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Trauma could occur during injections of local anesthetic in the mouth, or otherwise during dental treatments, frictional trauma from a sharp surface in the mouth, such as a broken tooth, or from tooth brushing

[2] It is the main and most common cause of vitamin B 12 deficiency anemia in developed countries, [3] and is characterized by a triad of symptoms: [2] Anemia with bone marrow promegaloblastosis (megaloblastic anemia)

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