Abstract
Oral manifestations of deficiency of iron, vitamin B12 and folic acid are thought to be common. Prevalence of these deficiencies among patients with compatible symptoms is not well known. The goal of this study was to summarize evidence from a dental practice of iron, vitamin B12 and folic acid deficiency in patients presenting with compatible oral manifestations. 250 patients who presented with burning mouth syndrome, angular cheilitis, recurrent aphthous stomatitis, papillar atrophy of the tongue dorsum or mucosal erythema were identified. Patients underwent clinical examination, and the blood samples were taken. 250 patients (208 females; 42 males, mean age 44.1 years) with at least one corresponding symptom or sign were identified. The nutritional deficiency of one or more nutrients was found in 119 patients (47.6%). Seven times more females than males were noted to have one type of deficiency (104 females, 15 males). Iron deficiency as defined was diagnosed in 62 patients (24.8%), vitamin B12 or folic acid deficiency in 44 patients (17.6%) and both deficiencies (iron + vitamin B12/folic acid) in 13 patients (5.2%). The only predictive factor was gender and only for iron deficiency. The presence of more than one deficiency was noted in 10 patients (4.9%). The most commonly observed deficiency in dental practice over the course of 11 years was an iron deficiency in the female population. Age, diet and reported co-morbidities did not show statistically significant predictable value in recognizing these deficiencies.
Highlights
Oral manifestations of deficiency of iron, vitamin B12 and folic acid are thought to be common
Dental practitioners are often some of the first healthcare providers to observe oral manifestations of burning mouth, mucosal erythema or papillary atrophy of the tongue dorsum
According to the World Health Organization (WHO), iron deficiency represents a common medical challenge with about 80% of anemias represented by iron deficiency, and 30% of the world population is at risk of developing iron deficiency [2]
Summary
Oral manifestations of deficiency of iron, vitamin B12 and folic acid are thought to be common Prevalence of these deficiencies among patients with compatible symptoms is not well known. The most frequently reported oral cavity symptoms of iron, vitamin B12 and folic acid deficiency are pale mucous membranes, erythema, glossitis, recurrent aphthous stomatitis, angular cheilitis and oral candidiasis [4, 5]. Angular cheilitis and glossitis are mentioned as some of the common symptoms of iron deficiency [6] These two clinical signs may represent other pathology. The burning mouth, burning tongue, paresthesia and dysesthesia of the oral cavity often represent non-specific symptoms with nutritional deficiencies identified as some of the more common systemic factors [8]
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