Oral Health Profile of Cirrhotic Patients Awaiting Liver Transplantation in the Brazilian Northeast

Abstract

Background. Infections are a frequent cause of morbidity and mortality among postoperative liver transplant (OLT) patients and a leading cause of decompensated chronic liver disease (CLD) among patients awaiting the procedure. Oral lesions that are frequently observed in subjects with CLD may represent foci for systemic infections before and after OLT.Aims. To evaluate the oral health profile of patients with CLD awaiting OLT. Methods. One hundred thirty one patients including 100 males of overall mean age 49.5 10.8 years with CLD were listed for OLT and examined for oral health status according to a established protocol. Results. One hundred thirty (99%) patients were partially edentulous; 66 (51%) had chewing difficulties; and 63 (48%) experienced reduced salivary flow. With respect to periodontal disease and oral infections, 68 (25%) had periodontitis, 63 (48%) had periapical lesion, 64 (49%) had abscesses, and 59 (45%) had root fragments. Loss of follow-up was observed in 21 subjects. Among the 110 other patients, 63 (57%) underwent dental treatments with complications in only two cases. Interestingly, mortality was significantly lower among treated (31%) versus nontreated patient (79%; P .001). Conclusions. Poor oral health status observed in most CLD patients may represent a source of systemic infections before and after OLT. Treatment of such lesions was feasible in the majority of the patients and seemed to be associated with a reduction in mortality.INFECTIONS, a frequent cause of morbidity and mortality among patients with chronic liver disease (CLD),1 are associated with disease severity, as assessed either by the Child-Pugh (CPS) or the Model for End-stage Liver Disease (MELD) score. Furthermore, infectious complications are also often seen after liver transplantation (OLT),due to the additive effects of surgery, intensive care procedures,as well as immunosuppression. In addition, poor oral health status is a recognized risk factor for the development of infections, such as endocarditis, respiratory tract problems,and liver abscess, particularly among elderly or diabetic subjects or recipients of some solid organs.2–7 Patients with