Anemia

Oral health effects

• Pale gums and mouth lining (mucosal pallor)

  Reduced hemoglobin causes visible pallor of the gingiva and oral mucosa, sometimes noticed by the dental team before a formal diagnosis.

  Clinical management: Note as a clinical observation and refer for medical evaluation/bloodwork if not already diagnosed; not itself a treatment-altering finding.

• Smooth, sore, red tongue (atrophic glossitis)

  A smooth, red, tender or burning tongue from atrophy of the filiform papillae, classically seen with iron-deficiency and B12/folate-deficiency anemia. Unlike geographic tongue, the pattern does not shift over time.

  Mechanism: Deficiency of iron, B12, or folate impairs the rapid cell turnover the tongue's papillae depend on.

  Clinical management: Recognize as a possible anemia sign rather than a primary oral condition; coordinate with the patient's physician on the underlying deficiency workup. Symptomatic relief (bland diet, avoiding acidic/spicy foods) as needed.

• Cracked, sore mouth corners (angular cheilitis)

  Cracking and fissuring at the corners of the mouth, often with secondary Candida albicans infection, associated with the iron and other nutritional deficiencies common in anemia.

  Clinical management: Topical antifungal if Candida is confirmed/suspected; address the underlying deficiency with the physician, since the fissuring recurs if the anemia itself isn't corrected.

• Recurring mouth ulcers (aphthous-like ulcers)

  Some patients with iron, B12, or folate deficiency anemia report more frequent or slower-healing oral ulcers.

  Clinical management: Standard aphthous ulcer care; consider deficiency workup if recurrence is frequent and otherwise unexplained.