As physicians, we often neglect inspection of the teeth. We seem to expect the dentist to do this part of the examination for us. Multiple cavities are found in diabetes mellitus, pernicious anemia, and multiparous women. Separation of the teeth may be a clue to hypopituitarism, whereas teeth that taper to a thin edge are typical of the screwdriver appearance of Hutchinson teeth in congenital syphilis. Who has not heard of the dramatic gum hypertrophy associated with phenytoin use in epileptic children? In scurvy, the gums become swollen, and the teeth get loose, drop out, or become misaligned. In dental ectodermal dysplasia, the teeth may be partially or completely absent, and, at times, there is no evidence of enamel formation. The dark blue line positioned where the gums meet the teeth is a sign of lead intoxication.
Mothers frequently complain that their children grind their teeth, but this is rarely of pathologic significance. Of course, it may be a sign of malocclusion and temporomandibular joint syndrome, especially in adults.
Yellow teeth are a sign that a child has been affected by tetracyclines either in utero or early childhood.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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More About This Book:
Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9 
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