Introduction: Mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) is a rare, neurodegenerative and fatal disease caused by mutations in the mitochondrial DNA. Multiple systems of the body, including the oral cavity, can be affected by this disease. An electronic search of Medline spanning the years 1985 to 2003 was carried out using the key words “MELAS, Dentistry.” It yielded no literature on the dental aspects of MELAS.Clinical Picture: This report documents the case of a 6-year-old Chinese boy diagnosed with MELAS and highlights problems encountered in the multidisciplinary management of MELAS patients, including its dental management. Treatment and Outcome: Dental management was successfully performed under general anaesthesia with close medical supervision by paediatrician and anaesthetist. Conclusions: There is no known treatment of the underlying disease and the clinical course is usually unpredictable. Preventive dental care is important in this group of patients as concurrent medical conditions can complicate dental care.
A 6-year-old Chinese boy presented at the Oral and Maxillofacial Surgery clinic with gingival bleeding due to poor oral hygiene, odontogenic pain due to multiple dental caries, phenytoin-induced gingival hyperplasia and severely worn-down and eroded dentition. He is under regular follow-up by the Paediatrics Department of the National University Hospital and was diagnosed to have mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS).
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