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Article: Volume 44 Number 4 Page 317 - April 2017

  Dent Update 2017; 44: 317-321  Read article

Paediatric dentistry:  Early Tooth Loss in Children: A Warning Sign of Childhood Hypophosphatasia

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Abstract: Premature exfoliation of primary teeth may be the first manifestation of this serious condition and the general dental practitioner plays an important role in recognizing dental anomalies and referring patients at an appropriate time. This is imperative to ensuring early diagnosis and good quality patient care. This article describes the case of a 4-year-old boy affected by childhood hypophosphatasia, who presented with premature exfoliation of his primary teeth as the first manifestation of this condition. An overview of the condition is outlined including a discussion of the likelihood of permanent dentition involvement.

Clinical relevance: Oral manifestations of hypophosphatasia may be the first and the only signs of this condition and may be the basis upon which a diagnosis is made.

Author notes: Sara L Hughes, BDS, MFDS RCS(Glasg), Dental Foundation Trainee Year 2, Unit of Paediatric Dentistry, Rachel C Parkes, BDS, MFDS RCS(Glasg), Specialist Trainee in Paediatric Dentistry, Unit of Paediatric Dentistry, Nicholas Drage, BDS, FDS RCS(Eng), DDR RCR, Consultant in Dental and Maxillofacial Radiology, Department of Dental Radiology and Mechelle Collard, BDS, MPhil, FDS(Paed Dent) RCS(Eng), Consultant in Paediatric Dentistry, Unit of Paediatric Dentistry, University Dental Hospital, Cardiff, UK.

Objective: To understand the oral manifestations of childhood hypophosphatasia and include this condition as part of the differential diagnosis in cases of premature primary tooth exfoliation.