Oral and dental symptoms in patients with acromegaly

Introduction: Growth of the tongue, mandibular and dental changes are well-known consequences of untreated growth hormone (GH) excess in acromegaly. However, data on the frequency of the individual oro-dental problems are sparse. To further elucidate this matter, we developed a self-assessment questionnaire on typical oro-dental changes, therapeutic measures, costs for prosthetic treatment and the role of the dentist in the diagnostic process of acromegaly. Methods: The questionnaire was sent out to 320 patients with acromegaly, operated upon in the department of neurosurgery of our university between 2000 – 2012. 165 answers were received and could be analyzed statistically with SPSS. Information on adenoma subtype was provided by the institute of neuropathology. Results: 37% of all patients reported to have visited a dentist at any time during the disease due to typical acromegalic pathologies. Most frequent oro-dental symptoms were growth of the tongue (54.5%), enlargement of interdental spaces (39.4%), mandibular growth (21.8%) and mandibular prognatism (20%). Overall, 74.9% of the patients were affected by any oro-dental pathology and 9.6% reported these to be under the first self-noticed symptoms. 7 patients were suspected to have acromegaly by the dentist. The mean self-spent costs for prosthetic treatment amounted to 1844 € with a maximum of 18 000 €. 67.9% of the patients with proven acromegaly informed their dentist about their disease. Of those patients with need for dental treatment 42.6% reported a reduction of visits to the dentist after surgery. While adenoma subtype had no influence on the occurrence of oro-dental symptoms (p = 0.816), frequency of occurrence was significantly lower when acromegaly was diagnosed and treated within two years from symptom onset (p = 0.007). Conclusions: Our data show that oro-dental symptoms occur in a significant number of patients with acromegaly and incur frequent visits to dental health care providers. Since most of these symptoms occur mostly during the progressive, untreated course of the disease, it can be supposed that an earlier diagnosis of acromegaly would reduce oro-dental pathologies and result in lowered health care costs.