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

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.

Keywords: Children; Dental caries; Developmental defects of enamel; Oral hygiene; Teeth.

Fig. 1

Pie charts showing the distribution of indications for organ transplantation in the heart, liver, and kidney patient groups

Fig. 2

The distribution of combined dmft/DMFT scores in children prior to liver, heart, and kidney transplantation. The x-axis shows the different groups. The y-axis shows the dmft/DMFT score. There was a significant difference between the groups in the Kruskal¬–Wallis test (p = 0.010). The liver group had a significantly higher dmft/DMFT score compared to the kidney group (p = 0.043, Dunn–Bonferroni test) and the heart group had a significantly higher dmft/DMFT score compared to the kidney group (p = 0.047, Dunn–Bonferroni test). Whiskers indicate the non-outlier maximum value, the circles denote mild outliers (1.5 × IQR above third quartile), and an asterisks denote extreme outliers (> 3.0 × IQR above third quartile)