title: Characteristics of oral abnormalities in liver transplant candidates.
abstract: BACKGROUND
  Several oral mucosal abnormalities have been reported to occur more frequently in patients with liver disease. It has, however, not been determined if these conditions are related to the disease or are manifestations of extraneous factors not associated with the liver pathology.
  
  
  OBJECTIVE
  To identify and quantify oral abnormalities in candidates for liver transplantation, and to determine whether these conditions were correlated with the type of liver disease or were the result of other patient variables.
  
  
  METHODS
  Oral examinations were performed on 300 candidates for liver transplantation to assess their oral health and to record the presence and types of oral mucosal pathologies. Abnormalities most frequently encountered were analyzed for significant associations with classification of liver disease, hyposalivation, diuretic therapy, edentulism, or smoking.
  
  
  RESULTS
  Among these subjects, 175 (58%) had one or more abnormalities. The anomalies most frequently found were fissured tongue (37%), atrophy of the papillae of the tongue (18%), angular cheilitis (4%) and manifestations of clinical candidiasis (2%). Clinical hyposalivation was found in 28.7% of all patients and 70% of those who were on diuretic therapy. Fissured tongue and atrophy of the tongue papillae were significantly associated with hyposalivation (p<0.001); hyposalivation was correlated to diuretic therapy (p=0.028). Pathologies suggestive of candidiasis were significantly associated with hyposalivation and total edentulism.
  
  
  CONCLUSIONS
  Several oral mucosal abnormalities that have previously been linked with liver diseases were found to be primarily associated with diuretic-induced hyposalivation, smoking, and total edentulism.
authors.affiliation: Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine.
authors.forename: J
authors.initials: J
authors.lastname: Guggenheimer
authors.affiliation: Department of Dental Public Health and Information Management, University of Pittsburgh, School of Dental Medicine.
authors.forename: J M
authors.initials: JM
authors.lastname: Close
authors.affiliation: Liver Transplant Center, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: B
authors.initials: B
authors.lastname: Eghtesad
authors.affiliation: Liver Transplant Center, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: C
authors.initials: C
authors.lastname: Shay
keywords: Candidiasis; Liver diseases; Mouth mucosa; Oral pathology; Xerostomia