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Arup Ratan Choudhury

Arup Ratan Choudhury

Birdem Hospital, Bangladesh

Title: Oral manifestations of systemic diseases

Biography

Biography: Arup Ratan Choudhury

Abstract

Many systemic diseases are reflected in the oral mucosa, maxilla and mandible.  Mucosal changes may include ulceration or mucosal bleeding. Immunodeficiency can lead to opportunistic diseases such as infection and neoplasia.  Bone disease can affect the maxilla and mandible.  Systemic disease can cause dental and periodontal changes. Drugs prescribed for a systemic disease can affect oral tissue.

Oral conditions have an impact on overall health and disease. Bacteria from the mouth can cause infection in other parts of the body when the immune system has been compromised by disease or medical treatments (e.g., infective endocarditis). Systemic conditions and their treatment are also known to impact on oral health (e.g., reduced saliva flow, altered balance of oral microorganisms). Oral manifestations - Commonly occurs in mucosal surface of buccal mucosa, vestibules, tongue, lips, floor of the mouth, palate. Appears weeks or months before the skin lesions.  Lesions are bilaterally symmetrical.

Oral health is essential to general health and well-being at every stage of life. A healthy mouth enables not only nutrition of the physical body, but also enhances social interaction and promotes self-esteem and feelings of well-being. The mouth serves as a “window” to the rest of the body, providing signals of general health disorders. For example, mouth lesions may be the first signs of HIV infection, aphthous ulcers are occasionally a manifestation of Coeliac disease or Crohn’s disease, pale and bleeding gums can be a marker for blood disorders, bone loss in the lower jaw can be an early indicator of skeletal osteoporosis, and changes in tooth appearance can indicate bulimia or anorexia. The presence of many compounds (e.g., alcohol, nicotine, opiates, drugs, hormones, environmental toxins, antibodies) in the body can also be detected in the saliva. Oral disease is the most widespread chronic disease, despite being highly preventable. It has become increasingly clear that the oral cavity can act as the site of origin for dissemination of pathogenic organisms to distant body sites, especially in immunocompromised hosts such as patients suffering from malignancies, diabetes, or rheumatoid arthritis or having corticosteroid or other immunosuppressive treatment. A number of epidemiological studies have suggested that oral infection, especially marginal and apical periodontitis may be a risk factor for systemic diseases.  The oral cavity contains some of the most varied and vast flora in the entire human body and is the main entrance for 2 systems vital to human function and physiology, the gastrointestinal and respiratory systems. Several diseases involve these 2 systems and manifest in the oral cavity. In addition, a specific pathologic condition, such as periodontitis (i.e., inflammation of the periodontal attachment of the teeth and the alveolar bone), may be present in the oral cavity. These specific conditions in the oral cavity may create foci of infection that can affect many other vital systems, such as the cardiovascular and renal systems. Foci of infection in the oral cavity arising from chronic periodontitis or chronic periapical abscesses (i.e., inflammation and abscess of the tissue attached to the apex of the root) may lead to subacute bacterial endocarditis (BE) and glomerulonephritis (GN).

That the mouth and body are integral to each other underscores the importance of the integration of oral health into holistic general health policies and of the adoption of a collaborative “Common Risk Factor Approach” for oral health promotion.

Recent Publications

1. Choudhury AR, et al; Dental caries and periodontal disease among diabetic population: BIRDEMJ experience. J Diabetic Assoc Bangladesh, 1990.

2. Choudhury AR, et al; Clinical pattern of dental caries and periodontal disease in diabetic population in Bangladesh. J. Diabetic Assoc Bangladesh 1991; 19:30-33.

3. Choudhury AR, et al; Diabetes mellitus and periodontal disease, Bangladesh Dent J 1991; 7:11-14.

4. Choudhury AR, et al Dental diseases in diabetes and non-diabetes. An observation J. Diabetic Assoc Bangladesh 1991; 19: 14-23.

5. Choudhury AR, et al: Diabetes may present with oral symptoms. J Diabetic Assoc Bangladesh 1992; 20: 21-25.

6. Choudhury A.R et al Comprehensive Detection of Human Papilloma virus in Buccal Cancer Collected in Bangladesh. Dentistry in Japan Vol.41 pp-19-24, March 2005.

7. Choudhury ARC at Relationship between Dental disease and Coronary heart disease in diabetic patients Bangladesh Medical Research Council Bulletin, 2011 ( Article in print Journal ).