Saudi Journal of Kidney Diseases and Transplantation

LETTER TO THE EDITOR
Year
: 2010  |  Volume : 21  |  Issue : 6  |  Page : 1151--1152

The importance of oral health in kidney diseases


Rajiv Saini1, Sugandha2, Santosh Saini3,  
1 Department of Periodontology, Rural Dental College, Loni, Maharashtra, India
2 Department of Prosthodontics, Rural Dental College, Loni, Maharashtra, India
3 Department of Microbiology, Rural Medical College, Loni, Maharashtra, India

Correspondence Address:
Rajiv Saini
Department of Periodontology, Rural Dental College, Loni, Maharashtra
India




How to cite this article:
Saini R, Sugandha, Saini S. The importance of oral health in kidney diseases.Saudi J Kidney Dis Transpl 2010;21:1151-1152


How to cite this URL:
Saini R, Sugandha, Saini S. The importance of oral health in kidney diseases. Saudi J Kidney Dis Transpl [serial online] 2010 [cited 2020 Nov 25 ];21:1151-1152
Available from: https://www.sjkdt.org/text.asp?2010/21/6/1151/72314


Full Text

To the Editor,

Chronic renal failure (CRF) is defined as a progressive decline in renal function associa­ted with a reduced glomerular filtration rate (GFR, as measured clinically by the creatinine clearance rate). The most common causes are diabetes mellitus, glomerulonephritis, and chro­nic hypertension. [1],[2],[3] In older individuals, the most commonly diagnosed causes of CRF are renovascular disease and diabetes mellitus, al­though other causes include polycystic kidney disease and pyelonephritis. The incidence of CRF continues to rise worldwide and, as a con­sequence, increasing numbers of individuals with such disease will probably continue to require oral health care. CRF and its treatment have systemic and oral manifestations. [1] In the last 3 to 4 decades, improvements in dialysis and transplantation have reduced morbidity and mortality among patients with end-stage renal disease. As survival improves, more attention must be focused on other areas such as cancer screening and management of coronary artery disease. Dental health appears to be one such area where attention has been lacking. [4]

Several changes occur in the oral cavity in patients with CRF and uremia. Researchers estimate that up to 90% of renal patients will show oral symptoms. [5],[6] The most commonly discernible oral manifestations of CRF and related therapies are listed in [Table 1]. [1] Perhaps the most common oral finding is pallor of the mucosa secondary to the anemia commonly seen in patients with renal failure who are undergoing hemodialysis. [5],[7],[8],[9] These problems may be related to a variety of factors, such as a relative state of immunosuppression, medications, renal osteodystrophy and bone loss, and restriction of oral fluid intake. [4] Untreated den­tal infection in immunosuppressed individuals can potentially contribute to morbidity and transplant rejection. Thus, there is a need for detailed assessment and provision of good den­tal care following the diagnosis of CRF and regular clinical review is important for the early identification of oral complications of renal disease. [1] Promoting good dental hygiene reduces the risk of oral infections that may predispose a patient to septicemia, endocarditis and possible endarteritis of the vascular access or line for hemodialysis or, of catheters for pe­ritoneal dialysis. [4] It has been recommended that patients requiring a renal transplant have a detailed oral assessment and treatment prior to surgery, perhaps highlighting a need for appro­priately trained oral health professionals to collaborate with renal physicians. The dental examination should be timed appropriately to allow any necessary dental treatment to be car­ried out in a planned manner. Most transplant centers worldwide have dental check-up in their pre-transplant protocol. [1]{Table 1}

Oral diseases are a source of active infection in the medically compromised renal diseased individuals and, as such, have dire implica­tions for morbidity and mortality. The dentist must be aware of the effect of renal disease and hemodialysis on dental treatment. The re­nal patient's dental disease can compromise the patient's general health and hamper medical management. Therefore, the dentist is a funda­mental provider in the overall health care of patients with this disease. Awareness must be raised among dialysis patients, their nephro­logists and their dentists about the need for basic dental deterrence.

References

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3McDonald SP, Russ GR, eds. Anzdata Registry Report, Australia and New Zealand Dialysis and Transplant Registry. Adelaide, South Australia, 2002
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6Levison SP. Diseases of the kidney and disturbances in electrolyte metabolism. In: Rose LF, Kaye D, eds. Internal medicine for dentistry. 2nd ed. St Louis: Mosby-Year Book; 1990:515-91.
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9Sowell SB. Dental care for patients with renal failure and renal transplants. J Am Dent Assoc 1982;104:171-7.