping review. J Am Dent Assoc 2020; 151:668-677.e9. [PMID: 32854869 DOI: 10.1016/j.adaj.2020.05.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Sickle cell disease (SCD) is an emerging global health issue with rapid progress in therapy especially since 2017. However, systematic reviews found no clinical trials on dental treatment of SCD. TYPES OF STUDIES REVIEWED Using a scoping review approach, the authors examined citations from 13 national SCD guidelines and 10 books spanning 4 decades. The authors also searched the following databases: PubMed, Cumulative Index to Nursing and Allied Health Literature, ScienceDirect, Scientific Electronic Library Online, and GoogleScholar. Eligibility criteria included SCD, oral health care and dental treatment, related to oral and systemic health, original data, or observations. RESULTS Systemic treatment of SCD might have opposing effects on caries, perhaps explaining the conflicting results published. Malocclusion correlates with marrow expansion. Other unusual orofacial findings reflect ischemia. Of 86 full-text articles examined, only 1, a Brazilian esthetic dentistry study, was a randomized clinical trial. No disease-specific data were found on risk of developing bacterial endocarditis, safety of inhaled nitrous oxide, safety of epinephrine with local anesthetic, or the benefit of comprehensive oral health care. PRACTICAL IMPLICATIONS In SCD, oral health and systemic health could be strongly linked. Penicillin, vaccines, and hydroxyurea might impact caries and bone. The interaction of SCD treatments and oral health merit study.
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Arumugam B, Subramaniam A, Alagaraj P. A Review on Impact of Medicinal Plants on the Treatment of Oral and Dental Diseases. Cardiovasc Hematol Agents Med Chem 2020; 18:79-93. [PMID: 32072908 DOI: 10.2174/1871525718666200219140729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 06/10/2023]
Abstract
Plants play a vital role in the general wellbeing of an individual. Globally plants are habitually used by the people for the treatment and prevention of various ailments. There is an increased attempt made from ancient days to prevent the disease occurrence rather than to treat it. Through the development of modern scientific procedures, it is now identified that the usage of plants in different forms promotes the health of the patient. Oral and dental hygiene is the primary factor of a human being to lead a healthy life. Poor diet, nutrition and improper hygienic practices lead to teeth and gum diseases, dental cavities and plaque etc., Use of herbal extracts and their products in day-to-day life is a promising and interesting alternative to synthetic compounds to control oral diseases. The present review summarizes the usage of medicinal plants in the treatment and prevention of oral and dental diseases in different aspects.
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Affiliation(s)
- Balakrishnan Arumugam
- Department of Biochemistry, Centre for Biological Sciences, K.S. Rangasamy College of Arts and Science (Autonomous), Tiruchengode, Namakkal-637215, Tamilnadu, India
| | - Arunambiga Subramaniam
- Department of Biochemistry, Centre for Biological Sciences, K.S. Rangasamy College of Arts and Science (Autonomous), Tiruchengode, Namakkal-637215, Tamilnadu, India
| | - Praveena Alagaraj
- Department of Biochemistry, Centre for Biological Sciences, K.S. Rangasamy College of Arts and Science (Autonomous), Tiruchengode, Namakkal-637215, Tamilnadu, India
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Barbe AG, Röhrig G, Hieggelke L, Noack MJ, Derman SHM. Interdisciplinary assessment and management of a patient with a fibrous gingival enlargement of unknown origin: A case report. Clin Case Rep 2020; 8:159-165. [PMID: 31998508 PMCID: PMC6982473 DOI: 10.1002/ccr3.2605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 12/21/2022] Open
Abstract
A gingival enlargement of unclear cause could only be diagnosed after interdisciplinary cooperation as plasma cell gingivitis of unknown origin. Interdisciplinary approaches remain crucial when diagnosing rare gum diseases.
