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European Archives of Paediatric Dentistry

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Open Access 14-03-2024 | Caries | Original Scientific Article

Oral findings in paediatric patients with severe heart, liver, and kidney failure prior to organ transplantation

Authors: I. Landén, A. E. Olander, E. Salmela, T. Jahnukainen, H. Ruokonen, H. Alapulli, J. Helenius-Hietala

Published in: European Archives of Paediatric Dentistry | Issue 2/2024

Abstract

Purpose

Organ transplantation is an effective treatment for children with severe heart, liver, and kidney diseases. These patient groups may have more oral and dental diseases than healthy controls. It is important to eliminate oral infection foci before transplantation and to maintain good oral health to avoid potential post-transplant complications. The aim of this study was to describe and compare oral health in Finnish paediatric heart, liver, and kidney transplant recipients prior to organ transplantation.

Methods

Eighty-six children who received a heart (n = 21), liver (n = 19), or kidney (n = 46) transplant in Finland during the years 2014–2018 were included in this study. The inclusion criterion was a pre-transplantation oral examination. Oral hygiene, enamel anomalies, and the number of decayed, missing, and filled teeth (dmft/DMFT) were analyzed retrospectively from medical and dental records and compared between the three patient groups.

Results

Children with liver (p = 0.043) or heart (p = 0.047) disease had higher combined primary and permanent dentition dmft/DMFT scores compared to children with kidney disease. A higher combined dmft/DMFT score was associated with poor oral hygiene (p = 0.005). No significant differences in oral hygiene between the patient groups were found. Furthermore, all patient groups had a high prevalence of developmental dental defects.

Conclusion

Children with liver or heart disease seem to have a higher combined dmft/DMFT score, indicating a higher prevalence of caries compared to children with kidney disease. Prevention of dental caries, along with promoting a good oral hygiene routine and regular check-ups, is suggested in these patient groups.

Alanzi A, Alkheder M, Qudeimat M. Oral health status of kuwaiti children with a history of chronic liver disease. Med Princ Pract. 2019;28(4):341–6. https://doi.org/10.1159/000499594.CrossRefPubMedPubMedCentral

Al-Nowaiser A, Roberts GJ, Trompeter RS, Wilson M, Lucas VS. Oral health in children with chronic renal failure. Pediatr Nephrol. 2003;18(1):39–45. https://doi.org/10.1007/s00467-002-0999-7.CrossRefPubMed

Amaral TH, Guerra C, Bombonato-Prado KF, Garcia de Paula E, Silva FW, de Queiroz AM. Tooth pigmentation caused by bilirubin: a case report and histological evaluation. Spec Care Dentist. 2008;28(6):254–7. https://doi.org/10.1111/j.1754-4505.2008.00048.x.CrossRefPubMed

Andrade MR, Salazar SL, de Sá LF, Portela M, Ferreira-Pereira A, Soares RM, Leão AT, Primo LG. Role of saliva in the caries experience and calculus formation of young patients undergoing hemodialysis. Clin Oral Investig. 2015;19(8):1973–80. https://doi.org/10.1007/s00784-015-1441-4.CrossRefPubMed

Bökenkamp A, Bohnhorst B, Beier C, Albers N, Offner G, Brodehl J. Nifedipine aggravates cyclosporine A-induced gingival hyperplasia. Pediatr Nephrol. 1994;8(2):181–5. https://doi.org/10.1007/BF00865474.CrossRefPubMed

Campbell PM, Humphreys GJ, Summers AM, Konkel JE, Knight CG, Augustine T, McBain AJ. Does the microbiome affect the outcome of renal transplantation? Front Cell Infect Microbiol. 2020;10:558644. https://doi.org/10.3389/fcimb.2020.558644.CrossRefPubMedPubMedCentral

Costa FS, Silveira ER, Pinto GS, Nascimento GG, Thomson WM, Demarco FF. Developmental defects of enamel and dental caries in the primary dentition: a systematic review and meta-analysis. J Dent. 2017;60:1–7. https://doi.org/10.1016/j.jdent.2017.03.006.CrossRefPubMed

Davidovich E, Davidovits M, Peretz B, Shapira J, Aframian DJ. The correlation between dental calculus and disturbed mineral metabolism in paediatric patients with chronic kidney disease. Nephrol Dial Transplant. 2009;24(8):2439–45. https://doi.org/10.1093/ndt/gfp101.CrossRefPubMed

de Goyet J, Baumann U, Karam V, Adam R, et al. European liver transplant registry: donor and transplant surgery aspects of 16,641 liver transplantations in children. Hepatology. 2022;75(3):634–45. https://doi.org/10.1002/hep.32223.CrossRef

