title: Effect of the aetiology and severity of liver disease on oral health and dental treatment prior to transplantation.
abstract: Elimination of dental infection foci has been recommended before liver transplantation (LT) because lifelong immunosuppression may predispose to infection spread. Association between pre-LT oral health and the aetiology and severity of chronic liver disease (CLD) was investigated retrospectively. A total of 212 adult patients (median age 51.1) who had received LT during 2000-2006 in Finland were included. Their oral health had been pre-operatively examined. Patients were divided into seven different CLD groups. Common indications for LT were primary sclerosing cholangitis (PSC 25.5%), alcohol cirrhosis (ALCI 17.5%) and primary biliary cirrhosis (PBC 14.6%). Patients were also categorized by the Model for End stage Liver Disease (MELD) scoring system. Medical, dental and panoramic jaw x-ray data were analysed between groups. PBC patients had the lowest number of teeth with significant difference to PSC patients (19.7 vs. 25.6, P < 0.005, anova, t-test). ALCI patients had the highest number of tooth extractions with significant difference in comparison to PSC patients (5.6 vs. 2.5, P < 0.005). Lower MELD score resulted in fewer tooth extractions but after adjusting for several confounding factors, age was the most important factor associated with extractions (P < 0.005). The aetiology of CLD associated with the oral health status and there was a tendency towards worse dental health with higher MELD scores.
authors: University of Helsinki, Institute of Dentistry, Helsinki, Finland. jaana.s.helenius@helsinki.fi
authors: Jaana
authors: J
authors: Helenius-Hietala
authors: Jukka H
authors: JH
authors: Meurman
authors: Krister
authors: K
authors: Höckerstedt
authors: Christian
authors: C
authors: Lindqvist
authors: Helena
authors: H
authors: Isoniemi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D012720:Severity of Illness Index; D014076:Tooth Diseases / Q000628:therapy