Oral and systtemic findings in biliary atresia: report of 11 cases

Eleven children, eight females and three males, ranging in age from 17 months to seven years, eight months, with surgically corrected biliary atresia, were examined for oral problems. Four children had green staining of both p~’mary teeth and gingival tissues. Five children had abnormally large pulp chambers, and four had delayed primary tooth eruption. A significant relationship between primary tooth stain and gingival stain at the .005 level was found. No other statistically significant relationships between oral and physical or laboratory findings were noted. Biliary atresia is a rare condition occurring in approximately one in 10,000 live births and affecting nearly 300 newborns in the United States each year. 1 The condition is characterized by perinatal jaundice, hyperbilirubinemia, tissue staining by excess bile pigments, and hepatospleno~negaly. Growth retardation and nutritional failure are common in early life, and death often occurs by five years of age. Early diagnosis and surgical intervention have decreased morbidity, returned growth and development to normal and improved the prognosis for survival. 2 Potential oral involvement ranges from delayed dental and skeletal development to intrinsic staining of the dentition with biliverdin, a bile pigment. Only one report appears in dental literature describing biliary atresia and its oral manifestations. 3 This paper presents a series of 11 children afflicted with biliary atresia who received surgery to ameliorate the condition. Oral and systemic manifestations are presented, and pertinent relationships between oral and physical or laboratory findings discussed.