Jain Swati, Singla Ashish, Basavaraj P, Singh Shilpi, Singh Khushboo, Kundu Hansa
Postgraduate Student, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Modinagar, Ghaziabad, Uttar Pradesh, India .
Senior Lecturer, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Modinagar, Ghaziabad, Uttar Pradesh, India .
J Clin Diagn Res. 2014 May;8(5):ZC65-9. doi: 10.7860/JCDR/2014/7853.4402. Epub 2014 May 15.
Dental health among the patients undergoing haemodialysis therapy has been found to be debilitated and gets worsened with the increased duration of hemodialysis.Hence the present study aimed to assess the effect of duration of hemodialysis and the underlying kidney disease on the dental health status of patients.
A cross-sectional study was conducted on 400 patients and 400 controls selected through stratified random sampling method from five zones of Delhi, India.
The patient group was divided into following five groups in order to evaluate influence of duration of hemodialysis therapy on dental status of the subjects-a)≤ three months b)four to six months c)seven to nine months d) ten to twelve months and e) more than twelve months. Dental health was assessed using WHO dentition status and treatment needs, community periodontal index, oral hygiene index, prosthetic status and needs.
Student t-test, Chi-square test, one-way analysis of variance (ANOVA) and Pearson's correlation was used to determine the difference in clinical parameters among the subgroup and between the patients and controls.
Positive correlation was found between the frequency of dialysis and maximum CPI scores (p-value=0.018). 81.25% of patients and 74.75% of the controls had CPI score 2. Loss of attachment scores in patients was higher than the healthy controls (p-value 0.035). Mean OHI scores for the patients was 5.15±1.975 and for controls was 5.01±2.213 (p=0.635). Mean DMFT score of patients and controls was 3.552 and 3.559 respectively (p=0.937). 23%of controls showed presence of dental prosthesis in comparison to only 14.5 % of patients (p=0.05). Type of underlying kidney disease and duration of hemodialysis had significant influence on O.H.I scores and Prosthetic needs.
Dental health status was found to be debilitated among the hemodialysis patients and got worsened with the duration of hemodialysis and the type of underlying kidney disease mainly due to oral health negligence contributing to morbidity and potential mortality. Further emphasis on the effective implementation of oral health promotion programme for medically compromised patients is thus advocated.
已发现接受血液透析治疗的患者牙齿健康状况不佳，且随着血液透析时间的延长而恶化。因此，本研究旨在评估血液透析时间和潜在肾脏疾病对患者牙齿健康状况的影响。
采用分层随机抽样方法，从印度德里的五个区域选取了400名患者和400名对照进行横断面研究。
为评估血液透析治疗时间对受试者牙齿状况的影响，将患者组分为以下五组：a）≤3个月；b）4至6个月；c）7至9个月；d）10至12个月；e）超过12个月。使用世界卫生组织的牙列状况和治疗需求、社区牙周指数、口腔卫生指数、修复状况和需求来评估牙齿健康。
采用学生t检验、卡方检验、单因素方差分析（ANOVA）和Pearson相关性分析来确定亚组之间以及患者与对照之间临床参数的差异。
透析频率与最大社区牙周指数（CPI）得分之间存在正相关（p值=0.018）。81.25%的患者和74.75%的对照CPI得分为2。患者的附着丧失得分高于健康对照（p值0.035）。患者的平均口腔卫生指数（OHI）得分为5.15±1.975，对照为5.01±2.213（p=0.635）。患者和对照的平均龋失补（DMFT）得分分别为3.552和3.559（p=0.937）。23%的对照有假牙，而患者中只有14.5%有假牙（p=0.05）。潜在肾脏疾病的类型和血液透析时间对口腔卫生指数得分和修复需求有显著影响。
血液透析患者的牙齿健康状况不佳，且随着血液透析时间和潜在肾脏疾病类型的变化而恶化，主要原因是口腔健康疏忽导致发病和潜在死亡。因此，提倡进一步强调为医疗状况不佳的患者有效实施口腔健康促进计划。
