|Year : 2017 | Volume
| Issue : 2 | Page : 142-143
Spontaneous teeth loss following herpes zoster
Anubhav Chauhan1, Neeraj Sharma2, Shveta Chauhan3
1 Department of Ophthalmology, Dr. Yashwant Singh Parmar Governmentt Medical College, Sirmaur, Himachal Pradesh, India
2 Department of Dermatology, Regional Hospital Hamirpur, Hamirpur, Himachal Pradesh, India
3 Private Practitioner at Pine Castle, Near Mist Chamber, Khalini, Shimla - 171 002, Himachal Pradesh, India
|Date of Web Publication||10-Aug-2017|
Department of Ophthalmology, Dr. Yashwant Singh Parmar Governmentt Medical College, Nahan, Sirmour, Himachal Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chauhan A, Sharma N, Chauhan S. Spontaneous teeth loss following herpes zoster. Kerala J Ophthalmol 2017;29:142-3
A 45-year-old male [Figure 1] presented with a history of burning sensation and deep boring pain over the left half of the face with loss of teeth over the left side of the lower jaw for the past 3 days. The patient was a diagnosed case of herpes zoster (HZ) ophthalmicus and had received treatment from the Department of Dermatology around 1 month back in the form of tablet Valacyclovir 1 g orally 3 times daily for 10 days and tablet amitriptyline 25 mg at bedtime for postherpetic neuralgia plus supportive treatment. He had also received consultation from the department of ophthalmology then. His ocular examination was within normal limits except for the swollen left lids and watery discharge for which he was prescribed a 2-week course of topical antibiotics and lubricants plus a regular follow-up. He was also advised blood examination in the form of complete hemogram, ELISA for HIV, liver function tests, and renal function tests. All the investigations were within normal limits.
At present, there were healed skin lesions over the left forehead, left eye, and left maxillary area. A dental consultation was advised. Gingival hypertrophy with loss of crown was present in the left lower mandibular arc and only the root stumps were visible [Figure 2]. He was advised X-ray of the jaw and orthopantograph and an oral prophylaxis was planned. Unfortunately, the patient never reported back and was lost for follow-up.
HZ is an acute, infectious, and painful viral disease characterized by inflammation of dorsal root ganglia or extra medullary cranial nerve ganglia, associated with vesicular eruptions of the skin or mucous membrane. The most commonly affected dermatomes are the thoracic (45%), cervical (23%), and trigeminal (15%). Involvement of C3, T5, L1, L2, and first division of trigeminal nerve are the most frequently encountered whereas the involvement of second and third division of trigeminal nerve is rarely seen. Factors leading to HZ reactivation are increased age, physical trauma, psychological stress, malignancy, radiation therapy, and immunocompromised states. The most common complication of HZ infection are postherpetic neuralgia while other complications are meningoencephalitis, uveitis, keratitis, cellulitis, and bronchitis.
Reports of dental complications are rare. These are secondary to HZ of second and third division of the trigeminal nerve. These include osteonecrosis, exfoliation of teeth, periodontitis, and calcified and devitalized pulps, periapical lesions and resorption of roots, irregular short roots and missing teeth. Dental complications are probably as a result of vasoconstriction, endarteritis, or vasculitis with ischemia of the blood supply that may be caused by the virus migrating along the trigeminal neurovascular bundle.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
We would like to thank our patient.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2]