Oral health and dental treatment of patients with renal disease.
OBJECTIVE
To outline aspects that need consideration in the dental office when treating patients with renal disease and to present data on the oral health parameters of patients during the different phases of their renal disease during a 10-year follow-up period. Differences in clinical and salivary study parameters during the course of treatment of the renal disease were expected to occur.


METHODS
Altogether, 39 patients with chronic renal failure were examined for dental health. Nine patients (mean age 50.8 years) were followed for 10 years through predialysis, dialysis, and posttransplant stages. The patients were examined clinically and radiographically and by analyzing the biochemical constituents of saliva. Patients' perceptions of oral health were recorded using structured questionnaires.


RESULTS
No statistically significant differences were observed in the clinical parameters studied during the follow-up period. However, analyses of saliva components after renal transplantation showed significant improvement compared with components found during the predialysis stage. For example, median salivary albumin concentration, which describes the leakage of serum components to saliva, was 399 microg/mL at the predialysis stage, 353 microg/mL at the dialysis stage, and 181 .g/mL at the posttransplant stage.


CONCLUSIONS
From the oral health point of view, the outcome was better than anticipated. The lower salivary albumin values after kidney transplantation may reflect the improvement of patients' health during the course of the treatment.
Vesterinen
Maarit
M
Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital and Institute of Dentistry, University of Helsinki, Helsinki, Finland. maarit.vesterinen@helsinki.fi
Ruokonen
Hellevi
H
Leivo
Tomi
T
Honkanen
Anne-Marie
AM
Honkanen
Eero
E
Kari
Kirsti
K
Lindqvist
Christian
C
Meurman
Jukka H
JH
D000328:Adult; D000418:Albumins / Q000032:analysis; D004245:DMF Index; D017742:Dental Care for Chronically Ill; D005260:Female; D019214:Gingival Overgrowth / Q000139:chemically induced; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D010512:Periodontal Index; D006435:Renal Dialysis; D012471:Salivary Proteins and Peptides / Q000032:analysis; D014987:Xerostomia / Q000209:etiology
D000418:Albumins; D012471:Salivary Proteins and Peptides