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Oral symptoms and oral health-related quality of life in patients with chronic kidney disease from predialysis to posttransplantation

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Abstract

Objective

This prospective follow-up cohort study analyzed chronic kidney disease (CKD) patients’ oral symptoms, health habits, and oral health-related quality of life (OHRQoL), from predialysis to posttransplantation. A simplified questionnaire method (Oral Health Quality Score, OHQS), based on these and clinical findings, was constructed and tested for identifying patients in need for referral to a dentist.

Material and methods

Fifty-three CKD patients were followed up for a mean of 10.3 years. Clinical oral, radiological, and salivary examination was performed at baseline and posttransplantation. Total Dental Index (TDI) indicating inflammation was calculated. The patients filled out a questionnaire on symptoms, oral hygiene and health care habits, smoking, alcohol use, and medication. General health-related quality of life was assessed with the 15-dimensional (15D) instrument at posttransplantation. Descriptive and analytical methods were used in statistics.

Results

OHQS significantly correlated with high TDI (p = 0.017), number of teeth (p = 0.031), and unstimulated salivary flow rate (p = 0.001) in transplanted patients. Number of daily medications showed a negative correlation with the OHQS (r = − 0.30; p = 0.028). The prevalence of oral symptoms was slightly, but not significantly, more common posttransplantation compared with predialysis stage.

Conclusion

OHQS identified patients with high oral inflammatory score thus confirming our study hypothesis.

Clinical relevance

Use of OHQS and measuring salivary flow indicate patients at risk for oral diseases. These markers might be easy to use chair-side also by auxiliary personnel.

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References

  1. Eckardt KU, Coresh J, Devuyst O, Johnson RJ, Köttgen A, Levey AS, Levin A (2013) Evolving importance of kidney disease: from subspecialty to global health burden. Lancet 382:158–169

    Article  PubMed  Google Scholar 

  2. Cignarelli M, Lamacchia O (2007) Obesity and kidney disease. Nutr Metab Cardiovasc Dis 17:757–762

    Article  PubMed  Google Scholar 

  3. Fisher MA, Taylor GW, Shelton BJ, Jamerson KA, Rahman M, Ojo AO, Sehgal AR (2008) Periodontal disease and other nontraditional risk factors for CKD. Am J Kidney Dis 51:45–52

    Article  PubMed  Google Scholar 

  4. Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, Saran R, Wang AYM, Yang CW (2013) Chronic kidney disease: global dimension and perspectives. Lancet 382:260–272

    Article  PubMed  Google Scholar 

  5. Vesterinen M, Ruokonen H, Furuholm J, Honkanen E, Meurman JH (2012) Clinical questionnaire study of oral health care and symptoms in diabetic vs. non-diabetic predialysis chronic kidney disease patients. Clin Oral Investig 16:559–563

    Article  PubMed  Google Scholar 

  6. Nylund KM, Meurman JH, Heikkinen AM, Furuholm JO, Ortiz F, Ruokonen HM (2018) Oral health in patients with renal disease: a longitudinal study from predialysis to kidney transplantation. Clin Oral Investig 22(1):339–347

    Article  PubMed  Google Scholar 

  7. Nylund K, Meurman JH, Heikkinen AM, Honkanen E, Vesterinen M, Ruokonen H (2015) Oral health in predialysis patients with emphasis on periodontal disease. Quintessence Int 46:899–907

    PubMed  Google Scholar 

  8. Vesterinen M, Ruokonen H, Leivo T, Honkanen AM, Honkanen E, Kari K, Lindqvist C, Meurman JH (2007) Oral health and dental treatment of patients with renal disease. Quintessence Int 38:211–219

    PubMed  Google Scholar 

  9. Locker D, Allen F. (2007) What do measures of oral health and dental treatment of patients with renal disease Oral Epidemiol 35: 401–411

  10. Patel RR, Richards PS, Inglehart MR (2008) Periodontal health, quality of life, and smiling patterns – an exploration. J Periodontol 79:224–231

    Article  PubMed  Google Scholar 

  11. Abrahamsson KH, Wennström JL, Hallberg U (2008) Patients’ views on periodontal disease; attitudes to oral health and expectancy of periodontal treatment: a qualitative interview study. Oral Health Prev Dent 6:209–216

    PubMed  Google Scholar 

  12. Sischo L, Broder HL (2011) Oral health-related quality of life: what, why, how, and future implications. J Dent Res 90:1264–1270

    Article  PubMed  PubMed Central  Google Scholar 

  13. Broder HL, Wilson-Genderson M (2007) Reliability and convergent and discriminant validity of the child oral health impact profile (COHIP child’s version). Community Dent Oral Epidemiol 35(Suppl 1):20–31

    Article  PubMed  Google Scholar 

  14. Slade GD (2002) Assessment of oral health-related quality of life. In: Inglehart MR, Bagramian RA (eds) Oral health-related quality of life, Quintessence Publishing Co, pp 29–46

