B12 Deficiency Oral Features — MFDS Part 1 MCQ
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Correct answer: B — Gingival enlargement
The correct answer is B. Gingival enlargement is not a recognised manifestation of vitamin B12 deficiency; it is classically associated with medicines such as phenytoin. Vitamin B12 deficiency can affect rapidly dividing oral epithelium, producing atrophic glossitis with a smooth, erythematous and depapillated tongue. Other recognised but nonspecific presentations include angular cheilitis, recurrent aphthous-like or nonspecific mucosal ulceration, glossodynia and oral burning. These oral features may precede overt anaemia or neurological symptoms, so unexplained persistent glossitis, ulceration or burning should prompt consideration of an underlying haematinic deficiency rather than being assumed to represent primary burning mouth syndrome.
Reference: Boukssim S et al. Oral manifestations of vitamin B12 deficiency associated with pernicious anemia: A case report. International Journal of Surgery Case Reports, 2024. https://pubmed.ncbi.nlm.nih.gov/38917702/