About blood disorders
There are a wide variety of blood conditions that can affect the quantity or proper function of one or more primary parts of your blood, which include:1
- Red blood cells that carry oxygen, vitamins, and nutrients to all parts of your body. These cells also pick up carbon dioxide from your cells and return it to your lungs to be exhaled.
- White blood cells that are produced in your bone marrow and found in your blood and lymph nodes. These cells are part of your immune system, and their primary function is to fight infection.
- Platelets that are small, colorless cells in your blood that work with clotting factors to form clots to stop or prevent bleeding.
- Clotting (coagulation) factors that are proteins circulating within blood plasma (the liquid part of your blood that moves cells and nutrients throughout your body). These factors work with platelets to form blood clots to stop internal and external bleeding.
Blood diseases are diagnosed in millions of people in the U.S. every year. Some are common; others are rare. Blood disorders are typically acquired genetically, but age, gender, pregnancy, and other medical conditions such as cancer or liver disease and their treatments can all increase your risk of developing temporary (acute) or long-term (chronic) conditions.
Blood disorders and your oral health
Undiagnosed or untreated blood disorders can have significant health effects. Many of these conditions show oral symptoms that your dentist can detect at an early stage. If your dentist identifies signs or symptoms of blood disorders and cannot rule out other causes, they will suggest you see a physician for further examination.2
Some of the more common blood disorders and the effects they can have on your oral health include:
- Anemia: This includes a variety of conditions related to the production of red blood cells, which transport iron and other vitamins and minerals throughout your body. Low production of red blood cells is commonly caused by vitamin B12 or iron deficiencies, autoimmune disorders, chronic kidney or other systemic diseases, or viruses such as HIV and malaria. When anemia prevents the soft tissue inside your teeth from getting the nutrients they need, that tissue may die and leave a hollow space open to the inside of your jaw bone. This has most frequently been reported in sickle cell anemia. If the tooth subsequently cracks or develops decay, bacteria can spread from the tooth into the surrounding tissues and jaw bone causing infection and pain. Anemia can also result in white patches in your mouth, increase the risk of infection, cause mouth sores, problems with your tongue3, and increase the risk of oral cancer.4 Since physicians do not normally look for these oral symptoms, your dentist can play an important role in early detection.
- Sickle cell disease (SCD): SCD includes a group of inherited red blood cell disorders that produce malformed red blood cells that restrict proper blood flow. It is one of the most common genetic disorders worldwide, affecting members of the black and Hispanic communities at a much higher rate than other races.5 Testing for SCD is standard at birth. When detected, SCD needs to be immediately and carefully monitored by dentists and physicians because it increases the risk of infection and abnormal bleeding. This can even affect infants and toddlers when teething or losing their primary teeth. SCD symptoms include discolored gums, slow tooth growth, weakened enamel, and swelling of the tongue. SCD can also increase your risk of periodontal disease.6
- Blood cancer: Hodgkins and Non-Hodgkin's lymphoma and leukemia affect your body's ability to produce healthy white blood cells. About 180,000 people in the U.S. are diagnosed each year with one of these diseases, accounting for nearly 10% of all new cancer cases.7 Cancer and its treatments can have severe effects on your oral health.
- Low white blood cell counts: Non-cancerous conditions, including autoimmune diseases like rheumatoid arthritis or lupus, or viral diseases such as HIV/AIDS, can also result in low white blood cell counts. You should always discuss possible symptoms and side-effects with your dentist and physicians.8
- Hemophilia: Hemophilia is a genetic disorder. It is most common in males and has been diagnosed in an estimated 33,000 people in the U.S. It is caused by the lack of specific clotting factors in the blood.9 Hemophilia can cause excessive bleeding when you brush, floss, or during routine or invasive dental treatment. It can also cause mouth sores and bruising of the lips and tongue.10
- Platelet disorders: Several conditions can result in low or abnormal production of platelets. These disorders can also be caused by a reaction to certain medications. Common oral effects of low platelet counts include excessive bleeding, bruising, or infections during routine oral hygiene or dental procedures. If you have a platelet disorder, you should encourage your dentist to discuss your condition with your primary care physician or hematologist prior to receiving dental treatment. This can help ensure that your dentist understands your situation so they can take proper steps to avoid unusual or excessive bleeding.
- Von Willebrand disease (VWD): This disorder results from low levels of specific proteins in the blood that prevent it from clotting properly. It affects 3.2 million people in the U.S.11 VWD is most often inherited but can also be caused by other medical conditions like cancer or lupus. Like platelet disorders, VWD can impact both at-home oral hygiene and treatment received at dental visits. You may want to encourage your dentist to discuss your condition with your physician or hematologist prior to receiving dental procedures to ensure they understand your condition and take the proper steps to avoid potential complications.