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Affiliation(s)
- Anna Greta Barbe
- Department of Operative Dentistry and PeriodontologyCenter of Dental MedicineUniversity of CologneKölnGermany
| | - Gabriele Röhrig
- Geriatric Diagnostic CenterMVZ Medicum Köln OstCologneGermany
| | - Lena Hieggelke
- Institute of PathologyUniversity Hospital CologneCologneGermany
| | - Michael Johannes Noack
- Department of Operative Dentistry and PeriodontologyCenter of Dental MedicineUniversity of CologneKölnGermany
| | - Sonja Henny Maria Derman
- Department of Operative Dentistry and PeriodontologyCenter of Dental MedicineUniversity of CologneKölnGermany
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Abstract
BACKGROUND Sickle cell disease is the most common single gene disorder and the commonest haemoglobinopathy found with high prevalence in many populations across the world. Management of dental complications in people with sickle cell disease requires special consideration for three main reasons. Firstly, dental and oral tissues are affected by the blood disorder resulting in several oro-facial abnormalities. Secondly, living with a haemoglobinopathy and coping with its associated serious consequences may result in individuals neglecting their oral health care. Finally, the treatment of these oral complications must be adapted to the systemic condition and special needs of these individuals, in order not to exacerbate or deteriorate their general health. Guidelines for the treatment of dental complications in this population who require special care are unclear and even unavailable in many aspects. Hence this review was undertaken to provide a basis for clinical care by investigating and analysing the existing evidence in the literature for the treatment of dental complications in people with sickle cell disease. This is an update of a previously published review. OBJECTIVES To assess methods of treating dental complications in people with sickle cell disease. SEARCH METHODS We searched the Cochrane Cystic Fibrosis and Genetic Disorders Review Group's Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. Date of last search: 01 August 2019. Additionally, we searched nine online databases (PubMed, Google Scholar, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Literature in the Health Sciences in Latin America and the Caribbean database, African Index Medicus, Index Medicus for South East Asia Region, Index Medicus for the Eastern Mediterranean Region, Indexing of Indian Medical Journals). We also searched the reference lists of relevant articles and reviews and contacted haematologists, experts in fields of dentistry, organizations, pharmaceutical companies and researchers working in this field. Date of last search: 07 November 2019. SELECTION CRITERIA We searched for published or unpublished randomised controlled studies of treatments for dental complications in people with sickle cell disease. DATA COLLECTION AND ANALYSIS Two review authors intended to independently extract data and assess the risk of bias of the included studies using standard Cochrane methodologies; however, no studies were identified for inclusion in the review. MAIN RESULTS No randomised controlled studies were identified. AUTHORS' CONCLUSIONS This Cochrane Review did not identify any randomised controlled studies assessing interventions for the treatment of dental complications in people with sickle cell disease. There is an important need for randomised controlled studies in this area, so as to identify the most effective and safe method for treating dental complications in people with sickle cell disease.
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Affiliation(s)
- Priti Mulimani
- School of Dentistry, University of WashingtonOral Health Sciences1959 Pacific Street NESeattleWAUSA98195
| | - Samir K Ballas
- Jefferson Medical College, Thomas Jefferson UniversityCardeza Foundation for Hematologic Research, Department of Medicine1015 Walnut StreetPhiladelphiaPAUSA19107‐5099
| | - Adinegara BL Abas
- Melaka‐Manipal Medical College (Manipal Academy of Higher Education)Department of Community MedicineJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Laxminarayan Karanth
- Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE)Department of Obstetrics and GynaecologyBukit Baru, Jalan BatuHamparMelakaMalaysia75150
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Abstract
The US Surgeon General's report Oral Health in America highlighted ways in which oral health and systemic conditions are associated with each other. An oral examination can reveal signs and symptoms associated with systemic diseases. In this article, multiple systemic diseases including but not limited to viral and immune modulated conditions and associated oral symptoms are discussed.
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Affiliation(s)
- Natasha Bhalla
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA.
| | - Yoav Nudell
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
| | - Jaykrishna Thakkar
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
| | - Harry Dym
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
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Evaluation of Mandible Fractures in Patients With Sickle Cell Anemia-A Nationwide Study. J Oral Maxillofac Surg 2019; 77:1418-1422. [PMID: 30707980 DOI: 10.1016/j.joms.2018.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/27/2018] [Accepted: 12/27/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE Sickle cell anemia is the most commonly inherited blood disorder in the United States. Despite its prevalence, clinicians know little about the extent of its impact on orofacial manifestations. MATERIALS AND METHODS All patients with diagnoses of mandible fracture and sickle cell anemia admitted from 2004 through 2014 were identified using the National Inpatient Sample. Patient demographics, fracture regions, and complications were characterized by descriptive statistics. RESULTS Fifty-one of 48,464 patients admitted for mandible fracture had sickle cell anemia. The mean age of the identified patients was 25 years (range, 4 to 58 yr). Of all admitted patients, mandible angle fracture was the most common (19%), followed by fracture of the body of the mandible. Seventy-five percent of cases reviewed were treated with open reduction and internal fixation. CONCLUSIONS Most mandible fractures in patients with sickle cell anemia were located in the angle of the mandible. Complications were minimal and outcomes were satisfactory. Aseptic necrosis of the jaw was a frequent complication of mandible fracture in patients with sickle cell anemia. These results provide clinicians with a better understanding of the distribution and hospital course of patients with sickle cell anemia and facial fractures.
