Oral health in children undergoing liver transplantation.
OBJECTIVE
To determine the prevalence of dental caries in children undergoing liver transplantation and to compare the plaque, gingivitis, and gingival overgrowth indices and oral mucosal lesions in children before and after liver transplantation.


METHODS
Patients undergoing liver transplantation at King's College Hospital were examined before transplantation, at 3 and 106 days post-transplantation. Healthy children from the Greenwich Health District, south-east London, were matched to the liver transplant patients by age, gender, socio-economic factors and the presence or absence of active dental caries.


RESULTS
Twenty-seven liver transplant patients (mean age: 7 years and 10 months; SD 3 years and 5 months) and 27 controls (mean age: 8 years and 6 months; SD 3 years and 7 months) were examined. The mean dmft and DMFT scores were 2.3 (SD 4.1) and 0.8 (SD 1.4), respectively, in the liver transplant patients, and 1.2 (SD 2.2) and 0.9 (SD 1.5), respectively, in the controls. There were no significant differences between either the mean plaque or gingivitis indices for the primary and permanent teeth in patients before and after transplantation. There were no significant differences between the liver transplant patients and the controls for either mean plaque or gingivitis indices at each examination time. Gingival overgrowth was present in 41% of liver recipients receiving cyclosporin with or without nifedipine, but not in the majority receiving tacrolimus at the final examination. Oral mucosal lesions were absent in both the patients and controls at each examination time.


CONCLUSIONS
The oral health of the children undergoing liver transplantation was inadequate. Funding and implementation of an oral health care programme must become a priority for all children before and after liver transplantation.
Sheehy
E C
EC
Guy's King's & St Thomas' (GKT) Dental Institute, Department of Paediatric Dentistry and Orthodontics, Guy's Campus, Guy's Hospital Tower, London, UK. e.sheehy@umds.ac.uk
Roberts
G J
GJ
Beighton
D
D
O'Brien
G
G
D000293:Adolescent; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use; D004245:DMF Index; D003731:Dental Caries / Q000145:classification*; D003773:Dental Plaque / Q000145:classification; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D019214:Gingival Overgrowth / Q000145:classification; D005891:Gingivitis / Q000145:classification; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D017093:Liver Failure / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D009543:Nifedipine / Q000008:administration & dosage / Q000627:therapeutic use; D010512:Periodontal Index; D015995:Prevalence; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D016559:Tacrolimus / Q000627:therapeutic use; D014094:Tooth, Deciduous
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009543:Nifedipine; D016559:Tacrolimus