Oral Health Status of Kuwaiti Children with a History of Chronic Liver Disease

Abstract

Objective: To investigate the oral health status and dental manifestations of children with a history of chronic liver disease (CLD) compared to healthy children.Subjects and Methods: Twenty children (15 boys and 5 girls) with a history of CLD were compared to 20 healthy controls matched for age and gender. The clinical examination was carried out by the same dentist. Caries prevalence, using the decayed, missing, and filled primary and permanent teeth indices (dmft/DMFT), was recorded. Developmental enamel defects, plaque scores, and gingival overgrowth were also investigated. Results: No statistically significant differences were found in mean dmft scores for children with a history of CLD (4.9 ± 5.4) and for healthy individuals (3.9 ± 4.5). However, the mean DMFT score was significantly higher (p =0.025) in children with CLD (4.2 ± 4.6) compared to controls (1.7 ± 1.6). The mean decayed teeth parameter (DT) was also significantly higher in children with CLD (p =0.004). All patients with CLD exhibited enamel defects compared to only 33% in the control group (p< 0.05). A higher mean plaque index was observed in children with a history of CLD (p< 0.001). Also, a positive correlation for gingival overgrowth was noted in patients with a history of CLD (p< 0.05). Green staining was evident only in the permanent dentition of 1 child with CLD. Conclusion: Children with a history of CLD exhibited a high caries prevalence, high plaque scores, and more enamel defects compared to healthy subjects. Gingival overgrowth is less prevalent among pediatric liver transplant patients on tacrolimus therapy.

Periodontal Outcomes in Liver Transplantation Individuals: A Systematic Review and Meta-analysis

“…From these 257 titles/abstracts, 49 full texts were evaluated considering the eligibility criteria at Phase 2. Eleven studies that met the eligibility criteria were included in this systematic review and meta-analysis [6,9,[13][14][15][16][17][18][19][20][21]. The 38 articles excluded after the evaluation of the full text and the reasons for exclusion are shown in the Supplementary File (Table I).…”

“…Of the eleven studies included, four were developed in Israel [13][14][15][16][17] one in Italy [18], one in the United States [9], one in Finland [6] one in Brazil [19], one in Germany [20], one in Kuwait [21] and one in the United Kingdom [14]. Ten included studies had a cross-sectional observational study design and one was a prospective controlled study design.…”

“…All articles were published in English between 2000 and 2019. Among the eleven studies included, four evaluated pre-LT and post-LT groups as well as a control group [13,15,16,20], three evaluated a post-transplantation group and a control group [6,17,18], two study evaluated a pre-transplantation group and a control group [9,19], one study evaluated pre and post-transplantation participants in a single group compared to a control group [21] and one follow-up study evaluating individuals at baseline and at post-LT compared to a control group [14]. The studies were conducted in hospitals, medical institutes or dental clinics.…”

“…Another study evaluated drug-induced gingival growth (DIGO) using the same index [6]. The study of Alanzi et al [21] evaluated the GO using a different index developed by Aas 1963 [25] and modified by McGaw et al 1987 [26] and PI was determined by the presence of visible plaque using the modified Quigley-Hein PI0. In two studies [17,18], the PI was classified as visible or not visible, according to Silness and Loe (1964), and gingival inflammation was classified by the presence or absence of bleeding 30 seconds after mild probing, according to Loe and Silness (1963).…”

“…In six articles, the samples consisted of representative cases with a correct description of periodontal indexes and conditions, setting of participants recruitment, and data collection period [6,9,15,16,18,19]. When one of these items was not clearly described, the requirement was considered incomplete due to a selection bias potential, which happened in four included articles [13,17,20,21].…”