El-Hawary YM, El-Sayed B, Abd-Alhakem G, Ibrahim FM. Deciduous teeth structure changes in congenital heart disease: Ultrastructure and microanalysis. Interv Med Appl Sci. 2014;6(3):111–7. https://doi.org/10.1556/IMAS.6.2014.3.3.CrossRefPubMedPubMedCentral

Gupta M, Gupta M, Abhishek. Oral conditions in renal disorders and treatment considerations—a review for pediatric dentist. Saudi Dental J. 2015;27(3):113–9. https://doi.org/10.1016/j.sdentj.2014.11.014.CrossRef

Hallett KB, Radford DJ, Seow WK. Oral health of children with congenital cardiac diseases: a controlled study. Pediatr Dent. 1992;14(4):224–30.PubMed

Hughes S, Balmer R, Moffat M, Willcoxson F. The dental management of children with congenital heart disease following the publication of paediatric congenital heart disease standards and specifications. Br Dent J. 2019;226(6):447–52. https://doi.org/10.1038/s41415-019-0094-0.CrossRefPubMed

Jahnukainen T, Bjerre A, Larsson M, Tainio J, Thiesson HC, Jalanko H, Schwartz Sørensen S, Wennberg L. The second report of the nordic pediatric renal transplantation registry 1997–2012: more infant recipients and improved graft survivals. Pediatr Transplant. 2016;20(3):364–71. https://doi.org/10.1111/petr.12686.CrossRefPubMed

Karhumaa H, Lämsä E, Vähänikkilä H, Blomqvist M, Pätilä T, Anttonen V. Dental caries and attendance to dental care in finnish children with operated congenital heart disease a practice based follow-up study. Eur Arch Paediatr Dent. 2021;22(4):659–65. https://doi.org/10.1007/s40368-021-00603-8.CrossRefPubMedPubMedCentral

Karikoski E, Sarkola T, Blomqvist M. Dental caries prevalence in children with congenital heart disease- a systematic review. Acta Odontol Scand. 2021;79(3):232–40. https://doi.org/10.1080/00016357.2020.1849792.CrossRefPubMed

Kwak EJ, Kim DJ, Choi Y, Joo DJ, Park W. Importance of oral health and dental treatment in organ transplant recipients. Int Dent J. 2020;70(6):477–81. https://doi.org/10.1111/idj.12585.CrossRefPubMedPubMedCentral

Limeira FIR, Yamauti M, Moreira AN, Galdino TM, de Magalhães CS, Abreu LG. Dental caries and developmental defects of enamel in individuals with chronic kidney disease: systematic review and meta-analysis. Oral Dis. 2019;25(6):1446–64. https://doi.org/10.1111/odi.12993.CrossRefPubMed

Lin YT, Yang FT. Gingival enlargement in children administered cyclosporine after liver transplantation. J Periodontol. 2010;81(9):1250–5. https://doi.org/10.1902/jop.2010.090743.CrossRefPubMed

Lucas S, Roberts GJ. Oro-dental health in children with chronic renal failure and after renal transplantation: a clinical review. Pediatr Nephrol. 2005;20(10):1388–94. https://doi.org/10.1007/s00467-005-1929-2.CrossRefPubMed

Malik S, Kassaï B, Cochat P. Overview of pediatric organ transplantation: current opinion and future perspectives on immunosuppression. Curr Opin Organ Transplant. 2015;20(5):527–35. https://doi.org/10.1097/MOT.0000000000000224.CrossRefPubMed

Meurman JH, Bascones-Martinez A. Oral infections and systemic health—more than just links to cardiovascular diseases. Oral Health Prev Dent. 2021;19(1):441–8. https://doi.org/10.3290/j.ohpd.b1993965.CrossRefPubMed

Nappalli D, Lingappa A. Oral manifestations in transplant patients. Dent Res J (isfahan). 2015;12(3):199–208.PubMed

Nunn JH, Sharp J, Lambert HJ, Plant ND, Coulthard MG. Oral health in children with renal disease. Pediatr Nephrol. 2000;14(10–11):997–1001. https://doi.org/10.1007/s004670050061.CrossRefPubMed

Olczak-Kowalczyk D, Gozdowski D, Pawłowska J, Grenda R. The status of dental and jaw bones in children and adolescents after kidney and liver transplantation. Ann Transplant. 2012;17(4):72–81. https://doi.org/10.12659/aot.883697.CrossRefPubMed

Olczak-Kowalczyk D, Kowalczyk W, Krasuska-Sławińska E, Dądalski M, Kostewicz K, Pawłowska J. Oral health and liver function in children and adolescents with cirrhosis of the liver. Prz Gastroenterol. 2014;9(1):24–31. https://doi.org/10.5114/pg.2014.40846.CrossRefPubMedPubMedCentral

