Oral manifestations of systemic diseases

GIT diseases
Crohn disease
diffuse labial, gingival or mucosal swelling cobblestoning of buccal mucosa and gingiva aphtous ulcers mucosal tags angular cheilitis oral granulomas

Crohn disease

Ulcerative colitis
oral signs are present in periods of exacerbation of disease aphtous ulceration or superficial hemorrhagic ulcers angular stomatitis pyostomatitis vegetans, pyostomatitis gangrenosum

pyostomatitis vegetans

Gastroesophageal reflux

reduction of the pH of the oral cavity below 5,5 enamel damage damage of the dentin higher sensitivity (to temperature..), caries

enamel damage and damage of the dentin

Chronic liver diseases

jaundice petechiae or gingival bleeding (hemostasis disorder)

Hematologic diseases
Anemias
folate and vit. B12 deficiency or iron deficiency

glossitis
red colour atrophic papilae recurrent aphthae candidal infection angular stomatitis oral pain

Leukemia
gingival hypertrophy petechiae mucosal ulcers hemorrhage Treatment of leukemia reactivation of herpes simplex virus oral mucosistis

gingival hypertrophy in leukemia Summary of oral manifestations of gastrointestinal and hematologic diseases Labial swelling Glossitis Crohn's disease Crohn's disease Iron-deficiency anemia Pernicious anemia Ulcerative colitis

Erosion of enamel and dentin Anorexia nervosa/bulimia Gastroesophageal reflux

Ulcerations and erosions Crohn's disease Iron-deficiency anemia Pernicious anemia Pyostomatitis vegetans Ulcerative colitis Hemorrhage Pyostomatitis vegetans Scurvy Ulcerative colitis Aphthous ulcers Crohn's disease Pernicious anemia Ulcerative colitis Candidiasis Crohn's disease (steriod therapy) Iron-deficiency anemia Pyostomatitis vegetans (steriod therapy) Ulcerative colitis (steroid therapy

Gingivitis Anorexia nervosa/bullimia Crohn's disease Scurvy Angular cheilitis Iron-deficiency anemia

Intraoral burning Iron-deficiency anemia Pernicious anemia

Connective-tissue diseases
Sjgren syndrome
autoimmune disease men : women - 1 : 9 50 years and older

Main signs
sicca syndrome keratoconjuctivitis sicca xerostomia

Oral signs
decrease in saliva xerostomia dry, red, wrinkled mucosa difficulty in swalloving and eating disturbance in taste and speech increased dental caries infections atrophy of the papilae candidiasis

Kawasaki disease
vasculitis of medium and large arteries

Oral signs
swelling of papilae on the surface of the tongue (strawbery tongue) intense erythema of the mucosal surfaces cracked, cherry red, swolen and hemorrhagic lips

Scleroderma
diffuse sclerosis of the skin, GIT, heart muscle, lungs, kidney

Oral signs
pursed lips dificult to open the mouth esophageal sclerosis gastroesophageal reflux damage of enamel pale, rigid mucosa teleangiectasias decreased mobility of tongue salivary hypofunction

Lupus erythematosus
autoimmune disease

Oral signs
ulcerations similar tooral lesions of lichen planus painful petechiae damage of salivary glands - xerostomia

Pulmonary diseases
Cystic fibrosis
Oral signs
disorder of salivary glands swelling lips gingivitis dryness

Sarcoidosis
Oral signs
multiple, nodular, painles ulcerations of the gingiva, bucal mucosa, labial mucosa and palate tumorlike swelling of salivary glans swelling of the tongue xerostomia facial nerve palsy

Cutaneous diseases
Psoriasis
Oral signs
fissured tongue

small white papules red and white plagues bright red patches

Acantosis nigricans
hyperpigmentation, papillomatosis

Oral signs
gingival hyperplasia gingiva, tongue, lips papilomas

Endocrine diseases
Diabetes mellitus
Oral signs
xerostomia caused decreased salivation and increased glucosa level in saliva gingivitis oral infections candidiasis higher incidence of caries bilateral enlargement of parotid glands altered taste burning mouth syndrome

Hypoparathyroidism
Oral signs
candidiasis upper lip twitching

Hyperparathyroidism
Oral signs
loss of the lamina dura surrounding the roots of the teeth decrease of trabecular density osseous lesions brown tumor

Cushings syndrome
Oral signs
fatty tissue deposition moon face osteoporosis pathological fractures of the mandible, maxilla or alveolar bone delayed healing of fractures and also sof tissue injuries

moon face

Addisons disease
Oral signs
bronzing hyperpigmentation of the skin oral mucosal melanosis buccal mucosa, tongue

hyperpigmentation

Renal diseases
Uremic stomatitis
rare in undiagnosed and untreated chronic renal failure irritation and chemical injury of mucosa by ammonia or ammonium compounds

Signs
painful plagues and crusts bucal mucosa, the floor or dosrum of the tongue, floor of the mouth Type I generalized or localized erythema exudate pain, burning, xerostomia, halitosis, gingival bleeding, candidiosis Type II ulceration secondary infection

anemia

painful plagues and crusts bucal mucosa, the floor or dosrum of the tongue, floor of the mouth