Dental Aspects of Iron Deficiency Anaemia in Patients with Generalized Periodontal Disease and Eating Disorders

Abstract

Relevance. Iron deficiency anemia (IDA) is a hematological syndrome characterized by impaired hemoglobin synthesis due to iron deficiency, which is manifested by anemia and sideropenia. One of the leading causes of IDA is insufficient iron intake in the diet and inflammatory diseases of the small intestine, which is typical for patients with generalized periodontal diseases (GPD) on the background of eating disorders (ED). With a negative balance of iron metabolism, iron is first consumed from the depot (latent iron deficiency). Subsequently, tissue iron deficiency occurs, which is manifested by impaired enzymatic activity and respiratory function of tissues, and later, IDA develops.
Aim: to determine the manifestations of iron deficiency anemia in the oral cavity of patients with generalized periodontal diseases with eating disorders.
Materials: The primary group—70 patients (aged 19–35 years) with GPD (generalized periodontitis (GP), initial-II stage, chronic course) with eating disorders. The comparison group included 59 patients of similar age, equal in gender, with GPD without eating disorders, who did not have blood diseases.
Methods: clinical and radiological, laboratory (complete blood count, determination of ferritin, transferrin, and serum iron), and statistical.
Results: Anemic syndrome in 87 ± 4.2% of patients with GPD with eating disorders was manifested by weakness, constant physical fatigue, frequent headaches, tinnitus, flickering “flies” before the eyes, lethargy, irritability, anxiety, shortness of breath during physical exertion, and increased heart rate.
In the oral cavities of the patients in the leading group, a change in the color of the mucous membrane was observed: it was pale pink (bloodless, anemic), with a grayish-green tint, especially pronounced in the distal parts of the oral cavity, and slightly moistened. In 33.3 ± 7.2% of patients with GPD and with eating disorders, multiple carious lesions of the teeth (often asymptomatic) were observed, as well as an increased level of tooth abrasion (41.2 ± 5.1%) and loss of natural enamel shine due to impaired metabolic processes in it.
Oral Candida albicans infection was diagnosed in 64.1±1.5% of patients in the leading group, compared to 12.4±0.6% of patients in the comparison group. Chronic recurrent aphthous stomatitis was detected in 34.2±6.3% of people with GPD against the background of eating disorders, compared to 0.9±0.3% of patients in the comparison group.
Conclusions: Timely detection and correct interpretation by the dentist of iron deficiency anemia contribute to the early recognition of blood diseases in patients with GD in eating disorders, thereby improving the quality of prevention and treatment for such individuals.