Oral manifestations of systemic disease

On examination, the oral cavity may exhibit manifestations of underlying systemic disease and serve as an indicator of overall health. Systemic diseases with oral findings include autoimmune, hematologic, endocrine, and neoplastic processes. Autoimmune disease may manifest as oral ulcerations, changes in the salivary and parotid glands, and changes in the tongue. Patients with hematologic illnesses may present with gingival bleeding or tongue changes such as glossitis, depending on the etiology. Oral changes associated with endocrine illness are variable and depend on the underlying condition. Neoplastic changes include metastatic lesions to the bony and soft tissues of the oral cavity. Patients with chronic diseases such as gastroesophageal reflux and eating disorders may present with dental erosions that cause oral pain or halitosis. In the pediatric population, oral changes can be related to rare cancers, such as Langerhans cell histiocytosis, or infectious etiologies, such as Kawasaki disease. In both adults and pediatric patients, poor oral health has been linked to poorer health outcomes overall. Thorough history taking and physical examination by dentists may aid in determining the underlying etiology of oral changes and allow for earlier intervention by medical colleagues.