Assessment and management of oral health in liver transplant candidates.
Liver transplantation has become a standard treatment for end-stage liver disease and the number of recipients has grown rapidly in the last few years. Dental care during pre-transplant workup is important to reduce potential sources of infection in the drug-induced immunosuppression phase of liver transplantation.


OBJECTIVE
The objectives of this study were to document the prevalence of oral abnormalities in patients on a liver transplant waiting list presenting to an urban dental school clinic, discuss the appropriate dental treatment according their systemic conditions and compare their oral manifestations with those of healthy individuals.


METHODS
A pilot study was conducted involving 16 end-stage liver disease individuals (study group- SG) attending the Special Care Dentistry Center of the University of São Paulo and 16 control individuals (control group--CG) with no liver diseases, receiving dental care at the Dental School of the University of São Paulo. These individuals were assessed for their dental status (presence of oral disease or abnormalities), coagulation status, and dental treatment indications.


RESULTS
The patients from SG exhibited a greater incidence of oral manifestations compared with CG (p=0.0327) and were diagnosed with at least one oral disease or condition that required treatment. Coagulation abnormalities reflecting an increased risk of bleeding were found in 93.75% of the patients. However, no bleeding complications occurred after dental treatment.


CONCLUSIONS
The patients with chronic liver diseases evaluated in this study exhibited a higher incidence of oral manifestations compared with the control group and had at least one oral disease or abnormality which required dental treatment prior to liver transplantation. Careful oral examination and evaluation of the patient, including laboratory tests, will ensure correct oral preparation and control of oral disease prior to liver transplantation.
Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil. paulosss@fob.usp.br
Paulo Sérgio da
PS
Silva Santos
Karin Sá
KS
Fernandes
Marina H C
MH
Gallottini
D000328:Adult; D017677:Age Distribution; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D017742:Dental Care for Chronically Ill; D058625:End Stage Liver Disease / Q000150:complications*; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D009909:Oral Health; D010865:Pilot Projects; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D014850:Waiting Lists