Oral Manifestations of Anaemia and Vitamin D Insufficiency In Pediatric-Patient

Abstract

Background: Anaemia is defined as a condition in which the number of red blood cells is poorly lowered. Vitamin D plays an important role in various biological systems, such as accelerating wound healing and regulating the immune system. Around 50% of the global population has vitamin D insufficiency. Both conditions in children are associated with impaired growth and developmental delay and can cause oral lesions. The aim of this paper is to report the oral manifestations related to anemia and vitamin D insufficiency in a pediatric patient. Case Report: A 6-year-old male came to the Dental and Oro Maxillofacial Unit, Universitas Indonesia Hospital, with a complaint of a canker sore on the lower gingiva since a week ago. Medical history revealed iron deficiency anemia in infancy and vitamin D deficiency. Intraoral examination showed a shallow single ulcer on the attached gingiva near the mucobuccal fold in the 71-81 region, linea alba, and mild atrophy on the tongue. Laboratory tests showed a low level of serum 25(OH)D.Case Management: A referral to a pediatrician was made. The patient was prescribed Vaseline and given hyaluronic acid gel to reduce pain. The patient was suggested to continue Vitamin D supplement and encouraged to carry out periodic control to the pediatrician. Discussion: Oral manifestations of anemia include angular cheilitis, atrophic tongue, and stomatitis. Vitamin D is confirmed to deliver strong immunomodulatory effects on both innate and acquired immunity responses in the pathogenesis of certain oral mucosal lesions. Comprehensive examination and identification of underlying conditions are very important in treating pediatric patients. Conclusion: Dentists play an important role in identifying oral disorders related to nutritional deficiencies, to further determine the appropriate treatment plan and referral. Management of oral lesions in pediatric cases requires an interdisciplinary approach with a pediatrician.