Leprosy in Pakistan, From Dental perspective!

 ‘’In my life, if there was one correction that I could make, it would be to come to Pakistan three years earlier than I did to cure Leprosy” (Dr Ruth Pfau)
Where on one hand this article is focused on increasing awareness among dental practitioners for increasing oral manifestations of Leprosy, On the other hand it is a tribute to Dr Ruth Pfau who has proved to be the light at the end of dark tunnel to Pakistan’s Lepers.

Dr Ruth Katherina Martha Pfau is a German-Pakistani who has devoted the last 50 years of her life to fighting leprosy in Pakistan by establishing Marie Adelaide Leprosy Centre (MALC) in Karachi, Pakistan. In 1996, Pakistan was declared by the World Health Organization to have controlled leprosy and is proudly, one of the first countries in Asia to achieve this goal.

Unfortunately, Leprosy is still a cruel reality in the poorest communities in Pakistan. It causes crippling disabilities and the victims often face difficult lives of shame and isolation.

It is now time for us to join hands in support to communities still fighting for its eradication.

Leprosy is a chronic infectious disease of humans caused by the bacteria’ Mycobacterium leprae’ For years, it was considered a mysterious disease associated with some type of curse, and individuals with the disease were isolated and ostracized. Today, the treatment options are available for patients diagnosed with Leprosy

Mycobacterium Leprae has an affinity for the cooler regions of the body. This to an extent explains the preferential sites involved in leprosy, the nasal and oral mucosa The disease can affect the skin, mucous membranes, and eyes and some of the nerves that are located outside the central nervous system. In severe cases, it may lead to loss of sensations, disfigurement, and blindness.

The most common site in mouth is hard palate. The lips

may appear swollen and firm which is quite displeasing aesthetically. According to WHO, the most common oral pathologies are dental cavities and gum diseases. Involvement of gums may be in the form of Inflammatory conditions in which gums appear swollen and bleed easily. Other oral lesions may occur causing superficial ulcers and fungal infections.

Although leprosy involves the oral cavity in up to 60% of the patients, examination of the oral cavity in leprosy clinics or oral health science clinics is often neglected.
It may be emphasized that examination of the oral mucosa should form an integral part of the examination of a patient with leprosy. Although the patient with leprosy will at first report to the dermatologist and rarely to the dental professionals, the dental professionals should be well aware of treatment protocols. Appropriate treatment of dental infections will help to reduce the recurrence in leprosy patients in addition to improving the general oral hygiene of the patient.

Further, it is believed that oral lesions along with nasal lesions form an important source of bacterial dissemination in the community, and the reduced number or absence of patients exhibiting oral manifestations of leprosy can be attributed to the early diagnosis of the disease and the effectiveness of multidrug therapy. It is also very important to highlight the dental issues while treating Leprosy patients. The dental professional should be well aware of the precautions (wearing gloves and mask, proper sterilization, etc.) to be taken while giving any kind of treatment to these patients in a leprosy centre.

Let’s join hands to eradicate Leprosy completely in Pakistan!