The oral manifestations of glossitis , stomatitis and mucosal ulceration in vitamin B[SUB12] deficiency have long bee n recognised.

These oral changes may occur in the absence of symptomatic anaemia or of macrocytosis. The aim of this paper is to describe a retrospective study of the wide range of oral signs and symptoms reported by 14 patients found to ha ve a previously undiagnosed vitamin B[SUB12] deficiency. None of the patients de scribed in this study had generalised symptoms sufficiently advanced to arouse s uspieions of vitamin B[SUB12] deficiency. The essential criteria for the diagnos is of pernicious anaemia are also discussed. [ABSTRACT FROM AUTH OR] Field, E. Anne et al

The oral manifestations of glossodynia, glossitis, and stomatitis in vitamin B12 deficiency have long been recognized. These oral changes may occur in the prean emic stage. The aim of this paper was to study the red blood cell distribution w idth (RDW), mean corpuscular volume (MCV), and hemoglobin (Hb) level in 34 patie nts with a wide range of oral symptoms and signs as the initial manifestations o f vitamin B12 deficiency. Of the 34 patients, 29 were normal to mildly anemic, a nd 5 were moderately to severely anemic; none had generalized symptoms sufficien t to arouse suspicion of micronutrient deficiency or anemia before they visited the Oral Medicine Clinic. Nine (26.4%) of the 34 patients had normal RDWs and 8 (88.9%) of these 9 patients also had normal MCVs. Overall, 13 (38.2%) of the 34 patients had normal MCVs and 3 (8.8%) had low MCVs. Our findings indicate that t he classic presentation of macrocytic heterogeneous anemia in vitamin B12 defici ency does not hold true in a large proportion of cases, and the increase of RDW is not necessarily the earliest indicator of vitamin B12 deficiency. Therefore, a diagnosis of vitamin B12 deficiency should be considered even in patients with normal Hb levels and low or normal MCVs. Nevertheless, the combined increase in the RDW and MCV in patients with a sore mouth is still a useful indicator of po ssible vitamin B12 deficiency after folate deficiency and chronic diseases have been ruled out. [ABSTRACT FROM AUTHOR]

The aim of this paper is to review the literature and identify orofacial manifes tations of hematological diseases, with particular reference to anemias and diso rders of hemostasis. A computerized literature search using MEDLINE was conducte d for published articles on orofacial manifestations of hematological diseases, with emphasis on anemia. Mesh phrases used in the search were: oral diseases AND anaemia; orofacial diseases AND anaemia; orofacial lesions AND anaemia; orofaci al manifestations AND disorders of haemostasis. The Boolean operator "AND" was u sed to combine and narrow the searches. Anemic disorders associated with orofaci al signs and symptoms include iron deficiency anemia, Plummer--Vinson syndrome, megaloblastic anemia, sic le cell anemia, thalassaemia and aplastic anemia. The manifestations include conjunctiva and facial pallor, atrophic glossitis, angula r stomatitis, dysphagia, magenta tongue, midfacial overgrowth, osteoclerosis, os teomyelitis and paraesthesia/anesthesia of the mental nerve. Orofacial petechiae , conjunctivae hemorrhage, nose-bleeding, spontaneous and post-traumatic gingiva l hemorrhage and prolonged post-extraction bleeding are common orofacial manifes tations of inherited hemostatic disorders such as von Willebrand's disease and h emophilia. A wide array of anemic and hemostatic disorders encountered in intern al medicine has manifestations in the oral cavity and the facial region. Most of these manifestations are non-specific, but should alert the hematologist and th e dental surgeon to the possibilities of a concurrent disease of hemopoiesis or hemostasis or a latent one that may subsequently manifest itself. [ABSTRACT FROM AUTHOR]