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da Fonseca MA. Oral and Dental Care of Local and Systemic Diseases. Pediatr Dent 2019. [DOI: 10.1016/b978-0-323-60826-8.00004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Brandão CF, Oliveira VMB, Santos ARRM, da Silva TMM, Vilella VQC, Simas GGPP, Carvalho LRS, Carvalho RAC, Ladeia AMT. Association between sickle cell disease and the oral health condition of children and adolescents. BMC Oral Health 2018; 18:169. [PMID: 30342522 PMCID: PMC6196017 DOI: 10.1186/s12903-018-0629-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 10/04/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sickle cell disease (SCD) is the most prevalent monogenic hereditary pathology associated with the presence of hemoglobin SS in the world. It can affect individuals, leading to changes in the face and body, causing a deficiency in dental and bone tissue formation that can ultimately result in a higher level of predisposition to developing dental caries. This study aimed to evaluate the oral condition of children and adolescents with SCD in comparison with the condition of healthy controls. METHODS This was a cross-sectional study of children and adolescents aged 5 to 18 of both sexes from a hematology center in Bahia, Brazil, and subjects without hemoglobinopathies from a public school of the same state (comparison group). There were 124 individuals, 63 in the comparison group and 61 in the disease group. Interviews, dental and periodontal exams using the DMFT and Periodontal Community Index, respectively, were performed, and the salivary buffer capacity and salivary flow rates of the entire sample population were evaluated. The categorical variables were compared using a chi-square test or Fisher's exact test. For comparison of means, the Student's-t test was used for independent samples that presented symmetrical distribution. RESULTS The study showed that the DMFT was 2.08 (2.71) for the SCD group and 1.05 (1.67) for the comparison group (p = 0.013). For dmft, the values were 2.3 (2.6) and 0.88 (1.2), respectively, (p = 0.018). Exams of the periodontium showed the presence of gingival bleeding and dental calculus, with no statistical significance between groups (p = 0.984). When evaluating salivary flow and buffer capacity, no significant differences were observed for the flow rates (p = 0.485), but the SCD group presented a lower buffer capacity compared with the comparison group (p = 0.006). Individuals who used hydroxyurea had a dmft (2.50) higher than that of the comparison group (2.00), and salivary flow was lower than the normal rate in 70% of the children who did not use this medication. CONCLUSION Children and teenagers with SCD had deficient oral health when compared with the comparison group, presenting a higher level of dental caries and lower buffer capacity.
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Affiliation(s)
- Carla Figueiredo Brandão
- Bahiana School of Medicine and Public Health, Avenida Dom João VI, no. 275, Brotas. ZIP: 40.290-000, Salvador, Bahia Brazil
| | - Viviane Maia Barreto Oliveira
- Bahiana School of Medicine and Public Health, Avenida Dom João VI, no. 275, Brotas. ZIP: 40.290-000, Salvador, Bahia Brazil
| | | | - Taísa Midlej Martins da Silva
- Bahiana School of Medicine and Public Health, Avenida Dom João VI, no. 275, Brotas. ZIP: 40.290-000, Salvador, Bahia Brazil
| | - Verônica Queiroz Cruz Vilella
- Bahiana School of Medicine and Public Health, Avenida Dom João VI, no. 275, Brotas. ZIP: 40.290-000, Salvador, Bahia Brazil
| | | | - Laura Regina Santos Carvalho
- Bahiana School of Medicine and Public Health, Avenida Dom João VI, no. 275, Brotas. ZIP: 40.290-000, Salvador, Bahia Brazil
| | - Raissa Aires Costa Carvalho
- Bahiana School of Medicine and Public Health, Avenida Dom João VI, no. 275, Brotas. ZIP: 40.290-000, Salvador, Bahia Brazil
| | - Ana Marice Teixeira Ladeia
- Bahiana School of Medicine and Public Health, Avenida Dom João VI, no. 275, Brotas. ZIP: 40.290-000, Salvador, Bahia Brazil
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Basyouni A, Almasoud NN, Al-Khalifa KS, Al-Jandan BA, Al Sulaiman OA, Nazir MA. Malocclusion and Craniofacial Characteristics in Saudi Adolescents with Sickle Cell Disease. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2018; 6:149-154. [PMID: 30787842 PMCID: PMC6196692 DOI: 10.4103/sjmms.sjmms_142_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Sickle cell disease can result in dentofacial abnormalities. However, in Saudi Arabia, there are limited data with respect to orthodontic manifestations in patients with sickle cell disease. Objective To determine the malocclusion and craniofacial characteristics in sickle cell disease adolescents and compare them with that of controls from the Eastern Province of Saudi Arabia. Methods This comparative cross-sectional study included 112 Saudi patients with sickle cell disease, aged 12-18 years, and 124 age-matched Saudi controls from three major hospitals in Al Khobar and Dammam, Saudi Arabia. The Dental Aesthetic Index was used to assess malocclusion and orthodontic treatment needs. Digital lateral cephalometric radiographs were recorded for each patient and control, and its analysis included linear and angular measurements. Results The prevalence of malocclusion was 87.5% in sickle cell disease patients and 54% in controls (P = 0.0001). The percentage of sickle cell disease patients with severe malocclusion that required orthodontic treatment was higher than that of controls (37.5% vs. 26.6%). In the sickle cell disease cohort, incisal segment crowding (72.4%), overjet (67.3%) and maxillary misalignment in the anterior segment (56%) were the most prevalent types of malocclusions and were significantly higher than that of controls (P < 0.05). About 38% and 67% of the sickle cell disease patients had openbite and posterior crossbite, respectively, compared with 19.3% (P = 0.001) and 37.1% (P = 0.0001) of controls, respectively. Cephalometric analysis showed that SNA (86.7°) and ANB (9.9°) angles were significantly higher in sickle cell disease patients than in controls (81.5° and 2°, respectively). In addition, lower central incisor-to-Frankfort horizontal plane (55°) and interincisal angles (121.5°) were significantly lower in sickle cell disease patients than in controls. Conclusion Adolescents with sickle cell disease had a higher prevalence of malocclusion and greater orthodontic treatment needs than controls. Similarly, they had greater incisal crowding, overjet, openbite and posterior crossbite and demonstrated higher SNA, ANB and lower interincisal angles than controls. The findings of this study suggest that adolescents with sickle cell disease should be provided frequent dental examinations and early orthodontic treatment to improve their oral health, and thus quality of life.
