Thalassemia review: features, dental considerations and management

Abstract

Thalassemia is a genetic disorder that involves abnormal haemoglobin formation. The two main categories of thalassemia are alpha and beta thalassemia that are then divided into further subcategories. While some mild forms of thalassemia might even go unnoticed and only cause mild anaemia and iron deficiency problems in patients, other more severe forms of thalassemia can even result in death. Individuals with thalassemia can get treatment according to the level of severity of their condition. The main oral manifestations of thalassemia are Class II malocclusion, maxillary protrusion, high caries index, severe gingivitis. Any dental surgical procedure for such patients should be done under antibiotic cover and immediately after transfusion. Caution should be exercised in thalassemia patients due to complications related to compromised immunity and cardiovascular issues. Multidisciplinary approach involving dental surgeon, haematologist and orthodontist is the best advised approach.

Survey of the status of iron and sclerostin in major Thalassemia Patients

“…The effects of iron overload can be seen on the scale of damage to the blood and bone [2]. Disease generates from a defect in the formation of the globin beta chain [3]. The main symptom of loss, defect or non-production of hemoglobin units is that it leads to impairment in the process of hematopoiesis which results to severe anemia [4].…”

Comparative evaluation of oral and dento-maxillofacial manifestation of patients with sickle cell diseases and beta thalassemia major

“…Other than that, the teeth of patients who have thalassemia might be discolored and have short crowns and roots [8,9]. Patients with BTM also present maxillary hyperplasia, pathologic fractures, cholelithiasis, systolic ejection murmur, and dental malocclusion [10,11].…”

Oro-dental clinical aspects in children with thalassemia

“…Appropriate nutrition is required when the patient experiences severe chronic anemia, but also to avoid the onset of haemolytic crises caused by outbreaks of dental infection. Dentists should consider, for this category of patients, that any surgical procedure will be under antibiotics and immediately after blood transfusion 11 .…”