Oral conditions in renal disorders and treatment considerations – A review for pediatric dentist

Abstract

This article reviews the current understanding of the oral and dental aspects of chronic renal disease (CRD). A PubMed literature search was performed and all relevant studies were assessed. As the number of people suffering from CRD increases worldwide, dentists are expected to encounter more patients with CRD who need oral care. In children, CRD can elicit a wide spectrum of oral manifestations in the hard and soft tissues. Bleeding, altered drug metabolism, impaired immune function, and an increased risk of dentally induced bacterial endocarditis are some important features that require attention. Dental management of patients with CRD requires that clinicians appreciate that multiple systems can be affected by the disease. Dentists should consult with nephrologists regarding the specific precautions required for each patient. Medical treatments in these patients may need to be postponed due to an unfavorable oral health status or potential risk of life-threatening infection after surgery. Improving oral hygiene and performing necessary dental and oral treatment before hemodialysis or transplantation may prevent endocarditis and septicemia in these patients. Hence, treatment plans should be formulated to restore the patient's dentition and protect them from potentially severe infections of dental origin.

Evaluation of mandibular inferior cortex changes in patients candidate for liver and kidney transplantation using panoramic view

“…Between them, noticeably, bone changes are prominent and refer to renal osteodystrophy (16). Approximately, 90% of CKD cases are involved in jaw bone changes (10). Bone anomalies in CKD patients reflect the defect in metabolism of calcium which results in secondary hyperparathyroidism.…”

“…Therefore, patients should be reminded of earlier dental treatment and the importance of good oral hygiene habits (30). Owing to oral complications, these patients require to visit a dentist before and after transplantation (10). Dental panoramic radiographs have a long history of radiological exam in dentistry.…”

“…Researchers estimate that oral symptom will be shown in more than 90% of patients with CRF which could be evaluated clinically or radiographically (9). Oral mucosa, teeth, salivary gland and jaw bone may be affected (10). Most of changes may be detected in panoramic views.…”

Oral disorders in patients with chronic renal failure. Narrative review.

“…intake, side effects of medications (primarily antihypertensive drugs), possible disruption of the salivary glands, and secondary oral breathing problems due to lung perfusion 12,15,28 . However, decreased salivary flow was not observed in studies conducted in post-dialysis patients when compared to healthy subjects because once the procedure is over water balance is normal levels 7 .…”

“…g) Tartar: Patients with CRF are susceptible to develop dental calculus due to increased levels of urea in saliva, phosphorus and large amounts of calcium carbonate that some patients take as part of their treatment 6,9,15 . A study conducted in 180 patients in Iran showed a 100% prevalence of oral abnormalities, being the most common: tartar, high DMF and plaque indexes and gingivorrhagia 34 .…”