Comment on: “Oral health-related quality of life in children and teens with sickle cell disease”☆

ickle cell disease (SCD) is an inherited red blood cell disorder, haracterized by chronic hemolysis, vaso-occlusive complicaions and progressive multi-organ damage, with major impact n the patients’ life expectancy and quality of life.1,2 The incience of SCD is estimated as more than 300 000 new cases orldwide per year.3 The estimated incidence of SCD in Brazil s 3500 new cases per year.4 SCD presents important maxillofacial features. Hypoxia elated to SCD has been associated with osteomyelitis of the aws, particularly the mandible. Neuropathies of the mental erve due to osteomyelitis of the mandible cause numbness in he lower lip and chin. Additionally, a diminished blood supply o teeth may cause necrosis of the dental pulp. Bone marrow yperplasia may result in depression of the nasal bridge, midacial overgrowth and malocclusion in this patient population. CD has been associated with moderate to very severe malcclusion, with anterior tooth loss, anterior sparing, overjet, nterior crossbite and open bite.5,6 Despite the maxillofacial alterations, SCD has little influnce on oral health and no influence on the incidence of dental ecay7–10 demonstrating that known risk factors for caries nfluence oral health more markedly than factors related to CD.11,12 On the other hand, in SCD, alterations related to dental cclusion have a strong influence on the quality of life of any patients. In a study of SCD involving 35 five-year-old