Dental status in children undergoing dialysis and after kidney transplantation

Abstract

Chronic kidney disease (CKD) can give a rise to a wide spectrum of dental pathology. Drug therapy for CKD has a number of side effects that affect both soft and hard oral tissues. The aim of study was to assess the state of organs and tissues of the oral cavity in children with end-stage renal disease.
Materials and methods.
The study included 31 children (1 on peritoneal dialysis and 30 after kidney transplantation) aged 1 to 18 years [Me (Q1; Q3) — 13.4 (10.5; 15.7) years].
Results.
The dental caries prevalence in examined group of patients was 41.4%. No cavitated teeth were detected in children with a primary dentition (dmft=0). In children with mixed dentition carious lesions were detected in 60% with a median caries rating index of 2.0 (1.5; 6.0). Among children with a permanent dentition cavitated lesions were diagnosed in 45.5%, the median DMFT index was 5.0 (4.0; 6.5). The most unfavorable value of the PLI hygiene index was registered in children with mixed dentition — 2.8 (2.6; 3.0). In children with a permanent dentition visible plaque was detected on almost all teeth, the median PLI index was 2.1 (1.7; 2.6). Gingivitis of moderate severity was detected after assessing the gums status, the median GI index was 2.0 (1.3; 2.7), bleeding of gingiva was diagnosed in 38.7%. Amlodipine-induced gingival hyperplasia was detected in 29% of examined children. The prevalence of enamel development defects among all the examined patients was 61.2% in which the median DDE index was 2.0 (2.0; 3.0).
Conclusions.
There is a low intensity of caries, poor oral hygiene and inflammation of the gum tissues of moderate severity in children who are undergoing renal replacement therapy. An early interdisciplinary approach of nephrologists and dentists to treatment and rehabilitation of such patients will promote timely prevention of dental diseases.