Oral health conditions in children with idiopathic nephrotic syndrome: a cross-sectional study

Abstract

Background: Nephrotic syndrome is one of the chronic illnesses in the pediatric age group. The aim of this study was to assess the oral health of patients with steroid-sensitive idiopathic nephrotic syndrome (iNS). Methods: A case-control study was performed on iNS patients and healthy from May 2018 to April 2019. Dental caries was assessed by the World Health Organization criteria, developmental defects of enamel by the mDDE index, oral hygiene by the OHI-S and API, and gingival condition by the GI. Oral health behavior was recorded using a standardized questionnaire including tooth brushing, fluoride prevention, dietary habits and utilization of dental care. Additionally, Streptococcus mutans (SM) and Lactobacillus spp. (LB) bacteria in saliva were assessed using the CRT bacteria test. Statistical analysis comparing oral health parameters was carried by Pearson's chisquared, Fisher's exact, Shapiro-Wilk verified by Student's t or Mann-Whitney U tests. Results: The study included 94 participants of both sexes at the age of 4 to 17 years (47 cases and 47 controls) who were treated in Clinic of Pediatric Nephrology or outpatients' dental clinic in Wroclaw, Poland. The iNS patients compared to the controls revealed some lower caries experience (83.0% vs 95.7%) and number of caries affected primary and/or permanent teeth (4.6 ± 3.5 vs 6.0 ± 4.1), a significantly lower number of filled primary and/or permanent teeth (1.1 ± 1.6 vs 3.5 ± 3.0, P < 0.001) and higher incidence of enamel hypoplasia (31.9% vs 4.3%, P < 0.001). The numbers of the iNS patients with high level of SM and LB were similar to the controls. The iNS patients had a higher OHI-S score (1.89 ± 1.59 vs 1.05 ± 1.02, P < 0.010) and a higher GI score (0.7 ± 1.0 vs 0.3 ± 0.6, P = 0.050). Moreover, they less frequently brushed their teeth twice a day (78.8% vs 93.6%, P = 0.026) and more frequently consumed three or more snacks daily (53.2% vs 23.4%, P = 0.002). Conclusions: The iNS patients despite the poor oral hygiene revealed lower caries experience but smaller number of restored caries-affected teeth, more severe gingivitis and more frequently teeth affected by enamel hypoplasia.

Selected salivary parameters in children with idiopathic nephrotic syndrome: a preliminary study

“…The examinations were performed from May 2018 to April 2019. The detailed data on oral health parameters and questionnaire items were published earlier [ 16 ]. In this paper, we used only several basic oral health parameters, which could potentially influence the studied salivary components.…”

“…Data on gender, age, frequency of toothbrushing, use of fluoridated toothpaste and topical professional application of fluoride specimens, and diet were reported by the parents of the participants. The detailed questionnaire items were published earlier [ 16 ].…”

“…This process included the assessment of the number of primary and permanent caries-affected teeth (dmft and DMFT values) according to World Health Organization criteria (WHO) [ 19 ], oral hygiene using the Approximal Plaque Index—API by Lange et al, 1974 [ 20 ] and gingival condition according to the Gingival Index—GI, by Löe and Silness, 1963) [ 20 ]. Additional oral health parameters had been analyzed previously [ 16 ].…”

Oro-Dental Health and Primary Nephrotic Syndrome among Vietnamese Children

“…Oral hygiene practice among children with PNS has been reported as poorer than among healthy controls [10], with significantly increased food debris and dental plaque [8,11]. Despite not providing specific calculus indices, two studies by Babu and Jana (2014) [12] and Subramaniam (2012) [8] revealed a high incidence of calculus, especially at the lingual surface of mandibular incisors, in children with PNS.…”

“…Routine hospitalization and a particular diet impede oral health care [13]. Evidence shows that poor oral care, high snack consumption, and the lack of parental supervision contribute to the worsening of oral health of children with PNS [10,12].…”