Pourmoghaddas Z, Meskin M, Sabri M, Norousali Tehrani MH, Najafi T. Dental caries and gingival evaluation in children with congenital heart disease. Int J Prev Med. 2018;9:52. https://doi.org/10.4103/ijpvm.IJPVM_401_15.CrossRefPubMedPubMedCentral

Raissadati A, Pihkala J, Jahnukainen T, Jokinen E, Jalanko H, Sairanen H. Late outcome after paediatric heart transplantation in Finland. Interact Cardiovasc Thorac Surg. 2016;23(1):18–25. https://doi.org/10.1093/icvts/ivw086.CrossRefPubMedPubMedCentral

Rakauskaite A, Juodzbalys G, Pauza DH, Cicciù M. Green pigmentation in human teeth. A stereomicroscopic study. J Clin Pediatr Dent. 2014;38(4):355–61. https://doi.org/10.17796/jcpd.38.4.057t211602x447j8.CrossRefPubMed

Sandoval MJ, Zekeridou A, Spyropoulou V, Courvoisier D, Mombelli A, McLin V, Giannopoulou C. Oral health of pediatric liver transplant recipients. Pediatr Transplant. 2017. https://doi.org/10.1111/petr.13019.10.1111/petr.13019.CrossRefPubMed

Sheehy EC, Roberts GJ, Beighton D, O’Brien G. Oral health in children undergoing liver transplantation. Int J Paediatr Dent. 2000;10(2):109–19. https://doi.org/10.1046/j.1365-263x.2000.00179.x.CrossRefPubMed

Shiboski CH, Kawada P, Golinveaux M, Tornabene A, Krishnan S, Mathias R, Den Besten P, Rosenthal P. Oral disease burden and utilization of dental care patterns among pediatric solid organ transplant recipients. J Public Health Dent. 2009;69(1):48–55. https://doi.org/10.1111/j.1752-7325.2008.00092.x.CrossRefPubMedPubMedCentral

Sivertsen TB, Aßmus J, Greve G, Åstrøm AN, Skeie MS. Oral health among children with congenital heart defects in Western Norway. Eur Arch Paediatr Dent. 2016;17(5):397–406. https://doi.org/10.1007/s40368-016-0243-y.CrossRefPubMed

Stecksén-Blicks C, Rydberg A, Nyman L, Asplund S, Svanberg C. Dental caries experience in children with congenital heart disease: a case-control study. Int J Paediatr Dent. 2004;14(2):94–100. https://doi.org/10.1111/j.1365-263x.2004.00531.x.CrossRefPubMed

Subramaniam P, Gupta M, Mehta A. Oral health status in children with renal disorders. J Clin Pediatr Dent. 2012;37(1):89–93. https://doi.org/10.17796/jcpd.37.1.7l913347q0232v01.CrossRefPubMed

Suominen-Taipale AL, Widström E, Sund R. Association of examination rates with children’s national caries indices in Finland. Open Dent J. 2009;3:59–67. https://doi.org/10.2174/1874210600903010059.CrossRefPubMedPubMedCentral

Vargas-Ferreira F, Salas MM, Nascimento GG, Tarquinio SB, Faggion CM Jr, Peres MA, Thomson WM, Demarco FF. Association between developmental defects of enamel and dental caries: a systematic review and meta-analysis. J Dent. 2015;43(6):619–28. https://doi.org/10.1016/j.jdent.2015.03.011.CrossRefPubMed

Vidigal EA, Abanto J, Haddad AE, Porta G, Alves FA, Bönecker M. Oral health-related quality of life among pediatric liver transplant candidates. Braz Oral Res. 2020;2020(34): e100. https://doi.org/10.1590/1807-3107bor-2020.vol34.0100.CrossRef

Wondimu B, Németh A, Modéer T. Oral health in liver transplant children administered cyclosporin A or tacrolimus. Int J Paediatr Dent. 2001;11(6):424–9. https://doi.org/10.1046/j.0960-7439.2001.00305.x.CrossRefPubMed

Title: Oral findings in paediatric patients with severe heart, liver, and kidney failure prior to organ transplantation
Authors: I. Landén
A. E. Olander
E. Salmela
T. Jahnukainen
H. Ruokonen
H. Alapulli
J. Helenius-Hietala
Publication date: 14-03-2024
Publisher: Springer Berlin Heidelberg
Keyword: Caries
Published in: European Archives of Paediatric Dentistry / Issue 2/2024
Print ISSN: 1818-6300
Electronic ISSN: 1996-9805
DOI: https://doi.org/10.1007/s40368-024-00879-6

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Springer Medicine

Oral findings in paediatric patients with severe heart, liver, and kidney failure prior to organ transplantation

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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