Letterer-Siwe disease: report of case.

Initial oral symptoms of Letterer-Siwe disease reveal the importance of a dentist in establishing this diagnosis. This case is important in that the patient was five months old, at which time an early diagnosis was made and treatment had begun. Because most cases occur in young children, a high level of suspicion is necessary, because the oral manifestations and radiographic findings in children may often resemble the periapical, periodontal or cystic involvements frequently seen first by the dentist. The oral lesions were necrotic, hemorrhagic, and degenerative gingival tissues in the maxillary molar area. Loss of alveolar bone was evident. There was precocious eruption of seven primary teeth, which were slightly mobile. Dentally, prophylaxis and fluoride applications were supportive measures.