Orofacial manifestations in patients with sickle cell disease.

BACKGROUND: The aim of this study was to review the orofacial manifestations in patients with sickle cell disease (SCD).

METHODS: Indexed databases were explored using various combinations of the following keywords: "sickle cell anemia," "sickle cell disease," "oral health status" and "dental inflammation."

RESULTS: Hypoxia has been associated with osteomyelitis of the jaws, particularly the mandible in patients with SCD. Bone marrow hyperplasia in these patients causes depression of nasal bridge, midfacial overgrowth and malocclusion. Mental nerve neuropathy due to osteomyelitis of the mandible causes numbness in the lower lip and chin. A diminished blood supply to teeth causes necrosis of the dental pulp in patients with SCD. Dental caries is a common manifestation in patients with SCD, particularly in those with underprivileged living standards. The association between SCD and periodontal inflammatory conditions remains unclear.

CONCLUSIONS: Oral health problems in patients with SCD are rare and occur mainly as a result of the poor oral hygiene maintenance.