From the Guidelines
Anemia is a significant medical condition that dentists should be aware of when treating patients, and according to the most recent evidence 1, oral iron should be considered as first-line treatment in patients with iron deficiency or mild anemia.
Anemia and Dental Care
Anemia, characterized by a deficiency of red blood cells or hemoglobin, can impact dental care in several important ways.
- Dentists should routinely screen for anemia through medical history reviews and be alert to oral manifestations such as pale mucosa, glossitis (inflamed tongue), angular cheilitis (cracks at corners of mouth), and recurrent oral ulcers.
- When treating anemic patients, dentists should consider consulting with the patient's physician before invasive procedures, especially for severe cases with hemoglobin levels below 10 g/dL.
- Local hemostatic measures like pressure packs, gelatin sponges, or tranexamic acid rinses may be necessary to control bleeding in anemic patients.
Types of Anemia
- For patients with iron deficiency anemia, which is the most common type, dentists might observe symptoms like burning mouth syndrome or oral candidiasis.
- Patients with sickle cell anemia require special attention due to increased infection risk and potential complications from dental procedures.
- Vitamin B12 deficiency anemia can present with oral manifestations like glossitis and mucosal ulcerations.
Medication Interactions and Patient Management
- Dentists should also be mindful of medication interactions, as patients taking iron supplements may experience temporary tooth staining, and those on anticoagulants for certain types of anemia might require modified treatment plans to prevent excessive bleeding.
- Stress reduction techniques and shorter appointments are often beneficial for anemic patients who may fatigue easily.
- By understanding anemia's implications for dental care, dentists can provide safer and more effective treatment for affected patients, as supported by the evidence from 1.
From the Research
Anemia and its Relation to Dentistry
- Anemia is a condition characterized by a decrease in the number of red blood cells or the amount of hemoglobin in the blood, leading to inadequate oxygen delivery to tissues and organs 2.
- Iron deficiency anemia is one of the most common causes of anemia, resulting from blood loss due to menstrual periods, gastrointestinal bleeding, or other factors 2.
- Dentists may encounter patients with anemia, particularly those with iron deficiency anemia, and should be aware of the signs and symptoms, such as fatigue, hair loss, and restless legs 2.
Diagnosis and Treatment of Anemia
- The most efficient test for diagnosing iron deficiency anemia is the serum ferritin test 2.
- Treatment of iron deficiency anemia typically involves iron replacement, which can be done orally or intravenously in patients who are not responsive to oral iron or have contraindications 2, 3.
- Ferrous sulfate is a commonly prescribed oral iron supplement, but it can cause gastrointestinal side effects, such as diarrhea, nausea, and vomiting 4, 5.
- Alternative oral iron formulations, such as iron polysaccharide complex, may be better tolerated by some patients, but may not be as effective in increasing hemoglobin levels 5.
Oral vs. Intravenous Iron Supplementation
- Intravenous iron supplementation is often recommended for patients who are refractory or intolerant to oral iron sulfate, as it can quickly correct iron deficiency anemia 6.
- However, intravenous iron administration requires precautions and can be expensive, affecting patients' quality of life 6.
- New oral iron formulations, such as sucrosomial iron, may offer a cost-effective alternative to intravenous iron supplementation, even at higher doses than traditional oral iron formulations 6.
Implications for Dentistry
- Dentists should be aware of the potential for anemia in their patients, particularly those with iron deficiency anemia, and consider referring them to a physician for diagnosis and treatment 2.
- Patients with anemia may require special consideration during dental procedures, such as avoiding certain medications or using alternative treatments to minimize bleeding risks 2.
- Further research is needed to explore the relationship between anemia and dentistry, including the potential impact of anemia on oral health and the role of dentists in diagnosing and managing anemia 2, 3, 4, 5, 6.