Oral manifestation in pre-renal transplant patients in Tertiary Care Hospital in Punjab

The incidence of renal failure is known to be increasing globally. Kidney transplant are considered the most efficient renal replacement therapy for a significant number of patients with end- stage renal disease. Renal failure can give rise to a large spectrum of oral manifestations, affecting overall health of patients with renal disease. End-stage renal disease (ESRD) patients have a plethora of oral findings. The aim of this study was to study oral symptoms and lesions in pre-renal transplant patients. This prospective study was conducted over a 6-month period. A total of 80 individuals (40 pre renal transplant patients and 40 controls) were recruited. Each patient was interviewed individually using questionnaire about oral symptoms. Each patient was examined for oral lesions and documented. For Caries DMFT and for Gingivitis CPITN index was used. In both study and control group majority were males and majority were in age group 21-30 years. In study group knowledge of importance of oral hygiene was more. The most common symptoms were dry mouth (20%), altered taste (52.5%) and bleeding gums (42.5%). Study group showed significantly more oral changes than those in the control group. DMFT index was positive in 60% of study and 80% control group. CPITN index was equally positive (92.5%) in both study and control group. Mucosal pallor, suburral tongue, leukoplakia and hyperplastic gingivitis was seen in 27.5%, 10%, 10% and 2.5% respectively in the study group. Prevalence of oral lesions is significantly higher in renal patients. The potential source of active infective lesions in medically compromised patients with ESRD must be treated before transplant.

Incisor tooth in the nose: Anecdotal sequel to dog bite in a 3-year-old child.

A 3-year-old male child presented to the casualty with history of unprovoked dog bite over the right lateral wall of nose. He was managed conservatively with antirabies prophylaxis and dressings. He presented after 3 months with a healed wound and the right upper central incisor projecting into the nostril. The Orthopantomogram showed a rotated temporary incisor with the roots of the permanent incisor placed normally. The tooth was extracted intranasally. Among the mutilating dog bite injuries referred to a plastic surgeon, this injury though thought provoking was also comical.