Two-Year Investigation of Periodontal Disease and Sickle-cell Anemia

Objective: The objective of this research was to extend our previous study of the relationship between periodontal disease and sickle-cell disease. Increased susceptibility to infection among individuals with sickle-cell disease (one:500 African Americans) provides the rationale for this study with larger sample sizes: Extended (two-year) examination of periodontal disease nature and severity in subjects with sickle-cell disease, compared to periodontal disease among similar population without sickle-cell trait. Infection may alter body temperature and tissue pH, precipitating painful crises. Dental infection, especially chronic infection of periodontal disease, may play role precipitating painful sickle-cell crises. Diagnosis and treatment of early-stage periodontal disease may forestall onset of debilitating, potentially life-threatening, sickle-cell crises.

Methods: One hundred-two (102) adult subjects, ages 17 to 63, received complete comprehensive periodontal examinations; periodontal indices including probing depth, clinical attachment level, bleeding upon probing, missing teeth, gingival recession, calculus recorded.

Results: Forty-two (42) subjects with sickle-cell disease (trait), 60 individuals without sickle-cell trait (controls). In total set, forty-four females (44 percent), fifty-eight males (57 percent); 78 African American racial identification (78 percent) versus 22 Caucasian identification (22 percent). Sixty-three (63) percent of individuals with sickle-cell disease also had demonstrable periodontal disease, compared to thirty-eight (38) percent of controls (p=0.01) (Fisher's exact analyses). Although periodontal disease was significantly greater, plaque was not (p=0.43).

Conclusion: Data showed significantly higher percentage of periodontal disease involvement among African Americans with sickle-cell anemia. Infection remains the most common cause of death for affected individuals (with better disease management, life-expectancy can reach age 50s, up from early adulthood). Close cooperation with both sickle-cell patients and primary care physicians will achieve heightened awareness of the implications of periodontal disease on sickle-cell anemia. Early diagnosis and treatment of periodontal disease in sickle patients will show productive, preventive benefits regarding sickle-cell crises.