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Affiliation(s)
- Ahmed Basyouni
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Naif Nasser Almasoud
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khalifa Sulaiman Al-Khalifa
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Badr Abdulrahman Al-Jandan
- Department of Biomedical Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Osama Abdulsalam Al Sulaiman
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Muhammad Ashraf Nazir
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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LOPES CMI, CAVALCANTI MC, ALVES E LUNA AC, MARQUES KMG, RODRIGUES MJ, DE MENEZES VA. Enamel defects and tooth eruption disturbances in children with sickle cell anemia. Braz Oral Res 2018; 32:e87. [DOI: 10.1590/1807-3107bor-2018.vol32.0087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 06/27/2018] [Indexed: 01/02/2023] Open
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Kawar N, Alrayyes S, Yang B, Aljewari H. Oral health management considerations for patients with sickle cell disease. Dis Mon 2018; 64:296-301. [DOI: 10.1016/j.disamonth.2017.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Gadiwalla Y, Patel V. Osteonecrosis of the jaw unrelated to medication or radiotherapy. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:446-453. [DOI: 10.1016/j.oooo.2017.12.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 12/04/2017] [Accepted: 12/20/2017] [Indexed: 01/02/2023]
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Ballas SK. Comorbidities in aging patients with sickle cell disease. Clin Hemorheol Microcirc 2018; 68:129-145. [DOI: 10.3233/ch-189003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Samir K. Ballas
- Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Kawar N, Alrayyes S, Aljewari H. Sickle cell disease: An overview of orofacial and dental manifestations. Dis Mon 2018; 64:290-295. [PMID: 29338872 DOI: 10.1016/j.disamonth.2017.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Nadia Kawar
- Diplomate, American Board of Periodontology, USA; Clinical Associate Professor, Department of Periodontology, College of Dentistry, University of Illinois, USA.
| | - Sahar Alrayyes
- Diplomate, American Board of Pediatric Dentistry, USA; Clinical Associate Professor, Department of Pediatric Dentistry, College of Dentistry, University of Illinois, USA
| | - Haider Aljewari
- Postgraduate Periodontics Program, College of Dentistry, University of Illinois, USA
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Tonguç MÖ, Ünal S, Arpaci RB. Gingival enlargement in children with sickle cell disease. J Oral Sci 2018; 60:105-114. [DOI: 10.2334/josnusd.16-0796] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Mine Ö. Tonguç
- Department of Periodontology, Faculty of Dentistry, Suleyman Demirel University
| | - Selma Ünal
- Depatment of Pediatrics, Faculty of Medicine, Mersin University
| | - Rabia B. Arpaci
- Depatment of Pathology, Faculty of Medicine, Mersin University
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Healthy Dental Pulp Oxygen Saturation Rates in Subjects with Homozygous Sickle Cell Anemia: A Cross-Sectional Study Nested in a Cohort. J Endod 2017; 43:1997-2000. [DOI: 10.1016/j.joen.2017.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/11/2017] [Accepted: 07/16/2017] [Indexed: 11/23/2022]
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Kalbassi S, Younesi MR, Asgary V. Comparative evaluation of oral and dento-maxillofacial manifestation of patients with sickle cell diseases and beta thalassemia major. Hematology 2017; 23:373-378. [DOI: 10.1080/10245332.2017.1404219] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Salmeh Kalbassi
- Orthodontist in private practice, Iran (Tehran and Esfahan), Oman and UAE
| | | | - Vahid Asgary
- Research and Development Laboratory, Javid Biotechnology Company, Incubator of Pasteur institute of Iran, Tehran, Iran
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Souza SFC, de Carvalho HLCC, Costa CPS, Thomaz EBAF. Association of sickle cell haemoglobinopathies with dental and jaw bone abnormalities. Oral Dis 2017; 24:393-403. [DOI: 10.1111/odi.12742] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 08/10/2017] [Accepted: 08/13/2017] [Indexed: 01/01/2023]
Affiliation(s)
- SFC Souza
- Department of Dentistry; Federal University of Maranhão; São Luıs Brazil
| | - HLCC de Carvalho
- Postgraduate Dentistry Program; Federal University of Maranhão; São Luıs Brazil
| | - CPS Costa
- Postgraduate Dentistry Program; Federal University of Maranhão; São Luıs Brazil
| | - EBAF Thomaz
- Department of Public Health; Federal University of Maranhão; São Luıs Brazil
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de Carvalho HLCC, Rolim JYS, Thomaz ÉBAF, Souza SDFC. Are dental and jaw changes more prevalent in a Brazilian population with sickle cell anemia? Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:76-84. [DOI: 10.1016/j.oooo.2017.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 02/21/2017] [Accepted: 02/24/2017] [Indexed: 01/23/2023]
