Clinical oral findings in dialysis and kidney-transplant patients.

OBJECTIVES: Oral lesions secondary to chronic renal failure or related to immunosuppressive therapy after transplant are reported in the literature, but their prevalence is still obscure. The aim of this study was to investigate oral clinical findings in patients undergoing renal dialysis and renal transplant recipients. METHOD AND MATERIALS: Forty-six patients treated with dialysis (DL), 33 kidney-transplant (KT) patients, and 37 control (C) patients were examined intraorally. Oral clinical findings were diagnosed and treated. RESULTS: The results showed that 95.6% (44/46) of the DL group, 93.9% (31/33) of KT patients, and 56.7% (21/37) of the control group presented at least one pathological entity in the oral mucosa. A high prevalence of oral lesions, such as saburral tongue and xerostomia, was found in the DL and KT groups. Certain oral lesions demonstrated a predisposition toward one type of group, such as a higher prevalence of metallic taste in the DL group and gingival overgrowth in the KT group. CONCLUSION: The prevalence of oral lesions was significantly higher in renal patients (DL and KT groups). The most prevalent oral clinical findings were saburral tongue and xerostomia for both groups. Metallic taste was more prevalent in the DL group. Although geographic tongue was more frequent in KT patients and melanin pigmentation in the control group, the number of lesions was low for all groups. In addition, gingival overgrowth was more prevalent in the KT group; however, the difference was not significant (P = .06).

Oral health in Brazilian patients with chronic renal disease.

BACKGROUND: Poor oral health status may have an impact on the health status of patients with chronic renal failure. AIM: To describe the oral health status of a group of Brazilian patients with chronic renal failure. MATERIAL AND METHODS: Retrospective review of the medical records of patients with chronic renal failure, of whom 13 (4.5%) were in a predialysis stage, 158 (55%) were on hemodialysis, 23 (8.4%) were on peritoneal dialysis and 92 (32.1%) were transplanted. General oral health, presence of dental calculus, and halitosis were recorded. The number of decayed, missed and filled teeth was analyzed by means of DMF-T (Decayed, Missed and Filled Teeth) index. RESULTS: The sample was composed of 152 men (53%) and 134 women (47%), aged 42+/-13 years. Oral health status was considered defective in most patients (83%). Eighty-seven percent had dental calculus and 55% had halitosis. Transplant patients reported significantly less halitosis (40.2%) than the rest of the groups. The DMF-T for the whole population was 20.6 and had a positive correlation with age. CONCLUSIONS: This group of patients with chronic renal failure presented a poor oral health status. Dental treatment programs for these patients should be implemented to avoid the exposure to dental pathogens.

Oral health in Brazilian patients with chronic renal disease / Salud oral en pacientes brasileños con insuficiencia renal crónica

Background: Poor oral health status mayhave an impact on the health status of patients with chronic renal failure. Aim: To describe the oral health status of a group of Brazilian patients with chronic renal failure. Material and methods: Retrospective review of the medical records of patients with chronic renal failure, ofwhom 13 (4.5 percent) werein apre dialysis stage, 158 (55 percent) were on hemodialysis, 23 (8.4 percent) were on peritoneal dialysis and 92 (32.1 percent) were transplanted. General oral health, presence of dental calculus, and halitosis were recorded. The number of decayed, missed and filled teeth was analyzed by means of DMF-T (Decayed, Missed and Filled Teeth) índex. Resulte: The sample was composed of 152 men (53 percent) and 134 women (47 percent), aged 42±13 years. Oral health status was considered defective in most patients (83 percent). Eighty-seven percent had dental calculus and 55 percent had halitosis. Transplant patients reponed significantly less halitosis (40.2 percent) than the rest of the groups. The DMF-T for the whole population was 20.6 and had a positive correlation with age. Conclusions: This group of patients with chronic renal failure presented a poor oral health status. Dental treatment programs for these patients should be implemented to avoid the exposure to dental pathogens.

Introducción: Las alteraciones de la cavidad oral pueden tener impacto en la salud de pacientes con insuficiencia renal crónica. Objetivo: Describir la salud oral de pacientes brasileños con insuficiencia renal crónica. Material y métodos: Revisión retrospectiva de las fichas dentales de pacientes con insuficiencia renal crónica, de los cuales 13 (4,5 por ciento) estaban en etapa prediálisis, 158 (55 por ciento) estaban en hemodiálisis, 23 (8,4 por ciento) estaban en peritoneodiálisis y 92 (32,1 por ciento) habían sido trasplantados. Se registró la salud oral general, la presencia de tártaro y halitosis. El número de piezas faltantes y obturadas fue analizado utilizando el índice DMF-T (Decayed, Missed and Filled Teeth o dientes con cañes, faltantes y obturados). Resultados: La muestra estaba constituida por 152 hombres y 134 mujeres con una edad promedio de 42±13 años. La salud dental general era deficitaria en 83 por ciento y 87 por ciento tenía tártaro. El 55 por ciento tenía halitosis y ¡os pacientes trasplantados tenían este problema con una frecuencia significativamente menor que el resto de ¡os grupos. El índice DMF-T global fue 20,6 y tuvo una correlación positiva con la edad. Conclusiones: La salud oral de estos pacientes con insuficiencia renal crónica es mala. Es importante implementar programas de tratamiento dental para estos pacientes para evitarla exposición a patógenos que pueden causar complicaciones sistémicas.

Avaliação clínica do aumento gengival induzido pela ciclosporina e nifedipina / Clinical evaluation of gingival enlargement induced by cyclosporin and ifedipine

O crescimento gengival induzido por drogas é um efeito colateral associado a ciclosporina (CsA) um imunossupressor; e aos bloqueadores de canais de cálcio como a nifedipina (Ni), um antinpertensivo. A severidade do crescimento gengival está relacionada com fatores de risco específicos que incluem pobre higiene oral, inflamação preexistente e a combinação de drogas. O objetivo deste estudo foi avaliar a prevalência e a severidade do aumento gengival em pacientes sob terapia com CsA e CsA/Ni e as possíveis relações entre o crescimento gengival e as variáveis idade, sexo, dose, concentração plasmática, tempo de uso da droga e o grau e crescimento gengival. Participaram do estudo 37 pacientes transplantados renais medicados com CsA (n=24) associada ou não a Ni (n=13). O crescimento gengival ocorreu em 14,45% das faces dentais avaliadas para os pacientes que ingeriam a CsA e em 10.06% no grupo que ingeria CsA/Ni. A concentração plasmática, o tempo de tratamento e as variáveis sexo e idade não demonstraram influenciar diretamente no grau de crescimento gengival. Concluiu-se que a prevalência e severidade do crescimento gengival foi similar em pacientes em terapia com a CsA ou CsA/Ni.