Carious status and supragingival plaque microbiota in hemodialysis patients

Abstract

ObjectiveThe aim of this study was to evaluate the carious status and the microbial profiles of supragingival plaque in patients with chronic kidney disease undergoing hemodialysis.MethodsThis study included 30 patients with chronic kidney disease undergoing hemodialysis as well as 30 control subjects. Dental examination was performed and the decayed-missing-filled-teeth was recorded. Supragingival plaque was taken and analyzed using 16S rRNA gene amplicon by Illumina MiSeq sequencing to detect microbial composition and community diversity and structure.ResultsThe level of decayed-missing-filled-teeth was higher in the hemodialysis group than that in the control group. Microbial analysis showed a decrease in α diversity and a increase in relative abundance and prevalence of many acidogenic and aciduric caries related species in the supragingival plaque samples of the hemodialysis patients, including Streptococcus mutans, Lactobacillus salivarius, Lactobacillus fermentum, Lactobacillus vaginalis, Scardovia wiggsiae F0424, and Actinomyces naeslundii.ConclusionOur results suggested that the hemodialysis patients were more susceptible to caries. More attentions for caries prevention and treatment should be paid to improve their life quality, and even to reduce their cardiovascular events and survival.

Possible link between dental diseases and arteriosclerosis in patients on hemodialysis

“…We previously reported that patients with IgA nephropathy have a higher frequency of dental caries than healthy individuals, and dental caries status is associated with proteinuria in such patients [1]. Patients on HD usually have reduced salivary flow or xerostomia because of HD, restricted oral fluid intake, side effects of drug therapy, and aging [5, 12]. Palmer et al showed that poorer dental health among patients on HD is associated with early death, whereas preventive oral care is associated with prolonged survival [13].…”

“…Yue et al reported a significantly higher DMFT index score among patients with CKD on HD than healthy controls (4.4 ± 3.9 vs 2.3 ± 2.5). However, they targeted a small group of patients (n = 30) with a mean age of 48.5 ± 12.7 years [5]. The mean age of our participants was 67.3 ± 12.2 years.…”

“…In addition, dentists might hesitate to provide oral care to such patients who tend to bleed because they are medicated with anticoagulants, are susceptible to bacterial infections, and might have unusual drug reactions. An association between oral diseases and systemic health has been identified [3, 4], and patients on HD are more susceptible to dental caries than healthy individuals [5]. Furthermore, an association between periodontitis and chronic kidney disease (CKD) has been identified [6–8].…”

Oral Health Status of Children Undergoing Hemodialysis and Kidney Transplantation in Mansoura City, Egypt

“…Many researches have stated low caries prevalence (8.5%) among patients with CKD compared to their control groups (40%) this may be due to elevated buffering capacity of saliva as a result of high level of salivary urea and a low count of Streptococci mutans. Additionally, an alternation in production of acid in kidney disease patients due to high concentration of salivary urea, which leads to less H+ ion production by dental plaque (6)(7)(8) .…”

“…Gingival inflammation was noticed significantly in children suffering from CKD compared to healthy children. This may be related to the prescribed drugs; it was found that children undergoing treatment with nifedipine and/or cyclosporine A had higher prevalence of gingivitis (6,7,9) .…”