435 - Dental Eruption Pattern in Patients With Congenital Adrenal Hyperplasia

Congenital Adrenal hyperplasia (CAH) is an inherited genetic disorder that results in reduced production of cortisol. This occurs due to the diminished activity of 21-hydroxylase enzyme, which plays a crucial role in cortisol synthesis. Consequently, the adrenal cortex experiences chronic overstimulation. The goal of this case report is to present a 10-year-old Hispanic female, who has been a patient of Staten Island University Hospital dental clinic receiving routine recall and restorative care. A clinical and radiographic analysis of patient’s teeth revealed early exfoliation of primary teeth and accelerated eruption of permanent teeth. Patient presented with primary molars and canines during a hygiene visit in 2021. However, during a recall visit in 2023 all primary teeth, except maxillary canines, were found to have been exfoliated in less than 2 years. This is considered early exfoliation of primary teeth that is not expected to be seen in a 10-year-old patient. Incomplete root formation was also noted on posterior teeth potentially due to premature eruption of teeth into the oral cavity. Patient was referred for an endocrinology consultation to assess hormone levels, specifically cortisol production. Insufficient activity of 21-hydroxylase enzyme was found leading to diagnosis of congenital adrenal hyperplasia. Observations such as premature exfoliation of primary teeth and accelerated eruption of permanent teeth, along with other oral manifestations of CAH can assist the dental provider to make appropriate referrals to medical specialists with the aim to improve patient’s overall health.

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