Owens B M, Gallien G S, Schuman N J, Turner J E
Department of General Dentistry, University of Tennessee, College of Dentistry, Memphis, USA.
J Tenn Dent Assoc. 1997 Jan;77(1):26-9.
During a routine dental appointment at a dental school clinic, a fifteen-year-old black male patient was diagnosed with severe erosion of the dentition together with several carious lesions and a crowded dentition. During treatment of the carious lesions, severe erosion (perimylolysis) of the maxillary and mandibular teeth were observed, which at first alerted the attending clinician to a preliminary diagnosis of anorexia and/or bulimia. Because of the age, gender and social and medical history of the patient, these preliminary diagnoses were discounted, with a hypothesis of gastrointestinal disorder presented to the patient and his parents after consultation with oral medicine and oral pathology faculty. Saliva pH analysis, along with further research concluded that gastrointestinal reflux disease (GERD), surreptitious rumination, or a combination of both were possible diagnoses. Referral to a gastroenterologist for further examination was recommended, while a night-guard was fabricated for the patient to wear at night with fluoride gel. Root canal therapy together with prosthodontic care are often treatment options for patients suffering from gastrointestinal problems. This paper demonstrates how important routine dental examinations are, especially since dentists can often recognize systemic disorders whose symptoms first appear in the oral cavity.
在一所牙科学院诊所进行的常规牙科检查中，一名15岁的黑人男性患者被诊断出患有严重的牙列侵蚀，伴有多处龋损和牙列拥挤。在治疗龋损过程中，观察到上颌和下颌牙齿出现严重侵蚀（牙周溶解），这一开始使主治医生初步诊断为厌食症和/或贪食症。鉴于患者的年龄、性别以及社会和病史，这些初步诊断被排除，在与口腔医学和口腔病理学教员协商后，向患者及其父母提出了胃肠道疾病的假设。唾液pH值分析以及进一步研究得出结论，胃肠道反流病（GERD）、隐匿性反刍或两者兼而有之可能是诊断结果。建议将患者转诊给胃肠病专家进行进一步检查，同时为患者制作了一个夜用护齿器，让其夜间佩戴并涂抹氟凝胶。根管治疗以及修复治疗通常是患有胃肠道问题患者的治疗选择。本文证明了常规牙科检查的重要性，特别是因为牙医常常能够识别出症状首先出现在口腔的全身性疾病。