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Whiteman LN, Haywood C, Lanzkron S, Strouse JJ, Batchelor AH, Schwartz A, Stewart RW. Effect of Free Dental Services on Individuals with Sickle Cell Disease. South Med J 2017; 109:576-8. [PMID: 27598367 DOI: 10.14423/smj.0000000000000510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Poor oral health can have a negative impact on overall health. This is especially concerning for individuals with sickle cell disease (SCD), an inherited blood disorder that affects hemoglobin and can lead to an increased risk of infection and hyperalgesia. Because the majority of individuals with SCD have Medicaid insurance and no dental coverage, we provided free basic dental care to individuals with SCD to determine whether it decreased overall healthcare utilization. METHODS Through a contract with a private dental office, we provided free basic dental care (eg, cleanings, fillings, x-rays) to individuals with SCD. We reviewed medical records for the 12 months before and after their initial dental visit to determine whether there were any changes in acute care visits (defined as a visit to the emergency department, sickle cell infusion center, or visits to both in the same day), hospitalizations, and total days hospitalized. We conducted a negative binomial regression to determine any differences in the pre-post periods. RESULTS In our multivariable analysis, there was a statistically significant decrease in hospital admissions. In addition, there was a significant decrease in total days hospitalized if dental work was completed, but an increase in days hospitalized in men. CONCLUSIONS Providing dental care to individuals with SCD who did not have dental insurance did not greatly alter acute care visits. A larger sample size may be necessary to observe an effect.
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Affiliation(s)
- Lauren N Whiteman
- From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland
| | - Carlton Haywood
- From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland
| | - Sophie Lanzkron
- From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland
| | - John J Strouse
- From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland
| | - Adrian H Batchelor
- From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland
| | - Anthony Schwartz
- From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland
| | - Rosalyn W Stewart
- From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland
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Correa MEP. Comment on: "Oral health-related quality of life in children and teens with sickle cell disease". Rev Bras Hematol Hemoter 2016; 38:97-8. [PMID: 27208566 PMCID: PMC4877661 DOI: 10.1016/j.bjhh.2016.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 03/01/2016] [Indexed: 12/03/2022] Open
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Abstract
BACKGROUND Sickle cell disease is the most common single gene disorder and the commonest haemoglobinopathy found with high prevalence in many populations across the world. Management of dental complications in people with sickle cell disease requires special consideration for three main reasons. Firstly, dental and oral tissues are affected by the blood disorder resulting in several oro-facial abnormalities. Secondly, living with a haemoglobinopathy and coping with its associated serious consequences may result in individuals neglecting their oral health care. Finally, the treatment of these oral complications must be adapted to the systemic condition and special needs of these individuals, in order not to exacerbate or deteriorate their general health.Guidelines for the treatment of dental complications in this population who require special care are unclear and even unavailable in many aspects. Hence this review was undertaken to provide a basis for clinical care by investigating and analysing the existing evidence in the literature for the treatment of dental complications in people with sickle cell disease. OBJECTIVES To assess methods of treating dental complications in people with sickle cell disease. SEARCH METHODS We searched the Cochrane Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books.Date of last search: 11 April 2016.Additionally, we searched nine online databases (PubMed, Google Scholar, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Literature in the Health Sciences in Latin America and the Caribbean database, African Index Medicus, Index Medicus for South East Asia Region, Index Medicus for the Eastern Mediterranean Region, Indexing of Indian Medical Journals). We also searched the reference lists of relevant articles and reviews and contacted haematologists, experts in fields of dentistry, organizations, pharmaceutical companies and researchers working in this field.Date of last search: 03 March 2016. SELECTION CRITERIA We searched for published or unpublished randomised controlled studies of treatments for dental complications in people with sickle cell disease. DATA COLLECTION AND ANALYSIS Two review authors intended to independently extract data and assess the risk of bias of the included studies using standard Cochrane methodologies; however, no studies were identified for inclusion in the review. MAIN RESULTS No randomised controlled studies were identified. AUTHORS' CONCLUSIONS This Cochrane review did not identify any randomised controlled studies assessing interventions for the treatment of dental complications in people with sickle cell disease. There is an important need for randomised controlled studies in this area, so as to identify the most effective and safe method for treating dental complications in people with sickle cell disease.
