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Scurvy presenting primarily as gingival manifestation in a young child: a diagnostic dilemma
Rashmi Chaluvaraj1, Paul F Ashley2, Susan Parekh2
1Buckinghamshire Priority Dental Service, CNWL, Milton Keynes, UK rashmi.chaluvaraj@nhs.net.
Insights
Vitamin C deficiency, or scurvy, still affects at-risk groups. Dentists can identify this condition, especially in children with restricted diets, by recognizing gingival inflammation.
Area of Science:
- Nutrition Science
- Pediatric Medicine
- Dental Health
Background:
- Vitamin C deficiency (scurvy) historically linked to sailors, but persists in specific populations.
- A 2020 global review indicates ongoing prevalence in at-risk groups.
- Dental professionals are often the first point of contact for oral health symptoms.
Observation:
- A case study details a non-verbal child with learning difficulties and a restricted diet.
- The primary presenting symptom was significant gingival inflammation.
- Non-specific symptoms led to a diagnostic dilemma and delayed diagnosis.
Findings:
- Gingival inflammation is a key indicator of vitamin C deficiency.
- Diagnosis was confirmed only after considering vitamin C deficiency.
- The case highlights challenges in diagnosing deficiency in vulnerable pediatric populations.
Implications:
- Dental practitioners play a crucial role in identifying potential vitamin C deficiency cases.
- Dietary evaluation and recognition of associated signs are vital.
- Considering vitamin C deficiency as a differential diagnosis is important for at-risk children.
Abstract:
Vitamin C deficiency, historically known as scurvy, was associated with sailors in the Victorian times, however, a global review in 2020 suggests it still exists in certain at-risk groups.A case is presented of a young non-verbal child with learning difficulties and on a restricted diet, in which the primary symptom was gingival inflammation. It posed a diagnostic dilemma due to the non-specific symptoms, and a delay in the diagnosis, until vitamin C deficiency was confirmed.Gingival inflammation is one of the common findings in vitamin C deficiency and dental professionals may be the first point of contact. The importance of dietary evaluation, identifying and looking for other signs and liaising with the medical colleagues are discussed.This case highlights the role of the dentist in identifying latent cases of vitamin C deficiency and to consider this as a differential diagnosis especially in certain at-risk groups.
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