Dental management of a patient with Wilson's disease

Wilson's disease (WD) is an autosomal recessive genetic disease, characterized by the accumulation of copper in the body--primarily in the brain and liver--due to defective biliary copper excretion by hepatocytes. WD may manifest clinically as liver disease, neurologic symptoms, and Kayser-Fleischer corneal rings. This article presents a case involving a 43-year-old man who had WD prior to liver transplantation. Oral examination revealed petechiae in the oral mucosa, poor oral hygiene, periodontal disease, missing teeth, and several carious teeth. Patients with WD may present systemic changes that affect dental care. Dental treatment prior to liver transplantation is recommended to eliminate the oral foci of infection and control oral disease.