Orofacial and dental condition in leprosy

Pereira, Raony Môlim de Sousa; Silva, Thalisson Saymo de Oliveira; Silva, Luciana Saraiva e; Santos, Tanit Clementino; Falcão, Carlos Alberto Monteiro; Pinto, Lucielma Salmito Soares

Abstract

AIM: To verify the orofacial and dental complex in individuals affected by leprosy concerning lesions, prevalence of dental caries and biofilm storage. METHODS: This study was performed on 56 patients with leprosy: 28 under treatment and 28 treated for the disease. A clinical form was prepared to include demographic and leprosy data. The prevalence of caries was analyzed using the decayed, missing, filled teeth (DMFT) index and oral hygiene was evaluated using the Plaque Control Record. The statistical significance was measured by chi-square and Student's t-test. RESULTS: The mean age was 56.4 years, and there was predominance of males. The treatment group had more women (Pearson ÷2=12.47, p=0.0004) and younger patients (Pearson ÷2=9.688, p=0.0079) than the healed group. As much as 30.4% of patients had orofacial complaints related to the disease. The most often observed variations of normality as racial melanin pigmentation (67.8%) and lingual varices (32.1%), and lesions such as atrophy of the anterior nasal spine (25%), inflammatory papillary hyperplasia (17.8%), and collapse of the nasal bridge (14.3%). There were no specific oral lesions among leprosy patients. The mean DMFT was 20.8 and the Plaque Control Record was 70.2%. The treated group had higher DMFT than the treatment group (Student's t p=0.003). CONCLUSIONS: The oral health status of individuals with leprosy is poor, with high levels of plaque and DMFT. No oral lesions associated with the disease were seen.

