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Avitaminosis
- 1. Chinu Maria Cyriac IV BDS AJ. INSTITUTE OF DENTAL SCIENCES MANGALORE
- 2. Vitamin is usually defined as an organic substances not made by the body, which is soluble either in fat or water & is ordinarily needed in only minute quantities to act as a co factor in a variety of metabolic reaction
- 3. Avitaminosis is any disease caused by chronic or long-term deficiency or caused by a defect in metabolic conversion, such as tryptophan to niacin. They are designated by the same letter as the vitamin. Types : vitamin A deficiency causes xerophthalmia or night blindness thiamine deficiency causes beriberi niacin deficiency causes pellagra vitamin B12 deficiency leads to megaloblastic anemia vitamin C deficiency leads to scurvy vitamin D deficiency causes rickets
- 4. Decreased intake Impaired absorption Increased metabolism Inadequate storage
- 6. Night Blindness Bitots spots Xerophthalmia Corneal ulceration Decreased salivary secretion( due to metaplasia of secretory epithelium of the salivary glands) Hyperkeratosis of the Oral Mucosa
- 7. Oral Manifestation • Defective formation of Enamel in teeth • Hypoplasia of teeth • Dentin lacks its normal tubular arrangement • Increased caries susceptibility • Periodontal disease • Hyperplasic Gingiva
- 8. Management Depending upon Deficiency, symptoms Vitamin A is given in the dose of 7500 to 15000 mcg per day for 1 month
- 10. If deficiency occurs in children & infants its called Rickets And in Adults its called osteomalacia Deficiency of vitamin D tends to cause hypocalcemia
- 11. RICKETS Clinical Features Cranio-tabes Frontal boss Pigeon Chest Bowing of legs Rachitic rosary Harrison grooves Oral Manifestation Developmental abnormalities of dentin & enamel Hypoplasia & mottling of enamel Increased caries susceptibly Large pulp chamber Malocclusion
- 12. Radiographic features Long bones A thinning of jaw cortical structures Teeth -if the disease occurs by 3 years of age # Enamel Hypoplasia # pulp cavities of deciduous tooth enlarged # Dentin is reduced to a thin margin #Narrowing of PDL space Management Dietary enrichment Calcium gluconate Hormonal therapy like flucytosine
- 13. OSTEOMALACIA Adult rickets Flat bones & diaphyses of long bones are effected Clinical Features Remodeling of the bone occurs in the absence of adequate calcium resulting of softening & distortion of the skeleton Patient has bone pain & muscle weakness Oral Manifestation Severe periodontitis
- 14. Radiographic features Pseudofracture lamina dura may be thin or absent in long standing cases Management Patient with Osteomalacia due to intestinal malabsorbtion require a larger dose of vitamin D & calcium ie 40,000 to 100000 iu of vitamin D & 15 – 20 gm of calcium lactate per day
- 16. Prolongation of clotting time & a tendency to bleed profusely There can also be increased bleeding after tooth extraction Oral Manifestation Gingival bleeding Management Its given in dose of 10- 20 mg daily
- 18. Mild deficiency – appear in the form of lassitude, fatigue, anorexia, muscular pain & susceptibility to infection Severe deficiency- causes Scurvy Clinical Features Folliculosis- Hair follicle rises above skin & there are perifollicular hemorrhage Hemorrhage- In the joint nerve sheath under the nails or conjunctiva Scorbutic child – assumes a frog like position Edema of limbs & Face
- 19. Oral Manifestation Petechiae & Ecchimosis of the oral mucosa Hyperemia Edema & Enlargement of Gingiva with bleeding Loss of teeth Management Vit. C 250 mg 3 times daily Bleeding Gums
- 21. Nervous Disorder Digestive symptoms Beri – Beri *Wet BeriBeri *Dry Beriberi *Infantile Beriberi Oral Manifestation Hypertensive mucosa Pain in the tongue jaws & Face
- 23. Clinical Features Seborrhagic Dermatitis Ocular changes Oral Manifestation Glossitis Angular Chelitis Management Riboflavin 25000_50000 mcg is given daily
- 25. Leads to a disease called pellagra Oral manifestation Entire oral mucosa becomes fiery red and painful Glossitis Stomatitis Management Niacin 10mg per day and vit b complex
- 27. Megaloblastic Anemia Weakness numbness Tingling of the extremities Oral manifestation Sore painful tongue Glossitis Glossodynia Denture wearing discomfort-due to weakened muscular tone Management oral –Its used in a dose of 6 – 150 mcg Parenteral- 100 mcg of Vitamins twice weekly