Endocrine Abstracts

Introduction: Growth of the tongue and mandible and dental pathologies are recognized consequences of untreated growth hormone excess in acromegaly. However, data on the frequency of the individual oro-dental pathologies are sparse. We, therefore, developed a self-report questionnaire on typical oro-dental changes, therapeutic measures, costs for prosthetic treatment and the role of dental professionals in the diagnostic process of acromegaly.

Methods: The questionnaire was sent out to 320 patients with acromegaly, operated upon between 2000 and 2012. 165 answers were received and analyzed statistically with SPSS. Information on adenoma subtype was provided by the institute of neuropathology.

Results: About 37% of all patients had visited a dentist at any time during the disease process due to oro-dental pathologies. Most frequently, growth of the tongue (54.5%), enlargement of interdental spaces (39.4%), mandibular growth (21.8%) and mandibular prognatism (20%) were reported. 74.9% of the patients suffered from an y oro-dental pathology and 9.6% reported these to be under the first self-noticed symptoms. Seven patients were suspected to have acromegaly by the dentist. The mean self-spent costs for prosthetic treatment amounted to 1,844€ (max. 18,000€). Of those patients with need for dental treatment 42.6% reported a reduction of visits to the dentist after pituitary surgery. 67.9% of the patients with proven acromegaly informed their dentist about their disease. While adenoma subtype had no influence on the occurrence of oro-dental symptoms (P=0.816), their occurrence was significantly lower when acromegaly was diagnosed and treated within 2 years from symptom onset (P=0.007).

Conclusions: Our data show that oro-dental symptoms are frequent in patients with acromegaly and incur frequent visits to dental health care providers. Since most of these symptoms occur during the progressive, untreated course of the disease, we suppose that an earlier diagnosis of acromegaly would reduce oro-dental pathologies and result in lowered health care costs.