Swapna Lingam Amara, Koppolu Pradeep, Prince Jyothi
Department of Oral Medicine and Diagnostic Sciences, Al Farabi Colleges, Riyadh, Saudi Arabia.
Department of Preventive Dental Sciences, Al Farabi Colleges, Riyadh, Saudi Arabia.
Saudi J Kidney Dis Transpl. 2017 Sep-Oct;28(5):1099-1105. doi: 10.4103/1319-2442.215123.
The objective of our study is to assess the subjective and objective oral manifestations and salivary pH in diabetic and nondiabetic uremic patients at a nephrology clinic. A total of 194 diabetic and nondiabetic patients with chronic kidney disease (CKD), who were divided into four groups, Group A, B, C, D, and who were attending a nephrology clinic were included in the study. Predialytic unstimulated whole salivary pH was recorded using pH- measuring strips. Subjective and objective findings were evaluated and recorded in the specially designed pro forma. Dental health assessment consisted of decayed, missing, and filled teeth index and community periodontal index (CPI). Dysgeusia was found to be significantly more prevalent in nondiabetic patients on dialysis. Uremic odor showed high significance (P <0.05) with 75% patients being positive in diabetic dialysis. There was no significant difference in the incidence of tongue coating between the four groups. A statistically high significance was observed with the objective oral manifestation of mucosal petechiae, with P = 0.01. There was an increased periodontal pocket depth among diabetic CKD patients as compared to that in nondiabetic patients. A moderate significance was found, with a CPI score showing P <0.05. Increased prevalence of caries was noticed among the diabetic CKD patients (Groups A, B). Recorded salivary pH showed no significant difference among diabetic and nondiabetic CKD patients. Findings suggest that these patients are at risk of developing complications, related to systemic health causing morbidity and mortality. Hence, these patients are to be motivated for comprehensive professional oral care and self oral hygiene instructions. Additional research is necessary to elucidate and correlate the combined influence of diabetes, CKD, and dialysis on oral health.
我们研究的目的是评估肾病科门诊中糖尿病和非糖尿病尿毒症患者的主观和客观口腔表现以及唾液pH值。共有194名患有慢性肾脏病（CKD）的糖尿病和非糖尿病患者被纳入研究，他们被分为A、B、C、D四组，均在肾病科门诊就诊。使用pH试纸记录透析前未刺激的全唾液pH值。主观和客观结果在专门设计的表格中进行评估和记录。牙齿健康评估包括龋失补牙指数和社区牙周指数（CPI）。发现味觉障碍在非糖尿病透析患者中更为普遍。尿毒症气味具有高度显著性（P<0.05），75%的糖尿病透析患者呈阳性。四组之间舌苔发生率无显著差异。黏膜瘀点的客观口腔表现具有统计学高度显著性，P = 0.01。与非糖尿病患者相比，糖尿病CKD患者的牙周袋深度增加。发现具有中等显著性，CPI评分显示P<0.05。在糖尿病CKD患者（A组、B组）中龋齿患病率增加。记录的唾液pH值在糖尿病和非糖尿病CKD患者之间无显著差异。研究结果表明，这些患者有发生与全身健康相关并发症的风险，可导致发病和死亡。因此，需要鼓励这些患者接受全面的专业口腔护理和自我口腔卫生指导。有必要进行进一步研究，以阐明并关联糖尿病、CKD和透析对口腔健康的综合影响。