leprosy; Mycobacterium leprae; oral health

¹
WHO. Expert Committee on Leprosy, 8th Report. WHO, Technical Report Series 968, 2012.
²
Abreu MAMM, Michalany NS, Weckx LLM, Pimentel DRN, Hirata CHW, Alchorne MMA. The oral mucosa in leprosy: a clinical and histopathological study. Rev Bras Otorrinolaringol. 2006;72:312-6.
³
Taheri JB, Mortazavi H, Moshfeghi M, Bakhshi M, Bakhtiari S, Azari-Marhabi S et al. Oro-facial manifestations of 100 leprosy patients. Med Oral Patol Oral Cir Bucal. 2012;17:728-32.
⁴
Pallagatti S, Sheikh S, Kaur A, Aggarwal A, Singh R. Oral cavity and leprosy. Indian Dermatol Online J. 2012;3:101-4.
⁵
Alencar CH, Ramos AN Jr, dos Santos ES, Richter J, Heukelbach J. Clusters of leprosy transmission and of late diagnosis in a highly endemic area in Brazil: focus on different spatial analysis approaches. Trop Med Int Health. 2012;17:518-25.
⁶
Brazil. Ministry of Health. Epidemiological Bulletin. Epidemiological situation of leprosy in Brazil - analysis of the selected last decade indicators and challenges for disposal. 2013;44.
⁷
Santos GG, Marcucci G, Marchese LM. Oral aspects of specific and unspecific lesions in Hansen's disease patients. Pesqui Odontol Bras. 2000;14:268-272.
⁸
Souza VA, Emmerich A, Coutinho EM, Freitas M, Silva EH, Merçon FG et al. Dental and oral condition in leprosy patients from Serra, Brazil. Lepr Rev. 2009;80:156-163.
⁹
Buczkowska-Radliñska J, Pol J, Szmidt M, Biñczak-Kuleta A. The influence of polymorphism of the MUC7 gene on the teeth and dental hygiene of students at a faculty of dentistry in Poland. Postepy Hig Med Dosw. 2012;19:204-9.
¹⁰
De Araújo Navas EA, Inocêncio AC, Almeida JD, Back-Brito GN, Mota AJ, Jorge AO et al. Oral distribution of Candida species and presence of oral lesions in Brazilian leprosy patients under multidrug therapy. J Oral Pathol Med. 2009;38:764-7.
¹¹
Dave B, Bedi R. Leprosy and its dental management guidelines. Int Dent J. 2013;63:65-71.
¹²
Rawlani SM, Rawlani S, Degwekar S, Bhowte RR, Motwani M. Oral health status and alveolar bone loss in treated leprosy patients of central India. Indian J Lepr. 2011;83:215-24.
¹³
Motta ACF, Furini RB, Simão JCL, Vieira MB, Ferreira MAN, Komesu MC et al. Could leprosy reactions episodes be exacerbated by oral infections? Rev Soc Bras Med Trop. 2011;44:633-5.
¹⁴
Heukelbach J, André Chichava O, de Oliveira AR, Häfner K, Walther F, de Alencar CH et al. Interruption and defaulting of multidrug therapy against leprosy: population-based study in Brazil's Savannah Region. PLoS Negl Trop Dis. 2011;5:1031-9.
¹⁵
Martins MD, Russo MP, Lemos JB, Fernandes KP, Bussadori SK, Corrêa CT et al. Orofacial lesions in treated southeast Brazilian leprosy patients: a cross-sectional study. Oral Dis. 2007;13:270-3.
¹⁶
Gomes CCD, Gonçalves HS, Pontes MAA, Penna GO. Clinical and epidemiological profile of patients diagnosed with leprosy in a reference center in the northeast of Brazil. An Bras Dermatol. 2005;80:283-8.
¹⁷
Monteiro LD, Alencar CHM, Barbosa JC, Braga KP, Castro MD, Heukelbach J. Physical disabilities in leprosy patients after discharge from multidrug therapy in Northern Brazil. Cad Saude Publica. 2013;29:909-20.
¹⁸
Cardona-Castro N, Beltrán-Alzate JC, Manrique-Hernández R. Survey to identify Mycobacterium leprae-infected household contacts of patients from prevalent regions of leprosy in Colombia. Mem Inst Oswaldo Cruz. 2008;103:332-6.
¹⁹
Bazan-Furini R, Motta AC, Simão JC, Tarquínio DC, Marques W, Barbosa MH et al. Early detection of leprosy by examination of household contacts, determination of serum anti-PGL-1 antibodies and consanguinity. Mem Inst Oswaldo Cruz. 2011;106:536-540.
²⁰
Ghosh S, Gadda RB, Vengal M, Pai KM, Balachandran C, Rao R et al. Oro-facial aspects of leprosy: report of two cases with literature review. Med Oral Patol Oral Cir Bucal. 2010;15:459-62.
²¹
Almeida JRS, Alencar CH, Barbosa JC, Dias AA, Almeida MEL. Self-perception of people afflicted with leprosy regarding their oral health and the need for treatment. Cien Saude Coletiva. 2013;18:817-26.
²²
Santos GG, Marcucci G, Guimarães Júnior J, Margarido LC, Lopes LHC. Molecular detection of Mycobacterium leprae by polymerase chain reaction in oral mucosa biopsy specimens. An Bras Dermatol. 2007;82:245-9.
²³
Brazil. [Department of Primary Care. Department of Health Care Project SB Brazil 2010: National Oral Health Survey - main results. Brasilia: Ministry of Health], 2011.Portuguese.
²⁴
Belmonte PCR, Virmond MCL, Tonello AS, Belmonte GC, Monti JFC. Characteristics of periodontal disease in leprosy. Bol Epidemiol Paulista. 2007;4:4-9.

Publication Dates

Publication in this collection
31 Jan 2014
Date of issue
Dec 2013

History

Received
25 Sept 2013
Accepted
03 Dec 2013

This work is licensed under a Creative Commons Attribution 4.0 International License.

[1] ¹
WHO. Expert Committee on Leprosy, 8th Report. WHO, Technical Report Series 968, 2012.

[2] ²
Abreu MAMM, Michalany NS, Weckx LLM, Pimentel DRN, Hirata CHW, Alchorne MMA. The oral mucosa in leprosy: a clinical and histopathological study. Rev Bras Otorrinolaringol. 2006;72:312-6.

[3] ³
Taheri JB, Mortazavi H, Moshfeghi M, Bakhshi M, Bakhtiari S, Azari-Marhabi S et al. Oro-facial manifestations of 100 leprosy patients. Med Oral Patol Oral Cir Bucal. 2012;17:728-32.

[4] ⁴
Pallagatti S, Sheikh S, Kaur A, Aggarwal A, Singh R. Oral cavity and leprosy. Indian Dermatol Online J. 2012;3:101-4.

[5] ⁵
Alencar CH, Ramos AN Jr, dos Santos ES, Richter J, Heukelbach J. Clusters of leprosy transmission and of late diagnosis in a highly endemic area in Brazil: focus on different spatial analysis approaches. Trop Med Int Health. 2012;17:518-25.

[6] ⁶
Brazil. Ministry of Health. Epidemiological Bulletin. Epidemiological situation of leprosy in Brazil - analysis of the selected last decade indicators and challenges for disposal. 2013;44.

[7] ⁷
Santos GG, Marcucci G, Marchese LM. Oral aspects of specific and unspecific lesions in Hansen's disease patients. Pesqui Odontol Bras. 2000;14:268-272.

