Dental and periodontal health status of subjects with sickle cell disease

Abstract

Background/purpose: Sickle cell disease (SCD) is a chronic, hereditary, autosomal recessive disorder. The pathophysiology of SCD is thought to result from polymerization of hemoglobin S in red blood cells under hypoxic conditions, which results in vaso-occlusion. The aim of this study was to determine the periodontal and dental health status of patients with SCD. Materials and methods: Fifty-five SCD patients and 41 healthy individuals were evaluated. Detailed medical and dental histories were taken, and a record made of dental status (missing teeth, restorations, impacted teeth, root canal treatment), periodontal status [plaque index (PI), gingival index (GI), probing depth (PD), bleeding on probing (BOP)], alveolar bone level (ABL), mandibular cortex index, and bone quality index. Results: Two hundred and six teeth were missing, and a total of 195 teeth had restorations. Between-group differences existed for the PI, GI, and BOP; these variables were higher in patients than in the healthy individuals (P < 0.0001). No between-group differences existed for PD. In patients, there was a positive correlation between PD and BOP (P < 0.0001; r = 0.657), PD and GI (P = 0.02; r = 0.299), PD and PI (P = 0.01; r = 0.343); BOP and GI (P < 0.0001; r = 0.503), BOP and PI (P < 0.0001; r = 0.496); and GI and PI (P = 0.003; r = 0.388). The ABL in patients was found to be similar to that of the general population with an unknown periodontal condition. Conclusion: No clinical periodontal disease or attachment loss was detected in patients. However the PI, GI, and BOP were significantly higher in patients with SCD, which may reflect an as yet undefined variable response to microbes. There were no significant differences, however, in pocket depth between the two groups. Therefore we are unable to confirm any significant relationship between SCD and periodontal diseases. Oral health is not a major concern for SCD patients. The reason for this finding may be the potentially severe complications of SCD, which mean that oral and dental problems are not major concerns for this particular group of patients.