Characterization of the oral health of transplant-ready chronic kidney disease patients

Abstract

Introduction

Chronic kidney disease (CKD) promotes salivary alterations that impact oral health. Post-transplantation immunosuppression could lead to localized mouth conditions becoming systemic.

Objective

To characterize the oral health of transplant-ready CKD patients by evaluating salivary flow and pH, salivary buffering capacity (SBC), oral lesions, gingival bleeding, calculus, and index of decayed, missing and filled teeth (DMFT).

Material and method

In the present cross-sectional, observational, and analytic study, spontaneous saliva was collected from 83 volunteers, with hyposalivation defined as < 0.3 mL/min. Salivary pH was measured using a test strip and considered alkaline when > 7. Ericsson's technique was used to assess SBC. A single trained examiner conducted the clinical assessments. Fisher's exact test, ANOVA, and linear regression were used in the statistical analysis, with a level of significance of 0.05 and 95% confidence interval.

Result

Hyposalivation occurred in 61% of the sample and was influenced by interdialytic fluid gains (p = 0.01). The presence of alkaline salivary pH was influenced by serum urea (p < 0.01) and hyperphosphatemia (p = 0.01). Salivary buffering capacity was optimal in 92% of patients and was influenced by salivary pH (p = 0.02). Three individuals exhibited infectious oral lesions. Gingival bleeding occurred in 55%, calculus in 94%, and caries in 88% of patients. The DMFT index of the sample was 17.9 ± 7.48.

Conclusion

The participants' oral health was considered poor; this condition can worsen if these individuals undergo transplantation. The importance of having a dentist in the team assisting the CKD patient is paramount.

Descriptors:
Oral health; saliva; dental caries; renal insufficiency