Oral Health and Liver Disease: Bidirectional Associations—A Narrative Review

Abstract

Several links between chronic liver disease and oral health have been described and are discussed in this narrative review. Oral manifestations such as lichen planus, ulcers, xerostomia, erosion and tongue abnormalities seem to be particularly prevalent among patients with chronic liver disease. These may be causal, coincidental, secondary to therapeutic interventions, or attributable to other factors commonly observed in liver disease patients. In addition, findings from both experimental and epidemiological studies suggest that periodontitis can induce liver injury and contribute to the progression of chronic liver disease through periodontitis-induced systemic inflammation, endotoxemia, and gut dysbiosis with increased intestinal translocation. This has brought forward the hypothesis of an oral-gut-liver axis. Preliminary clinical intervention studies indicate that local periodontal treatments may lead to beneficial liver effects, but more human studies are needed to clarify if treatment of periodontitis truly can halt or reverse progression of liver disease and improve liver-related outcomes.

Manejo estomatológico del paciente con hepatopatías: Una revisión de la literatura

“…Las enfermedades hepáticas también tienen repercusión en la salud oral de quienes las padecen. Muchas de estas manifestaciones pueden explicarse por los factores de riesgo asociados, como el tabaco, la diabetes y el consumo de alcohol 21 . En la cavidad oral se puede apreciar el compromiso de los tejidos duros (dientes), las glándulas salivales y las manifestaciones mucocutáneas 22 .…”

“…También se han reportado lesiones liquenoides y leucoplasia en las enfermedades hepáticas no virales. Una biopsia temprana es fundamental, ya que un bajo porcentaje de estas lesiones pueden progresar con un carácter maligno 21 .…”

Is there is a link between oral microbiome and chronic liver diseases

“…This results in changes in the composition of gut microbiota leading to increased gut permeability, translocation, endotoxemia and systemic inflammation 16 . The link between oral cavity, gut and liver is known as oral-gut-liver axis and play an important role in development and pathogenesis of many liver diseases 17 . Migration of oral bacteria (e.g.…”

Dental and medical management of the patient with bipolar disorder

“…Prior to commencing any surgical procedure, it is imperative the hepatic system is functioning normally and there is no extensive damage to the liver. Oral manifestations of ulcers, lichen planus, petechia, tongue abnormalities, erosion and xerostomia may be a sign of liver disfunction and should warrant a consult with a prescribing physician 32 …”