Orofacial and Systemic Features of Thalassemia Major: Management, and Prevention with Reference to Populations in the Arabian Gulf

Abstract

Recognizing genetic disease symptoms in our patients is critical for comprehensive care. Dr. Hattab, a professor of several dental schools, has compiled a 106-page monograph about thalassemia major that includes epidemiology, pathophysiology, and clinical diagnosis. This monograph book has an unusual organization in that it does not have numbered chapters. Each paragraph or couple of paragraphs has a bold heading with references to dentistry scattered throughout the manuscript. The first part has a review of thalassemia and its various manifestations; the rest appears to be mostly long excerpts of published articles. There are 199 references, with only 7 of these published in the last 5 years. Many pages describe medical management. The dental management only includes periodontal care and a brief paragraph about the need for orthodontics with no descriptions of what type of orthodontic treatments are most beneficial. There is no information about new areas of research like microbiome [1] and genetic therapeutic approaches [2]. The only imaging described are lateral cephalometric and panoramic x-rays. There is no mention of cone beam computed tomography (CBCT) to diagnose craniofacial anomalies in the maxilla and mandible. There is also no mention of whether or how the upper airway might compromise breathing or if there are TMD-related symptoms. Much space is devoted to the smaller size and shape of teeth and how to diagnose periodontal disease. We are not advised on dental interventions that might improve growth and development at a young age. I had to do an internet search to discover an article that presented an orthodontic case history and outcome [3]. This monograph book has a lot of information but does not offer up-to-date, concise, comprehensive, wellorganized maxillofacial symptomology or treatment options.