DENTAL, VISUAL, AUDITORY AND OLFACTORY COMPLICATIONS IN PAGETS-DISEASE OF BONE

OBJECTIVE: To determine the prevalence of dental problems in Paget's p atients and in a control population without Paget's disease. The relat ionship of localization of bony involvement of Pager's disease with th e prevalence of dental, auditory, visual, and smell changes is examine d. DESIGN: Cross-sectional national survey. PARTICIPANTS: Four hundred ninty-eight subjects with Paget's disease were generated randomly fro m the mailing list of the Paget Foundation. INTERVENTION: Each subject was sent a cover letter, two questionnaires, and a stamped, addressed return envelope. One questionnaire contained questions specific for t he individual with Paget's disease. Subjects were asked to give the ot her questionnaire, which contained the same questions except for those asking about the specifics of Paget's disease, to an unaffected spous e or a similar aged friend. MEASUREMENTS: All subjects were asked abou t their age, gender, race, educational level, income, living situation , chronic medical conditions, self-rating of their general physical an d dental health, the number of teeth present, and the presence of dent al, auditory, visual, and olfactory problems. Paget's subjects were al so asked to indicate which bones were affected. RESULTS: Paget's disea se subjects assessed their oral health to be poorer than the controls. Paget's subjects were more likely to report pain when opening the mou th and were more likely to have had dental extractions. A significantl y higher percentage of Paget's individuals with facial or maxillomandi bular involvement reported having heart trouble. Paget's individuals w ith skull, facial or maxillo-mandibular involvement were more likely t o report a change in their hearing, sight, and smell than Paget's subj ects without involvement of the craniofacial complex. Dental problems were reported by 93% of those Paget's subjects with maxillomandibular involvement, compared with only 10% for those with skull involvement o nly or involvement at sites distant to the craniofacial complex. CONCL USIONS: Patients with Paget's disease of bone involving facial or maxi llo-mandibular parts of the skeleton have a higher prevalence of chang e in hearing, sight, smell, and dental problems. We also have found an association of heart disease in patients who have involvement of faci al or maxillo-mandibular bones.