Skip to main content

Advertisement

SpringerLink
Log in

Assessment of the oral health status of children with chronic kidney disease

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Background

There are various oral symptoms related to the disease and its management in individuals with chronic kidney disease (CKD). The aim of the study was to investigate the oral health status of children with different stages of CKD, kidney transplant recipients (KTR), and healthy children.

Methods

A total of seventy-one children diagnosed with CKD and fifty-two healthy children were included in the study. Each patient was examined for dental caries by the decayed-missing-filled-teeth (DMFT/dmft) index and the International Caries Detection and Assessment System (ICDAS-II), developmental defects of enamel (DDE) by the DDE index, and oral hygiene by the debris (DI), calculus (CI), and simplified oral hygiene (OHI-S) indices.

Results

The median number of DMFT/dmft was 1.00 (interquartile range (IQR):1.00–4.00) in children with stage 1–3 CKD, 0.00 (IQR: 0.00–2.50) in stage 4–5 children, 0.00 (IQR: 1.00–3.00) in KTR, and 8.00 (IQR: 1.00–13.00) in healthy children. According to ICDAS-II categories, the percentage of children with severe caries was 53.8% in healthy children, while it was 44.4% in KTR, 25.9% in stage 1–3, and 11.4% in stage 4–5 children. While the percentage of children with DDE was 88.8% in KTR, 80% in stage 4–5, and 66.7% in stage 1–3 children, this rate was 44.2% in healthy children. The highest mean OHI-S score was observed in stage 4–5 children (2.10 ± 1.08), followed by KTR (1.46 ± 1.19), stage 1–3 (1.27 ± 0.61), and healthy children (0.45 ± 0.44), respectively.

Conclusions

Compared to healthy children, children with CKD had more debris accumulation, calculus formation, and more DDE but a lower severity of dental caries.

Graphical abstract

A higher resolution version of the Graphical abstract is available as Supplementary information.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ammirati AL (1992) (2020) Chronic Kidney Disease. Rev Assoc Med Bras 66:s03–s09. https://doi.org/10.1590/1806-9282.66.S1.3

    Article  Google Scholar 

  2. Brück K, Stel VS, Fraser S, De Goeij MC, Caskey F, Abu-Hanna A, Jager KJ (2015) Translational research in nephrology: chronic kidney disease prevention and public health. Clin Kidney J 8:647–655. https://doi.org/10.1093/ckj/sfv082

    Article  CAS  Google Scholar 

  3. Sebastião YV, Cooper JN, Becknell B, Ching CB, McLeod DJ (2021) Prediction of kidney failure in children with chronic kidney disease and obstructive uropathy. Pediatr Nephrol 36:111–118. https://doi.org/10.1007/s00467-020-04661-w

    Article  Google Scholar 

  4. Warady BA, Chadha V (2007) Chronic kidney disease in children: the global perspective. Pediatr Nephrol 22:1999–2009. https://doi.org/10.1007/s00467-006-0410-1

    Article  Google Scholar 

  5. Centres for Disease Control and Prevention (2020) Chronic kidney disease (CKD) surveillance system. https://nccd.cdc.gov/CKD. Accessed 19 Oct 2021

  6. Velan E, Sheller B (2021) Oral health in children with chronic kidney disease. Pediatr Nephrol 36:3067–3075. https://doi.org/10.1007/s00467-020-04913-9

    Article  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. https://doi.org/10.3290/j.qi.a34698

    Article  Google Scholar 

  8. Kesmez Ö, Frøjk MJ, Eidemak I, Jensen SB, Kragelund C (2020) Oral symptoms and pathologies in Danish patients with chronic kidney disease - a pilot study. APMIS 128:401–405. https://doi.org/10.1111/apm.13042

    Article  Google Scholar 

  9. Andaloro C, Sessa C, Bua N, Mantia I (2018) Chronic kidney disease in children: assessment of oral health status. Dent Med Probl 55:23–28. https://doi.org/10.17219/dmp/81747

  10. Nunn JH, Sharp J, Lambert HJ, Plant ND, Coulthard MG (2000) Oral health in children with renal disease. Pediatr Nephrol 14:997–1001. https://doi.org/10.1007/s004670050061

    Article  CAS  Google Scholar 

  11. Martins C, Siqueira WL, Guimarães Primo LS (2008) Oral and salivary flow characteristics of a group of Brazilian children and adolescents with chronic renal failure. Pediatr Nephrol 23:619–624. https://doi.org/10.1007/s00467-007-0718-5

    Article  Google Scholar 

  12. Proctor R, Kumar N, Stein A, Moles D, Porter S (2005) Oral and dental aspects of chronic renal failure. J Dent Res 84:199–208. https://doi.org/10.1177/154405910508400301

    Article  CAS  Google Scholar 

  13. Lucas VS, Roberts GJ (2005) Oro-dental health in children with chronic renal failure and after renal transplantation: a clinical review. Pediatr Nephrol 20:1388–1394. https://doi.org/10.1007/s00467-005-1929-2

