Spontaneous Tooth Exfoliation after Trigeminal Herpes Zoster: A Case Series of an Uncommon Complication
This 45-year-old HIV-negative male presented with spontaneous loss of few teeth from right lower jaw about 3 weeks after severe gingival/tooth pain and vesiculo-ulcerative eruptions over tongue and skin over right mandibular region, suggestive of HZ. He had no loose teeth previously. The skin and gingival lesions had healed in about 2 weeks, but he still felt abnormal sensations over the healed skin eruption area. There was hyperpigmentation and hyperesthesia over right facial skin innervated by mandibular division of right trigeminal nerve, loss of right lower incisors, canine, premolar teeth, exposed portions of the empty tooth sockets in the alveolar bone, and root surfaces of the exfoliated teeth, but no loose teeth were found []. X-ray of the jaw showed empty sockets corresponding to lost teeth and no necrosis or other abnormality of the alveolar bone. Systemic examination, laboratory work-up, and chest X-ray were essentially normal, and there were no predisposing factors for immune suppression. The patient declined for OPG and biopsy. The exposed bone was trimmed, and oral prophylaxis performed. He did not follow-up further.