The Oral and Dental Health Status in Children Under Haemodialysis

Abstract

Untreated dental infection in End Stage Renal Disease (ESRD) patients can potentially contribute to morbidity and transplant rejection. There is a need for detailed assessment and provision of good dental care following the diagnosis of chronic renal failure (CRF). Hence, regular clinical review is important for the early identification of oral complications of renal disease. Aim: The present study was carried out at Pediatric Nephrology Unit in Zigzag University Hospital to evaluate the dental health status in CRF children. Design: The dental health status of 50 children under 15 years suffering from CRF were compared results to the results of an age and sex matched control group (n=50). This study was done to evaluate enamel hypoplasia, dmft, DMFT, Gingival Index (GI), Plaque Index (PI), intrinsic and extrinsic stain and the changes in oral microflora including salivary Calcium, phosphorus, alkaline phosphatase and urea concentrations were measured using phenol Sulphur acid colorimetric method. The estimated stimulated salivary pH, buffering capacity and count of Streptococcal Mutants and lactobacilli were determined on selective media of all participants. Results: The study and control groups did not significantly differ in daily tooth brushing frequency and periodic dental check up frequency. Severe enamel hypoplasia was present in study group. The means of dmft, DMFT and PI were significantly greater in the study group (p<0.05). The differences among groups for GI were statistically insignificant. Our findings of intrinsic brown staining were 22% and 20% extrinsic staining of patients. Conclusion: The salivary pH of patients and salivary levels of cariogenic S. mutans and lactobacilli in the study group were significantly lower than the control group, probably due to increased concentrations of antibacterial chemicals such as urea in the saliva of CRF children. The presence of uremia during the development of dentitions cause Intrinsic staining but black brown extrinsic staining due to using ferrous sulfate syrup for treatment CRF children anemia. Although dental treatment need is not high, these children should receive dental health education, including oral hygiene instruction, in order to improve their overall oral health.