Oral Manifestations of Systemic Disease
Oral Indicators of Systemic Health Issues
• Often serious and may sometimes be lethal.
• Oral changes may be of diagnostic importance.
Many systemic diseases present orally.
Classification Desquamative Gingivitis: not
just plaque related because
• Soft Tissues/Hard Tissues unlike plaque-related, which
o Mucosa/Teeth/Bones/Multiple Sites. is confined mainly to the free Hole in the palate – congenital
gingiva, Desquamative (e.g. cleft) tumour that was
• System by System.
Gingivitis affects the sulcus surgically removed, syphilis (3°
o Dermatomes/Gastrointestinal/Connecti Syphillis Gumma).
ve Tissue Disease. also.
• Ulcerative/Non-Ulcerative.
The Oral Mucous Membrane: ABNORMAL COLOUR
• Pallor due to anaemia.
• Yellowish tint due to jaundice.
• Brown Pigmentation (in Caucasians? Addison’s
Disease).
The Oral Mucous Membrane: GINGIVAL OR MUCOSAL BLEEDING
• PURPURA:
o Acute leukaemia and AIDS.
o May be subcutaneously and submucosally.
o Excessive gingival bleeding may be a feature.
o Purpura are small bleeding areas under the mucosa.
• DISORDERS OF CLOTTING:
o Excessive gingival bleeding may be a feature.
o Purpura is not present (haemophilia is the most important cause).
The Oral Mucous Membrane: ACUTE GINGIVITIS
• Main Causes:
o Acute leukaemia, immunodeficiencies, AIDS,
agranulocytosis and uncontrolled diabetes.
o (Systemic Disease).
• Vitamin Deficiencies:
o Scurvy and Pellagra (very rare).
o Vitamin C is involved in cross-linking collagen ! low
Vitamin C ! Scurvy.
Well controlled diabetes – affects polymorph function – periodontal disease slightly worse.
Poorly controlled diabetes – periodontal disease is much worse – more gingival bleeding etc.
The Oral Mucous Membrane: STOMATITIS
• Non-ulcerative:
o Sjogren’s Syndrome
! Dry mouth.
! Affects the lacrimal/salivary glands.
! May be a manifestation of Systemic Disease (e.g. RA).
o Candidosis
Oral Indicators of Systemic Health Issues
• Often serious and may sometimes be lethal.
• Oral changes may be of diagnostic importance.
Many systemic diseases present orally.
Classification Desquamative Gingivitis: not
just plaque related because
• Soft Tissues/Hard Tissues unlike plaque-related, which
o Mucosa/Teeth/Bones/Multiple Sites. is confined mainly to the free Hole in the palate – congenital
gingiva, Desquamative (e.g. cleft) tumour that was
• System by System.
Gingivitis affects the sulcus surgically removed, syphilis (3°
o Dermatomes/Gastrointestinal/Connecti Syphillis Gumma).
ve Tissue Disease. also.
• Ulcerative/Non-Ulcerative.
The Oral Mucous Membrane: ABNORMAL COLOUR
• Pallor due to anaemia.
• Yellowish tint due to jaundice.
• Brown Pigmentation (in Caucasians? Addison’s
Disease).
The Oral Mucous Membrane: GINGIVAL OR MUCOSAL BLEEDING
• PURPURA:
o Acute leukaemia and AIDS.
o May be subcutaneously and submucosally.
o Excessive gingival bleeding may be a feature.
o Purpura are small bleeding areas under the mucosa.
• DISORDERS OF CLOTTING:
o Excessive gingival bleeding may be a feature.
o Purpura is not present (haemophilia is the most important cause).
The Oral Mucous Membrane: ACUTE GINGIVITIS
• Main Causes:
o Acute leukaemia, immunodeficiencies, AIDS,
agranulocytosis and uncontrolled diabetes.
o (Systemic Disease).
• Vitamin Deficiencies:
o Scurvy and Pellagra (very rare).
o Vitamin C is involved in cross-linking collagen ! low
Vitamin C ! Scurvy.
Well controlled diabetes – affects polymorph function – periodontal disease slightly worse.
Poorly controlled diabetes – periodontal disease is much worse – more gingival bleeding etc.
The Oral Mucous Membrane: STOMATITIS
• Non-ulcerative:
o Sjogren’s Syndrome
! Dry mouth.
! Affects the lacrimal/salivary glands.
! May be a manifestation of Systemic Disease (e.g. RA).
o Candidosis
