Periodontal disease and sickle cell anemia among adults and children

Objectives: The principal objective was to examine periodontal disease in subjects with sickle cell disease, compared to periodontal disease among a similar population of individuals without sickle cell trait. Increased susceptibility to infection among individuals with sickle cell disease is well-known (rationale). Infection is the most common cause of death for individuals with sickle cell anemia, and dental infection, especially the chronic infection of periodontal disease, may have a role in precipitating sickle-cell crisis. Diagnosis and treatment of periodontal disease at an early stage may prevent the onset of debilitating, potentially life-threatening, sickle-cell crisis.

Experimental Methods: Sixty-two (62) subjects, aged 1 to 62, were examined. Complete comprehensive periodontal examinations including probing depth, clinical attachment level, bleeding upon probing, missing teeth, gingival recession, and calculus were performed and recorded.

Results: Fifteen (15) children, aged 1 to 16, and 47 adults, aged 17 to 62, were examined. Thirty (30) adults without sickle cell were randomly selected as controls, among them 18 (60%) female and 12 (40%) male. Among children with sickle cell anemia (all African American), seven (50%) had periodontal disease. Among adults with sickle cell anemia, seven (42%) were female and 10 (58%) were male; 16 (94%) were African American. Among adults with sickle cell anemia, 71% (twelve) had periodontal disease, compared to 13% (four adults) with periodontal disease among the controls.

Conclusion: Data showed significantly higher percentage of periodontal involvement among African Americans with sickle cell anemia (Fisher's exact analyses p=0.002). We hope that by working closely with both sickle cell patients and their primary care physicians, a heightened awareness of the implications of periodontal disease on sickle cell anemia can be achieved. We further hope that early diagnosis and treatment of periodontal disease in sickle patients will show productive benefits regarding sickle cell crises.