Evaluation of oral and dental health in children with chronic kidney disease

Oral and dental health may be adversely affected in chronic diseases. In this study, we aimed to determine the state of oral and dental health in chronic kidney disease (CKD) and to evaluate whether the presence of metabolic bone disease (MBD) has an effect. The study included fifty-one children followed up with the diagnosis of CKD in the Pediatric Nephrology Outpatient Clinic of Karadeniz Technical University (KTU) Faculty of Medicine and fifty-one age- and gender-matched healthy children who applied to the KTU Faculty of Dentistry Pedodontics Clinic were evrolled. Sociodemographic characteristics of their patients were questioned, oral care and nutritional habits of children were questioned. Gum health was evaluated with plaque index (PI) and gingival bleeding index (GBI), and teeth with Decay-Missing-Filling-Teeth (DMFT/dmft) index. It was approved by the Scientific Research Ethics Committee of KTU Faculty of Medicine. Of the patients 29 (56.8%) were male and the mean age was 12.7±3.3 years. It was determined that the education level and income level of the parents were lower in the CKD group, and the tooth brushing habits of the patients were worse (p:0.04, p:<0.0001, p:0.02, respectively). Children in the CKD group had higher PI (54.5% versus 45.5%, p:0.021) and GBI score (48.8%-37.8%, p:0.028, respectively) than the control group. It was determined that the DMFT index of the children in the CKD group was lower than the control group, and this difference was statistically significant (0.02±0.03 versus 0.03±0.03, p:0.024). When PI, GBI and DMFT/dmft indices were evaluated in the presence of MBD, no significant difference was found (p>0.05). In our study, the fact that there was no significant difference between the CKD and the control group in terms of caries despite the lower education and income level of the parents in the CKD group and the worse oral and dental health habits in children. It was attributed to the fact that they received sodium bicarbonate therapy for acidosis. It was thought that the significantly higher PI and GBI in patients with CKD might be due to the formation of tartar and the associated increase in inflammation in CKD. Children with CKD and their families should be informed about oral complications that may be related to the disease, and pediatric nephrologists and pediatric dentists should be in contact in order to take necessary precautions and intervene without delay. Although our study is the first to evaluate oral and dental health in the presence of MBD in CKD, we think that the lack of difference in the presence of MBD may be due to the small number of cases and the fact that the patients were under treatment. With these results, we think that large-scale studies with larger number of patients are needed.