  15. McGrath C, Bedi R (2001) An evaluation of a new measure of oral health related quality of life – OHQoL-UK (W)©. Community Dent Health 18:138–143

    PubMed  Google Scholar 

  16. Slade G (1997) Derivation and validation of a short form oral health impact profile. Community Dent Health 25:284–290

    Google Scholar 

  17. Caglayan F, Altun O, Miloglu O, Kaya M-P, Yilmaz A-B (2009) Correlation between oral health-related quality of life (OHQoL) and oral disorders in a Turkish patient population. Med Oral Patol Oral Cir Bucal 14(11):e573–8. https://doi.org/10.4317/medoral.14.e573

  18. Klein HT, Palmer CE, Knuston JW (1938) Studies on dental caries I dental status and dental needs of alimentary school children. Public Health Rep 53:751–765

    Article  Google Scholar 

  19. World Health Organization Geneva (1997) Oral health survey basic methods. 4th ed. Delhi; AITBS publishers and distributors, pp 36–38

  20. Mattila KJ, Nieminen MS, Valtonen VV, Rasi VP, Kesaniemi YA, Syrjala SL, Jungell PS, Isoluoma M, Hietaniemi K, Jokinen MJ (1989) Association between dental health and acute myocardial infarction. BMJ 298:779–781

    Article  PubMed  PubMed Central  Google Scholar 

  21. Lindy O, Suomalainen K, Makela M, Lindy S (2008) Statin use is associated with fewer periodontal lesions: a retrospective study. BMC Oral Health 8:16–6831-8-16

    Article  Google Scholar 

  22. Sintonen H (2001) The 15D instrument of health-related quality of life: properties and applications. Ann Med 33:328–336

    Article  Google Scholar 

  23. Ortiz F, Aronen P, Koskinen P et al (2014) Health-related quality of life after kidney transplantation: who benefits the most? Transpl Int 27:1143–1151

    Article  PubMed  Google Scholar 

  24. Niklander S, Veas L, Barrera C, Fuentes F, Chiappini G, Marshall M (2017) Risk factors, hyposalivation and impact of xerostomia on oral health-related quality of life. Braz Oral Res 16:31. https://doi.org/10.1590/1807-3107BOR-2017.vol31.0014

  25. Närhi TO, Meurman JH, Ainamo A (1999) Xerostomia and hyposalivation Causes, consequences and treatment in the elderly. Drugs Aging 15:103–116

    Article  PubMed  Google Scholar 

  26. Närhi TO, Meurman JH, Ainamo A (1992) Association between salivary flow rate and the use of systemic medication among 76-, 81-, and 86- year – old inhabitants in Helsinki, Finland. J Dent Res 1:1875–1880

    Article  Google Scholar 

  27. Liem YS, Bosch JL, Arends LR, Heijenbrok-Kal MH, Hunink MG (2007) Quality of life assessed with the medical outcomes study short form 36-item health survey of patients on renal replacement therapy: a systematic review and meta-analysis. Value Health 10:390–397

    Article  PubMed  Google Scholar 

  28. Jofre R, Lopez-Gomez JM, Moreno F, Sanz-Guajardo D, Valderrabano F (1998) Changes in quality of life after renal transplantation. Am J Kidney Dis 32:93–100

    Article  PubMed  Google Scholar 

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Funding

The work was supported by the Helsinki University Hospital EVO grant TYH2013334.

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Authors and Affiliations

  1. Head and Neck Center, Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, P.O.Box 263, Kasarmikatu 11-13, FI-00029 HUS, Helsinki, Finland

    Hellevi Ruokonen, Karita Nylund, Jukka H. Meurman, Anna M. Heikkinen, Jussi Furuholm & Timo Sorsa

  2. Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden

    Timo Sorsa

  3. Group Administration, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    Risto Roine

  4. Department of Social and Health Management, University of Eastern Finland, Kuopio, Finland

    Risto Roine

  5. Abdominal Center, Nephrology, Helsinki University Hospital, Helsinki, Finland

    Fernanda Ortiz

  6. Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland

    Fernanda Ortiz

Authors
  1. Hellevi Ruokonen
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  2. Karita Nylund
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  3. Jukka H. Meurman
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  4. Anna M. Heikkinen
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  5. Jussi Furuholm
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  6. Timo Sorsa
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  7. Risto Roine
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  8. Fernanda Ortiz
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Correspondence to Hellevi Ruokonen.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants in the study.

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Ruokonen, H., Nylund, K., Meurman, J.H. et al. Oral symptoms and oral health-related quality of life in patients with chronic kidney disease from predialysis to posttransplantation. Clin Oral Invest 23, 2207–2213 (2019). https://doi.org/10.1007/s00784-018-2647-z

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  • DOI: https://doi.org/10.1007/s00784-018-2647-z

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