[8] ⁸
Souza VA, Emmerich A, Coutinho EM, Freitas M, Silva EH, Merçon FG et al. Dental and oral condition in leprosy patients from Serra, Brazil. Lepr Rev. 2009;80:156-163.

[9] ⁹
Buczkowska-Radliñska J, Pol J, Szmidt M, Biñczak-Kuleta A. The influence of polymorphism of the MUC7 gene on the teeth and dental hygiene of students at a faculty of dentistry in Poland. Postepy Hig Med Dosw. 2012;19:204-9.

[10] ¹⁰
De Araújo Navas EA, Inocêncio AC, Almeida JD, Back-Brito GN, Mota AJ, Jorge AO et al. Oral distribution of Candida species and presence of oral lesions in Brazilian leprosy patients under multidrug therapy. J Oral Pathol Med. 2009;38:764-7.

[11] ¹¹
Dave B, Bedi R. Leprosy and its dental management guidelines. Int Dent J. 2013;63:65-71.

[12] ¹²
Rawlani SM, Rawlani S, Degwekar S, Bhowte RR, Motwani M. Oral health status and alveolar bone loss in treated leprosy patients of central India. Indian J Lepr. 2011;83:215-24.

[13] ¹³
Motta ACF, Furini RB, Simão JCL, Vieira MB, Ferreira MAN, Komesu MC et al. Could leprosy reactions episodes be exacerbated by oral infections? Rev Soc Bras Med Trop. 2011;44:633-5.

[14] ¹⁴
Heukelbach J, André Chichava O, de Oliveira AR, Häfner K, Walther F, de Alencar CH et al. Interruption and defaulting of multidrug therapy against leprosy: population-based study in Brazil's Savannah Region. PLoS Negl Trop Dis. 2011;5:1031-9.

[15] ¹⁵
Martins MD, Russo MP, Lemos JB, Fernandes KP, Bussadori SK, Corrêa CT et al. Orofacial lesions in treated southeast Brazilian leprosy patients: a cross-sectional study. Oral Dis. 2007;13:270-3.

[16] ¹⁶
Gomes CCD, Gonçalves HS, Pontes MAA, Penna GO. Clinical and epidemiological profile of patients diagnosed with leprosy in a reference center in the northeast of Brazil. An Bras Dermatol. 2005;80:283-8.

[17] ¹⁷
Monteiro LD, Alencar CHM, Barbosa JC, Braga KP, Castro MD, Heukelbach J. Physical disabilities in leprosy patients after discharge from multidrug therapy in Northern Brazil. Cad Saude Publica. 2013;29:909-20.

[18] ¹⁸
Cardona-Castro N, Beltrán-Alzate JC, Manrique-Hernández R. Survey to identify Mycobacterium leprae-infected household contacts of patients from prevalent regions of leprosy in Colombia. Mem Inst Oswaldo Cruz. 2008;103:332-6.

[19] ¹⁹
Bazan-Furini R, Motta AC, Simão JC, Tarquínio DC, Marques W, Barbosa MH et al. Early detection of leprosy by examination of household contacts, determination of serum anti-PGL-1 antibodies and consanguinity. Mem Inst Oswaldo Cruz. 2011;106:536-540.

[20] ²⁰
Ghosh S, Gadda RB, Vengal M, Pai KM, Balachandran C, Rao R et al. Oro-facial aspects of leprosy: report of two cases with literature review. Med Oral Patol Oral Cir Bucal. 2010;15:459-62.

[21] ²¹
Almeida JRS, Alencar CH, Barbosa JC, Dias AA, Almeida MEL. Self-perception of people afflicted with leprosy regarding their oral health and the need for treatment. Cien Saude Coletiva. 2013;18:817-26.

[22] ²²
Santos GG, Marcucci G, Guimarães Júnior J, Margarido LC, Lopes LHC. Molecular detection of Mycobacterium leprae by polymerase chain reaction in oral mucosa biopsy specimens. An Bras Dermatol. 2007;82:245-9.

[23] ²³
Brazil. [Department of Primary Care. Department of Health Care Project SB Brazil 2010: National Oral Health Survey - main results. Brasilia: Ministry of Health], 2011.Portuguese.

[24] ²⁴
Belmonte PCR, Virmond MCL, Tonello AS, Belmonte GC, Monti JFC. Characteristics of periodontal disease in leprosy. Bol Epidemiol Paulista. 2007;4:4-9.

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Orofacial and dental condition in leprosy

Abstract

Publication Dates

History