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Affiliation(s)
- Priti Mulimani
- Department of Orthodontics, Melaka-Manipal Medical College, Jalan Batu Hampar, Bukit Baru, Malaysia, India, 75150
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da Matta Felisberto Fernandes ML, Kawachi I, Fernandes AM, Corrêa-Faria P, Paiva SM, Pordeus IA. Oral health-related quality of life of children and teens with sickle cell disease. Rev Bras Hematol Hemoter 2016; 38:106-12. [PMID: 27208568 PMCID: PMC4877612 DOI: 10.1016/j.bjhh.2016.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 01/06/2016] [Accepted: 01/19/2016] [Indexed: 11/21/2022] Open
Abstract
Background Children with sickle cell disease may have their quality of life affected by oral alterations. However, there is still little data on oral health-related quality of life in these children. The aim of this study was to investigate the influence of sickle cell disease, socioeconomic characteristics, and oral conditions on oral health-related quality of life of children and teens. Method One hundred and six children and teens with sickle cell disease were compared to a similar sample of 385 healthy peers. Data were collected through oral examinations, interviews to assess quality of life (Child Perceptions Questionnaire for children aged 8–10 and 11–14) and questionnaires containing questions on socioeconomic status. Results There were no statistically significant differences in the total scores of the Child Perceptions Questionnaires or domain scores comparing sickle cell disease patients to control subjects. When sub-scales were compared, oral symptoms and functional limitations had a greater negative impact on the quality of life of adolescents with sickle cell disease (p-value <0.001 and p-value <0.01, respectively) when compared to healthy controls. The only statistically significant determinants of negative impact on oral health-related quality of life in the overall sample was home overcrowding (more than two people/room) in the younger children's group, and dental malocclusion among teens. Conclusion There was no significant difference in the negative impact on the oral health-related quality of life between the group with sickle cell disease and the control group. Of the oral alterations, there was a significant difference in the oral health-related quality of life between adolescents with sickle cell disease and controls only in relation to malocclusion. Among the socioeconomic characteristics, only overcrowding was significantly associated with a negative impact on oral health-related quality of life.
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de Carvalho HLCC, Thomaz EBAF, Alves CMC, Souza SFC. Are sickle cell anaemia and sickle cell trait predictive factors for periodontal disease? A cohort study. J Periodontal Res 2015; 51:622-9. [DOI: 10.1111/jre.12342] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2015] [Indexed: 12/31/2022]
Affiliation(s)
| | - E. B. A. F. Thomaz
- Department of Public Health; Federal University of Maranhão; São Luıs Maranhão Brazil
| | - C. M. C. Alves
- Postgraduate Dentistry Program; Federal University of Maranhão; São Luıs Maranhão Brazil
| | - S. F. C. Souza
- Postgraduate Dentistry Program; Federal University of Maranhão; São Luıs Maranhão Brazil
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Brighenti FL, Medeiros AC, Matos BM, Ribeiro ZEA, Koga-Ito CY. Evaluation of caries-associated virulence of biofilms from Candida albicans isolated from saliva of pediatric patients with sickle-cell anemia. J Appl Oral Sci 2015; 22:484-9. [PMID: 25591017 PMCID: PMC4307760 DOI: 10.1590/1678-775720130603] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 08/13/2013] [Indexed: 12/19/2022] Open
Abstract
A previous study demonstrated that the amount of Candida spp. in saliva is higher in children with sickle-cell disease. The results from a recent study demonstrate its participation in the etiology of dental caries.
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Affiliation(s)
| | - Amanda Coelho Medeiros
- Institute of Science and Technology, Universidade Estadual Paulista, São José dos Campos, SP, Brazil
| | - Bruno Mello Matos
- Institute of Science and Technology, Universidade Estadual Paulista, São José dos Campos, SP, Brazil
| | | | - Cristiane Yumi Koga-Ito
- Institute of Science and Technology, Universidade Estadual Paulista, São José dos Campos, SP, Brazil
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Abstract
"Numb chin syndrome" (NCS) refers to new-onset numbness of the lower lip and chin within the distribution of the mental or inferior alveolar nerves. While this focal numbness may be downplayed or even overlooked by patients and clinicians, in the right clinical scenario this may be the presenting symptom of an underlying malignancy. In the absence of any obvious, temporally related dental cause, there are certain conditions that clinicians should consider including orofacial and systemic malignancies as well as several inflammatory disorders. Thorough diagnostic evaluation should always be performed when no clear cause is evident. This paper will discuss the differential, recommended evaluations, and the prognosis, for a patient presenting with NCS.
