Evaluating Red Patches and Burning Mouth Symptoms as Oral Biomarkers in Cobalamin Deficiency: A Comparative Study

Background Vitamin B12 (cobalamin) deficiency can manifest through various nonspecific oral symptoms. Early diagnosis is crucial but challenging due to subtle and progressive clinical features. Laboratory investigations like serum cobalamin levels and mean corpuscular volume (MCV) are used but have limitations. Purpose To assess the reliability of red patches and burning mouth symptoms as oral biomarkers for clinical and subclinical vitamin B12 deficiency, and correlate them with serum cobalamin and MCV values. Methods A sequential diagnostic analysis was conducted on 120 adult subjects (aged 18-45), divided into a control group consisting of asymptomatic subjects with subclinical cobalamin deficiency and a study group with symptomatic subjects with clinical cobalamin deficiency . Oral examinations and laboratory tests for MCV and serum cobalamin levels were performed. Statistical analyses included descriptive statistics, t-tests, and logistic regression. Results Significant differences were found in MCV and cobalamin levels between study and control groups (P < .001). The presence of red patches and burning mouth symptoms strongly correlated with variations in MCV and cobalamin levels. Logistic regression analysis showed high accuracy (98.3%) in distinguishing between groups based on these markers. Conclusion Oral red patches and burning mouth symptoms, in conjunction with MCV and cobalamin levels, can serve as reliable indicators for identifying clinical cobalamin deficiency. This underscores the importance of monitoring these oral indicators during initial clinical examinations for early detection and management of vitamin B12 deficiency. Plain Language Summary Title: Oral Biomarkers in Cobalamin Deficiency: A Comparative Study Plain Language Summary Why was the study done? The study was done to find out if oral symptoms like red patches in the mouth and burning sensations could serve as early warning signs (biomarkers) of vitamin B12 (cobalamin) deficiency. Diagnosing this deficiency early is difficult because the symptoms are often mild and nonspecific. Although lab tests like serum cobalamin and MCV are used, they have limitations. Therefore, the researchers wanted to determine whether these common oral signs could reliably indicate B12 deficiency, especially in settings where lab testing may be delayed or unavailable. What did the researchers do? The researchers examined 120 adults, dividing them into symptomatic and asymptomatic groups based on oral signs of vitamin B12 deficiency. They conducted oral examinations and measured serum cobalamin and MCV levels. Statistical analyses were used to compare groups and assess whether oral symptoms could reliably indicate B12 deficiency. What did the researchers find? The study found that people in the study group had significantly lower B12 levels and higher MCV values compared to the control group. These laboratory differences were strongly linked to the presence of oral red patches and burning sensations. Logistic regression analysis showed that cobalamin levels were a significant predictor of B12 deficiency. The overall model was highly accurate (98.3%), meaning it could correctly identify who had the deficiency in most cases. What do the findings mean? The findings indicate that oral red patches and burning mouth symptoms, when observed in conjunction with high MCV and low cobalamin levels, can be considered strong clinical indicators of vitamin B12 deficiency. These signs can help dentists identify and treat B12 deficiency earlier, especially before more serious symptoms appear. This is particularly useful in situations where lab testing is delayed, costly, or unavailable, making these oral symptoms valuable tools for early diagnosis and management.