Oral Health Status in Children with Fanconi's Aplastic Anemia

OBJECTIVES:Fanconi's anemia (FA) is an autosomal-recessive disorder characterized by a progressive pancytopenia, diverse congenital abnormalities, and increased predisposition to malignancy. The present study aimed to investigate the oral health status of 26 children with FA. METHODS: Children with FA were examined for dental caries using the decayed, missing, and filled teeth (DMF) indices and for gingival, plaque conditions using the gingival index (GI) (Loe-Silness), and Plaque index (PI)(Silness-Loe). Stimulated saliva was collected and salivary pH, buffer capacity, and salivary mutans streptococci levels were evaluated. Panoramic radiographies of the patients were also obtained to detect congenitally dental abnormalities.RESULTS:The mean age of the children with FA was 10.04+5.24 (range:2-23 years) while 17 were boys and 9, girls. Of these 26 patients; 7 (26.9 %) of them had never brushed their teeth and 9 (34.6 %) had gingivitis. The mean values of dmft, dmfs, DMFT, DMFS, GI and PI indices were 2.2±2.6, 3.6±5.3, 2.5±3.5, 4.5±8.8, 1.6±0.6 and 1.2±0.5, respectively. Of these 26 patients with FA, 16 (61.5 %) had never visited dentist before. Radiological evaluation of the patients revealed that 5 (20 %) of them had congenital missing teeth. Moreover, microdontia of all teeth was found in 10 patients and 2 supernumerary teeth were also observed in one patient. A correlation between plaque index and gingival index (r=0.74, p=0.000) was found. There were also a correlation between salivary buffer capacity and DMFT index (r=0.79, p=0.004) and salivary buffer capacity and DMFS index (r=0.73, p=0.004).CONCLUSION:Children with FA are more susceptible to infections than healthy children. As oral health diseases and manifestations constitute source of infection in these patients.Thus, besides systemic control, additional preventive measures during their whole life to maintain oral health and careful diagnosis in regard to congenitally dental abnormalities are necessary in these children.