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Affiliation(s)
- Ryan M Smith
- Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55901, USA
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Gadallah N, El Hefnawy H, Ahmed SF, Ali J, Mahdy A. Trigeminal nerve electrophysiological assessment in sickle cell anemia: correlation with disease severity and radiological findings. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2015. [DOI: 10.4103/1110-161x.157865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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COSTA CPS, CARVALHO HLCC, SOUZA SDFC, THOMAZ EBAF. Is sickle cell anemia a risk factor for severe dental malocclusion? Braz Oral Res 2015; 29:S1806-83242015000100219. [DOI: 10.1590/1807-3107bor-2015.vol29.0017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 09/08/2014] [Indexed: 11/22/2022] Open
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Al-Alawi H, Al-Jawad A, Al-Shayeb M, Al-Ali A, Al-Khalifa K. The association between dental and periodontal diseases and sickle cell disease. A pilot case-control study. Saudi Dent J 2014; 27:40-3. [PMID: 25544813 PMCID: PMC4273253 DOI: 10.1016/j.sdentj.2014.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 07/15/2014] [Accepted: 08/27/2014] [Indexed: 01/22/2023] Open
Abstract
Objective This is a pilot case-control study conducted to investigate the prevalence of dental caries and periodontal disease and examine the possible association between oral health deterioration and SCD severity in a sample of Saudi SCD patients residing in the city of Al-Qatif, Eastern Province, Saudi Arabia. Materials and methods Dental examination to determine the Decayed, Missing and Filled Teeth index (DMFT), Community Periodontal Index (CPI), and plaque index system were recorded for 33 SCD patients and 33 age and sex-matched controls in the Al-Qatif Central Hospital, Qatif, Saudi Arabia. Self-administered surveys used to assess socio-economic status; oral health behaviors for both SCD patients and controls were recorded. In addition, the disease severity index was established for all patients with SCD. SPSS data analysis software package version 18.0 was used for statistical analysis. Numerical variables were described as mean with a standard deviation. Results Decayed teeth were significantly more in individuals with ages ranging from 18 to 38 years with SCD compared to the control group (p = 0.036) due to oral hygiene negligence. The mean number of filled teeth was significantly lower in individuals with SCD when compared to the control group (p = 0.015) due to the lack of appropriate and timely treatment reflected in the survey responses of SCD patients as 15.2% only taking oral care during hospitalization. There were differences between the cases and controls in the known caries risk factors such as income level, flossing, and brushing habit. The DMFT, CPI, and plaque index systems did not differ significantly between the SCD patients and the control group. Conclusion Data suggest that patients with SCD have increased susceptibility to dental caries, with a higher prevalence of tooth decay and lower prevalence of filled teeth. Known caries risk factors influenced oral health more markedly than did factors related to SCD.
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Affiliation(s)
- Haidar Al-Alawi
- College of Dentistry, University of Dammam, Dammam, Saudi Arabia
| | | | - Mahdi Al-Shayeb
- College of Dentistry, University of Dammam, Dammam, Saudi Arabia
| | - Ali Al-Ali
- College of Dentistry, University of Dammam, Dammam, Saudi Arabia
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Oral microbial colonization in children with sickle cell anaemia under long-term prophylaxis with penicillin. Arch Oral Biol 2014; 59:1042-7. [DOI: 10.1016/j.archoralbio.2014.05.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 02/12/2014] [Accepted: 05/06/2014] [Indexed: 11/18/2022]
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Cortes-Ramírez JM, Ayala CDLL, Cortes de la Torre JMDJ, Cortes de la Torre RA, Otilia Salazar L, Castelo OO, de la Torre MJ. Oral Alterations in children with cancer. Literature review. JOURNAL OF ORAL RESEARCH 2014. [DOI: 10.17126/joralres.2014.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Rana S, Houston PE, Wang WC, Iyer RV, Goldsmith J, Casella JF, Reed CK, Rogers ZR, Waclawiw MA, Thompson B. Hydroxyurea and growth in young children with sickle cell disease. Pediatrics 2014; 134:465-72. [PMID: 25157002 PMCID: PMC4144002 DOI: 10.1542/peds.2014-0917] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Growth impairment is a known complication of sickle cell disease. Effects of hydroxyurea (HU) on growth in very young children are not known. METHODS Height, weight, BMI, and head circumference (HC) were compared with World Health Organization (WHO) standards in BABY HUG, a multicenter, randomized, double-blinded, placebo-controlled 2-year clinical trial of HU in 193 children 9 to 18 months of age. Anthropometric data were closely monitored and converted to z scores by using WHO standardized algorithms for descriptive analyses. The treatment and placebo groups were compared longitudinally by using a mixed model analysis. RESULTS At entry, the z scores of BABY HUG children were higher than WHO norms. After 2 years of HU or placebo treatment, there were no significant differences between the groups, except for the mean HC z scores at study exit (HU: +0.8 versus placebo: +1.0, P = .05). Baseline z scores were the best predictors of z scores at study exit. The absolute neutrophil count, absolute reticulocyte count, and total white blood cell count had significant negative correlations with growth measures. CONCLUSIONS Both groups had normal or near normal anthropometric measures during the study. The HC z scores at study entry and exit were slightly greater than WHO norms. Higher baseline white blood cell count, absolute reticulocyte count, and absolute neutrophil count were associated with poorer growth. The significance of the slightly lower HC in the treatment group at study exit is not clear. Trends toward normalization of weight and height and effects on HC will be monitored in ongoing BABY HUG follow-up studies.
