Oral Manifestations and Dental Challenges of Hypophosphatemic Rickets in Children: a Case Report

Abstract

Introduction: Hypophosphatemic rickets is a rare hereditary disorder of phosphorus metabolism, whose prevalence is still unknown, marked by the resistance to vitamin D therapy. Case report: This article reports the case of a 3-year-old boy diagnosed with this condition and focuses on his oral manifestations and the challenges encountered in treating them. The general symptoms reported included stunted growth, irritability, agitation, craniotabes, prominence of the frontal bones, and bowing of the legs. Orofacial and dental manifestations included enlarged pulp chambers, dental abscess in teeth 51 and 61, alveolar bone loss and diminished lamina dura. Dental prophylaxis program was set up and extraction of affected teeth was performed under local anesthesia. Comment: Pediatric dentists should remain vigilant for these symptoms as they can be among the earliest indicators of the disease and contribute to an early diagnosis, thus facilitating rapid management within an interdisciplinary team. When taking care for children with vitamin-D-resistant rickets, dental professionals must pay particular attention to the establishment of a trust-based relationship with the patient due to their tendency to be irritable, the patient’s education and dental prophylaxis and the provision of radical dental care following the complications encountered, given the poor prognosis of affected teeth. Conclusion: this case report outlines the dental and maxillofacial manifestations of a 3-year-old boy diagnosed with hypophosphatemic rickets.