title: Underlying kidney disease and duration of hemodialysis: an assessment of its effect on oral health.
abstract: BACKGROUND
  Dental health among the patients undergoing haemodialysis therapy has been found to be debilitated and gets worsened with the increased duration of hemodialysis.Hence the present study aimed to assess the effect of duration of hemodialysis and the underlying kidney disease on the dental health status of patients.
  
  
  METHODS
  A cross-sectional study was conducted on 400 patients and 400 controls selected through stratified random sampling method from five zones of Delhi, India.
  
  
  METHODS
  The patient group was divided into following five groups in order to evaluate influence of duration of hemodialysis therapy on dental status of the subjects-a)≤ three months b)four to six months c)seven to nine months d) ten to twelve months and e) more than twelve months. Dental health was assessed using WHO dentition status and treatment needs, community periodontal index, oral hygiene index, prosthetic status and needs.
  
  
  METHODS
  Student t-test, Chi-square test, one-way analysis of variance (ANOVA) and Pearson's correlation was used to determine the difference in clinical parameters among the subgroup and between the patients and controls.
  
  
  RESULTS
  Positive correlation was found between the frequency of dialysis and maximum CPI scores (p-value=0.018). 81.25% of patients and 74.75% of the controls had CPI score 2. Loss of attachment scores in patients was higher than the healthy controls (p-value 0.035). Mean OHI scores for the patients was 5.15±1.975 and for controls was 5.01±2.213 (p=0.635). Mean DMFT score of patients and controls was 3.552 and 3.559 respectively (p=0.937). 23%of controls showed presence of dental prosthesis in comparison to only 14.5 % of patients (p=0.05). Type of underlying kidney disease and duration of hemodialysis had significant influence on O.H.I scores and Prosthetic needs.
  
  
  CONCLUSIONS
  Dental health status was found to be debilitated among the hemodialysis patients and got worsened with the duration of hemodialysis and the type of underlying kidney disease mainly due to oral health negligence contributing to morbidity and potential mortality. Further emphasis on the effective implementation of oral health promotion programme for medically compromised patients is thus advocated.
authors.affiliation: Postgraduate Student, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Modinagar, Ghaziabad, Uttar Pradesh, India .
authors.forename: Swati
authors.initials: S
authors.lastname: Jain
authors.affiliation: Senior Lecturer, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Modinagar, Ghaziabad, Uttar Pradesh, India .
authors.forename: Ashish
authors.initials: A
authors.lastname: Singla
authors.affiliation: Professor & Head Department, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Modinagar, Ghaziabad, Uttar Pradesh, India .
authors.forename: P
authors.initials: P
authors.lastname: Basavaraj
authors.affiliation: Senior Lecturer, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Modinagar, Ghaziabad, Uttar Pradesh, India .
authors.forename: Shilpi
authors.initials: S
authors.lastname: Singh
authors.affiliation: Postgraduate Student, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Modinagar, Ghaziabad, Uttar Pradesh, India .
authors.forename: Khushboo
authors.initials: K
authors.lastname: Singh
authors.affiliation: Postgraduate Student, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Modinagar, Ghaziabad, Uttar Pradesh, India .
authors.forename: Hansa
authors.initials: H
authors.lastname: Kundu
keywords: Dental health; Duration of dialysis; Hemodialysis; Kidney diseases