Assistant professor Dr. Jelena Juloski

Oral Manifestations of Systemic Diseases in Children

Oral cavity is the unique environment that represents a mirror of general health or disease. Many systemic diseases in children can present with various signs and symptoms in the oral cavity. Oral manifestations may appear as the first, or even the only sign of a systemic disease, or they accompany signs and symptoms of diseases primarily affecting other parts of the body. Comprehensive and meticulous examination of the oral cavity together with the thorough medical and dental history play a crucial role in the early diagnosis and prompt treatment of a systemic disease. Oral manifestations are often seen in children with gastrointestinal diseases, hematologic diseases, autoimmune diseases, endocrine and metabolic diseases, viral and bacterial diseases, nutritional disorders, and vitamin deficiencies. Oral signs and symptoms can be specific for a certain disease, but much more often they are non-specific and could be seen in various diseases or even healthy children. All oral and perioral structures of head and neck may be affected by a systemic disease - oral mucosa, periodontal tissues, teeth, bone of upper and lower jaw, tongue, lips, perioral skin, salivary glands, and lymph nodes of head and neck. Oral signs and symptoms such as mucosal inflammation, aphthous ulcerations, pallor of oral mucosa, lips and skin, lip swelling, angular cheilitis, gingival hyperplasia, gingival bleeding, petechiae and ecchymoses on oral mucosa, glossitis, burning sensations, oral pain, xerostomia, defects in tooth structure, delayed or premature eruption of teeth, and many others may be indicative of a systemic condition. Both physicians and dentists should have adequate knowledge and skills in recognizing abnormal oral features and placing them in the context of a systemic disease.

References
1. Nasim Fazel (editor). Oral signs of systemic disease. Springer. 2019. ISBN 978-3-030- 10863-2.
Gaddey HL. Oral manifestations of systemic disease. Gen Dent. 2017 Nov-Dec;65(6):23- 29.
2. Mays JW, Sarmadi M, Moutsopoulos NM. Oral manifestations of systemic autoimmune and inflammatory diseases: diagnosis and clinical management. J Evid Based Dent Pract. 2012 Sep;12(3 Suppl):265-82.
3. Cruz IT, Fraiz FC, Celli A, Amenabar JM, Assunção LR. Dental and oral manifestations of celiac disease. Med Oral Patol Oral Cir Bucal. 2018 Nov 1;23(6):e639-e645.
4. Schlosser BJ, Pirigyi M, Mirowski GW. Oral manifestations of hematologic and nutritional diseases. Otolaryngol Clin North Am. 2011 Feb;44(1):183-203, vii.
5. Saccucci M, Di Carlo G, Bossù M, Giovarruscio F, Salucci A, Polimeni A. Autoimmune Diseases and Their Manifestations on Oral Cavity: Diagnosis and Clinical Management. J Immunol Res. 2018 May 27;2018:6061825.

Jelena Juloski is an assistant professor at Clinic for Paediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade in Serbia. She specialized in preventive and paediatric dentistry with the highest grade at the University of Belgrade, Serbia and received a PhD degree at the University of Siena, Italy in 2014. Prof. Jelena Juloski is a visiting professor at the Department of Medical Biotechnologies at University of Siena where she is engaged in teaching paediatric dentistry to fifth year undergraduate students.
Prof. Jelena Juloski published 32 articles in international journals with impact factor and 5 articles in national journals. Her cumulative impact factor is 59,601, number of citations 609 and h-index 13, according to Scopus database. She is an author of several chapters in 5 books published in Serbia and the Balkan region. Jelena Juloski was an invited lecturer at two international and 13 national congresses. She was a member of local organizing committee of 13th Congress of the European Academy of Paediatric Dentistry held in 2016. in Belgrade, Serbia, and a member of several organizing and scientific committees of national paediatric and preventive congresses in Serbia.
Prof. Jelena Juloski is a member of Serbian Medical Society, International Association for Dental Research (IADR) and European Academy of Paediatric Dentistry (EAPD). She speaks English and Italian language.