Better Dental Care Needed for Sickle Cell Anemia Patients, Brazilian Study Finds

A Brazilian study of the relationship between sickle cell anemia (SCA) and endodontic disease indicated that SCA patients in need of a root canal are at risk of infections that stimulate the immune system. The findings highlight the need for government polices to improve dental care for these patients.

The study, “Sickle cell anemia in Brazil: personal, medical and endodontic patterns,” was published in Brazilian Oral Research.

Sickle cell anemia (SCA), the most prevalent genetic disease in the world, is characterized by infections and painful vaso-occlusive episodes. The disease is caused by a mutation in the beta globulin gene of the hemoglobin molecule, leading to the production of abnormal hemoglobin, called hemoglobin S or sickle hemoglobin. As a result, red blood cells have an abnormal shape that causes these cells to obstruct blood vessels, resulting in pain, tissue damage, and insufficient oxygenation of certain tissues. SCA patients are more vulnerable to infections, and dental problems have been extensively reported in this population.

Researchers compared personal information, medical data such as virologic testing, blood transfusions and medications, and information on the need for endodontic treatment among 108 SCA patients who were registered and followed at Fundação Hemominas, in Minas Gerais. Results showed that among these patients there was a need for endodontic therapy, namely root canal treatment, at a rate of 10.2%. Furthermore, a comparison between groups with and without the need for endodontic treatment found that, among those needing a root canal, counts of eosinophils and atypical lymphocyte were higher. These higher levels of white blood cells, called leucocytosis, are a marker for morbid events in sickle cell disease.

The researchers suggested that such occurrences are connected to the stimulation of the immune system that can occur in the presence of root canal infection, and can be harmful for SCA patients.

“This study reinforces the necessity for government polices to improve dental health service for these individuals,” the authors concluded.