title: Mucosal pH, dental findings, and salivary composition in pediatric liver transplant recipients.
abstract: BACKGROUND
  Oral health and dental maintenance have become part of the standard of care for pediatric liver transplant recipients. These individuals tend to suffer particularly from dental problems, such as gingival enlargement, gingivitis, poor oral hygiene, dental hypoplasia, and caries. Saliva composition influences oral hygiene and disease states. We investigated saliva composition and its association with the oral health of young recipients of liver transplants.
  
  
  METHODS
  In 70 patients, 36 liver transplant recipients (ages 2-23 years) and 34 healthy controls (ages 4-21 years), we measured the following variables: (a) oral hygiene, (b) gingival inflammation, (c) caries status, (d) dental calculus formation, (e) oral mucosal pH, and (f) salivary protein composition.
  
  
  RESULTS
  Lower mean decayed, missing, and filled teeth index (P=0.0038), higher mean gingival index (P=0.0001), and higher mean calculus score (P=0.003) were found in the transplanted study group compared with the control. The mean mucosal pH for seven intraoral sites was higher in the transplant group (P=0.0006). The median salivary albumin concentration was significantly lower in the transplant group (P=0.01), as was the median salivary albumin/total protein ratio (P=0.0002).
  
  
  CONCLUSIONS
  In post-liver transplant pediatric recipients, low incidence of caries, together with high incidence of dental calculus, could be attributed to elevated oral mucosal pH. Salivary albumin and immunoglobulin A levels were relatively low in these patients. Clinicians should pay particular attention to the oral health and dental care of liver transplanted children.
authors.affiliation: Department of Pediatric Dentistry, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
authors.forename: Esti
authors.initials: E
authors.lastname: Davidovich
authors.forename: Ran
authors.initials: R
authors.lastname: Asher
authors.forename: Joseph
authors.initials: J
authors.lastname: Shapira
authors.forename: Henk S
authors.initials: HS
authors.lastname: Brand
authors.forename: Enno C I
authors.initials: EC
authors.lastname: Veerman
authors.forename: Rivka
authors.initials: R
authors.lastname: Shapiro
mesh_terms: D000293:Adolescent; D000418:Albumins / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004245:DMF Index; D003728:Dental Calculus / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism; D003731:Dental Caries / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005891:Gingivitis / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007070:Immunoglobulin A / Q000378:metabolism; D015994:Incidence; D016031:Liver Transplantation; D008297:Male; D009061:Mouth Mucosa / Q000378:metabolism*; D009911:Oral Hygiene Index; D011183:Postoperative Complications / Q000175:diagnosis / Q000378:metabolism; D027544:Salvia / Q000378:metabolism*; D055815:Young Adult
chemical_list: D000418:Albumins; D007070:Immunoglobulin A