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Affiliation(s)
- Sohail Rana
- Department of Pediatrics and Child Health, Howard University, Washington, District of Columbia;
| | - Patricia E Houston
- Department of Pediatrics and Child Health, Howard University, Washington, District of Columbia
| | - Winfred C Wang
- St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Rathi V Iyer
- University of Mississippi Medical Center, Jackson, Mississippi
| | | | - James F Casella
- Division of Hematology, Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland
| | - Caroline K Reed
- Department of Pediatrics and Child Health, Howard University, Washington, District of Columbia
| | | | | | - Bruce Thompson
- Clinical Trials & Surveys Corporation, Owings Mills, Maryland
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Javed F, Ramalingam S, Ahmed HB, Gupta B, Sundar C, Qadri T, Al-Hezaimi K, Romanos GE. Oral manifestations in patients with neurofibromatosis type-1: A comprehensive literature review. Crit Rev Oncol Hematol 2014; 91:123-9. [DOI: 10.1016/j.critrevonc.2014.02.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 02/07/2014] [Accepted: 02/28/2014] [Indexed: 11/29/2022] Open
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Alves e Luna AC, Godoy F, de Menezes VA. Malocclusion and treatment need in children and adolescents with sickle cell disease. Angle Orthod 2014; 84:467-472. [PMID: 24274957 PMCID: PMC8667506 DOI: 10.2319/070913-503.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 09/01/2013] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVE To assess the prevalence of malocclusion and treatment need in children and adolescents with sickle cell disease (SCD). MATERIALS AND METHODS In this cross-sectional study, the sample size comprised 35 five-year-old children and 36 adolescents of both sexes, aged between 12 to 18 years, with SCD. Dental occlusion was assessed using two indexes: the Malocclusion Index (World Health Organization) and the Dental Aesthetic Index (DAI). RESULTS The prevalence of malocclusion in the preschool children was 62.9%. The main malocclusions observed in this age group were Class II (37.1%), increased overjet (28.6%), reduced overbite (28.6%), and open bite (17.1%). In the 12- to 18-year-old subjects, the prevalence of malocclusion was 100%, and the most prevalent types of malocclusion were maxillary overjet (63.9%) and maxillary misalignment (58.3%). It is noteworthy that the majority of adolescents (80.6%) had very severe or disabling malocclusions. CONCLUSION The results revealed a high prevalence of malocclusion in children and adolescents with SCD. According to DAI score, the majority of the sample presented with very severe malocclusion and a compulsory treatment need.
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Affiliation(s)
- Ana Cláudia Alves e Luna
- PhD Student, Pediatric Dentistry, Dental School, University of Pernambuco, Camaragibe, Pernambuco, Brazil
| | - Fabiana Godoy
- PhD, Post-Doctoral Program, Pediatric Dentistry, Dental School, University of Pernambuco, Camaragibe, Pernambuco, Brazil
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Abstract
PURPOSE OF REVIEW To summarize the findings of the recent publications on sickle cell bone disease (SBD). RECENT FINDINGS Individuals with sickle cell disease (SCD) are living longer and develop progressive organ damage including SBD with age. Recent studies suggest alternative radiological diagnostics such as ultrasound and scintigraphy can detect and differentiate between different forms of SBD. MRI with or without diffusion-weighted sequences remains the gold standard. Case reports of cranio-orofacial SBD highlight the rarity of this presentation. Vitamin D deficiency is highly prevalent at all ages, but may not be an independent risk factor for avascular necrosis (AVN). Gene polymorphisms of the Annexin A gene may predict AVN in SCD. A recent study demonstrated reduced days with pain and improved physical activity quality of life following high-dose vitamin D therapy. The high rates of osteopenia and osteoporosis in SCD support the need for research addressing this rising public health problem. Lastly, results of total hip arthroplasty for AVN in SCD has improved significantly over time with the use of cementless prosthetic material and improved supportive care. SUMMARY SBD remains poorly studied. Prospective randomized studies targeting predictors, diagnostics, prevention, and treatment options for SBD are sorely needed.
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Affiliation(s)
- Ifeyinwa Osunkwo
- Children's Healthcare of Atlanta and The Department of Pediatrics Emory University, Atlanta, Georgia, USA
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