    Article  Google Scholar 

  14. Akar H, Akar GC, Carrero JJ, Stenvinkel P, Lindholm B (2011) Systemic consequences of poor oral health in chronic kidney disease patients. Clin J Am Soc Nephrol 6:218–226. https://doi.org/10.2215/CJN.05470610

    Article  Google Scholar 

  15. National Kidney Foundation Kidney Disease Quality Outcome Initiative (K/DOQI) (2002) Clinical practice guidelines for chronic kidney disease: evaluation. Classification and stratification. Am J Kidney Dis 39:128–142

    Google Scholar 

  16. Schwartz GJ, Brion LP, Spitzer A (1987) The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 34:571–590. https://doi.org/10.1016/s0031-3955(16)36251-4

    Article  CAS  Google Scholar 

  17. Luo F, Liao Y, Cui K, Tao Y (2020) Noninvasive evaluation of renal oxygenation in children with chronic kidney disease using blood-oxygen-level-dependent magnetic resonance imaging. Pediatr Radiol 50:848–854. https://doi.org/10.1007/s00247-020-04630-3

    Article  Google Scholar 

  18. Abrão RO, Lopes M, Silva GJS, Ferraro AA, Koch VH (2021) Study of the association between generic and disease-specific quality of life and behavior problems in pediatric patients with chronic kidney disease stage 3 or higher and the quality of life and mental health of their primary caregivers. Pediatr Nephrol 36:3201–3210. https://doi.org/10.1007/s00467-021-04986-0

    Article  Google Scholar 

  19. Zalunardo N, Levin A (2009) Cardiovascular disease in chronic kidney disease. In: Lerma EV, Berns JS, Nissenson AR (eds) Current Diagnosis & Treatment: Nephrology & Hypertension, 1st edn. McGraw-Hill, New York, pp 160–169

    Google Scholar 

  20. Inker LA, Astor BC, Fox CH, Isakova T, Lash JP, Peralta CA, Kurella Tamura M, Feldman HI (2014) KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis 63:713–735. https://doi.org/10.1053/j.ajkd.2014.01.416

    Article  Google Scholar 

  21. Neyzi O, Bundak R, Gökçay G, Günöz H, Furman A, Darendeliler F, Baş F (2015) Reference values for weight, height, head circumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol 7:280–293. https://doi.org/10.4274/jcrpe.2183

    Article  Google Scholar 

  22. World Health Organization (2013) Oral Health Surveys Basic Methods. WHO Press, Geneva

    Google Scholar 

  23. Ekstrand KR, Gimenez T, Ferreira FR, Mendes FM, Braga MM (2018) The International Caries Detection and Assessment System - ICDAS: a systematic review. Caries Res 52:406–419. https://doi.org/10.1159/000486429

    Article  Google Scholar 

  24. Doğan M, Şahiner ÜM, Ataç AS, Ballıkaya E, Soyer ÖU, Şekerel BE (2021) Oral health status of asthmatic children using inhaled corticosteroids. Turk J Pediatr 63:77–85. https://doi.org/10.24953/turkjped.2021.01.009

  25. FDI (1992) A review of developmental defects of enamel index (DDE index). Commission on Oral Health, Research & Epidemiology. Report of an FDI Working Group. Int Dent J 42:411–426

  26. Andrade NS, Dos Santos IT, Lima LMS, Lima CCB, Moura LFAD, Barros SSLV, Moura MS, Lima MDM (2019) Impact of developmental enamel defects on quality of life in 5-year-old children. Int J Paediatr Dent 29:557–565. https://doi.org/10.1111/ipd.12498

    Article  Google Scholar 

  27. Greene JC, Vermillion JR (1964) The simplified oral hygiene index. J Am Dent Assoc 68:7–13. https://doi.org/10.14219/jada.archive.1964.0034

  28. Ertuğrul F, Elbek-Cubukçu C, Sabah E, Mir S (2003) The oral health status of children undergoing hemodialysis treatment. Turk J Pediatr 45:108–113

    Google Scholar 

  29. Limeira FIR, Yamauti M, Moreira AN, Galdino TM, de Magalhães CS, Abreu LG (2019) Dental caries and developmental defects of enamel in individuals with chronic kidney disease: systematic review and meta-analysis. Oral Dis 25:1446–1464. https://doi.org/10.1111/odi.12993

    Article  Google Scholar 

  30. Davidovich E, Davidovits M, Peretz B, Shapira J, Aframian DJ (2009) The correlation between dental calculus and disturbed mineral metabolism in paediatric patients with chronic kidney disease. Nephrol Dial Transplant 24:2439–2445. https://doi.org/10.1093/ndt/gfp101

    Article  CAS  Google Scholar 

  31. Menezes CR, Pereira AL, Ribeiro CC, Chaves CO, Guerra RN, Thomaz ÉB, Monteiro-Neto V, Alves CM (2019) