Oral manifestations of anemia
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Common Oral Manifestations of Anemia
Anemia often presents with several noticeable changes in the mouth. The most frequently reported oral manifestations include pallor of the oral mucosa and lips, atrophic glossitis (smooth, shiny tongue due to loss of papillae), burning sensations in the mouth, angular cheilitis (cracks at the corners of the mouth), glossodynia (tongue pain), recurrent aphthous ulcers, candidiasis (fungal infection), fissured tongue, xerostomia (dry mouth), taste disturbances, and perioral numbness. These symptoms are seen across different types of anemia, including iron deficiency, megaloblastic, hemolytic, sickle cell anemia, and thalassemia 13456710.
Iron Deficiency Anemia and Oral Lesions
Iron deficiency anemia (IDA) is the most common type of anemia associated with oral changes. Studies consistently report a high prevalence of oral pallor, atrophic glossitis, angular cheilitis, burning mouth syndrome, and recurrent aphthous stomatitis in patients with IDA. Pallor of the lips and oral mucosa is especially common, affecting up to 97% of patients in some studies. Atrophic glossitis, fissured tongue, and angular cheilitis are also frequently observed, while other symptoms like oral ulcers, burning sensations, and taste disturbances occur less often 4568910.
Megaloblastic and Pernicious Anemia: Unique Oral Features
Megaloblastic anemia, often due to vitamin B12 deficiency (as seen in pernicious anemia), can cause distinctive oral symptoms. These include burning sensations, mucosal erythema, atrophy (especially "Hunter glossitis"), and sometimes pigmentation changes. Oral symptoms may appear before other systemic signs, making them important early indicators of vitamin B12 deficiency. Burning sensations and atrophic glossitis are particularly common in these patients 37.
Oral Manifestations in Special Populations
In patients with HIV/AIDS, anemia is common and often presents with oral candidiasis, glossodynia, glossitis, and angular cheilitis. These manifestations can be more severe in immunocompromised individuals and may require more intensive management to improve prognosis and quality of life .
Clinical Importance for Dental and Medical Professionals
Oral manifestations of anemia can be among the earliest signs of systemic disease. Dentists and healthcare providers should be aware of these symptoms, as early recognition can prompt further investigation and diagnosis of underlying anemia. Proper management of oral symptoms can also improve patient comfort and quality of life 379.
Conclusion
Anemia frequently causes a range of oral manifestations, including pallor, glossitis, burning sensations, angular cheilitis, and ulcers. These symptoms are especially common in iron deficiency and megaloblastic anemia, but can occur in other types as well. Recognizing these oral changes is crucial for early diagnosis and effective management of anemia.
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