title: Oral findings and dental behaviour before and after liver transplantation - a single-centre cross-sectional study.
abstract: OBJECTIVE
  The aim of this single-centre, cross-sectional study was to evaluate dental, periodontal and mycological findings, as well as oral behaviour, in patients before (pre-LTx) and after (post-LTx) liver transplantation.
  
  
  METHODS
  A total of 47 patients pre-LTx and 119 patients post-LTx were asked to participate. Oral health behaviour was assessed using a standardised questionnaire. Oral examinations included dental [decayed, missing and filled teeth (DMFT) index] and periodontal [papillary bleeding index (PBI), periodontal probing depth (PPD) and clinical attachment loss (CAL)] findings. For Candida screening, swabs from the oral mucosa were cultured. Statistical analysis was performed using the Student's t-test or the Mann-Whitney U-test, depending on whether or not the data followed a normal distribution; Fisher's exact test was also performed. The significance level was α = 5%.
  
  
  RESULTS
  A total of 110 patients were included (pre-LTx, n = 35; post-LTx, n = 75). Different patients were investigated in the post-LTx and pre-LTx groups. Lack of use of supplemental oral-hygiene aids was noted. Between-group comparisons failed to find significant overall differences in DMFT and periodontal status. The post-LTx group showed fewer decayed teeth (P = 0.03). A total of 86% of patients pre-LTx and 84% of patients post-LTx were found to need dental treatment, and 60% of patients pre-LTx and 55% of patients post-LTx showed a need for periodontal treatment. The prevalence of Candida albicans was high; however, there were no statistically significant differences between the groups in regard to fungal infection.
  
  
  CONCLUSIONS
  Improved dental care pre- and post-transplant, including screening for fungal infections, is recommended to avoid systemic infections in LTx patients. Increased attention to oral health care, and interdisciplinary collaboration to provide guidance, is needed to improve the oral health of patients before and after LTx.
authors.affiliation: Department of General, Visceral and Pediatric Surgery, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Kauffels
authors.affiliation: Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schmalz
authors.affiliation: Department of General, Visceral and Pediatric Surgery, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Otto
authors.initials: O
authors.lastname: Kollmar
authors.affiliation: Department of General, Visceral and Pediatric Surgery, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Jan E
authors.initials: JE
authors.lastname: Slotta
authors.affiliation: Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Weig
authors.affiliation: Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Groß
authors.affiliation: Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Bader
authors.affiliation: Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Ziebolz
mesh_terms: D002180:Candidiasis, Oral / Q000453:epidemiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D009910:Oral Hygiene; D010510:Periodontal Diseases / Q000453:epidemiology / Q000517:prevention & control; D010512:Periodontal Index; D015995:Prevalence
keywords: Dental care; liver transplantation; oral health; oral hygiene