Oral cavity does not only help in chewing but it also acts as a mirror of the systemic conditions.
Oral cavity has a special importance in competitive exams. Histopathology & clinical features of oral cavity in systemic diseases has been asked a lot of times in NEET-PG & FMGE. It is of paramount importance in NEXT preparation as well.
Let us overview some of the most common systemic conditions & their oral reflections.
Gastrointestinal tract disturbances are the one which create most of the oral manifestations, because of the acid reflux and gut floral disturbances. Nutritional deficiencies cause apthous ulcers in cheek mucosa. Inflammatory bowel syndrome like Crohn’s disease causes buccal cobble stone lesions. Gastro esophageal reflux causes oral ulcers & dental caries due to acid reflux.
Renal dysfunction causes elevated urea levels in blood & saliva, where it gets converted to ammonia, thus causing ammonical halitosis. Liver cirrhosis or hepatitis cause rotten halitosis (fetor hepaticus) because of increased levels of sulphur in the blood stream. Thalassemia causes bleeding gums, loosened teeth & gingivitis. Immune compromised patient are more likely to suffer from xerostomia, candidiasis/ oral thrush. Oral thrush is also common in infants due to poor oral hygiene.
Vitamin deficiency also causes different oral manifestations like
- Vitamin C deficiency: swollen & bleeding gums
- Vitamin b complexdeficiency: ulcers specifically on inner side of lips and below tongue.
- Vitamin B12 deficiency: Strawberry tongue &ulcers over tongue.
Other conditions that cause strawberry tongue are: Scarlet fever & Kawasaki disease. Calcium deficiency causes caries prone teeth. Endocrinal disorders like diabetes causes fruity halitosis, hypothyroidism causes dry mouth & swelling of cheek mucosa. Likewise any kind of fever causes xerostomia, cracked lips due to generalized dehydration.
Systemic medications like metronidazole & clarithromycin also causes oral side effects like metallic taste.
Thus it is important to keep a check on the changes happening in the oral cavity for the sake of early cure or systemic diseases. Keep in mind that when a MCQ has image of oral cavity, the disease may be systemic & not limited to oral cavity.
Dr. Shraddha shah
Medical Content Writer