Oral Findings in Systemic Disorders

Thrush (oral candidiasis)

Diabetes, AIDS, other causes of immunosuppression (eg, agranulocytosis, neutropenia, leukemia, immunoglobulin defects, disorders of leukocyte function), antibiotic use

Atrophic glossitis (a smooth tongue caused by atrophy of filiform papillae)

Iron deficiency

Painful atrophy of the oral mucosa and surface of the tongue, sometimes with aphthous ulcers

Megaloblastic anemias

Magenta tongue

Vitamin B12 deficiency

Darkly pigmented areas (if not a racial characteristic)

Hemochromatosis, Addison disease, Peutz-Jeghers syndrome, melanoma (rare, but may be seen on the palate), smoker’s melanosis

Linear, grayish discoloration (lead line) in the gingiva adjacent to teeth

Lead, silver, or bismuth poisoning

Violaceous patches

Kaposi sarcoma, AIDS

Keratotic lichenoid patches, sometimes with painful mucosal atrophy

Graft-vs-host disease if in the mouth of an organ transplant recipient

Reddish discoloration of the teeth

Congenital erythropoietic porphyria

High, arched soft palate

Marfan syndrome

Notched incisors, domed or mulberry molars

Congenital syphilis

Hairy leukoplakia (white, vertical folds on lateral border of tongue)

HIV transforming to AIDS

Red or reddish purple collections of oral telangiectases

Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome)

Multiple impacted supernumerary teeth and osteomas

Gardner syndrome

Granulomatous gingivitis with cobblestone appearance

Crohn disease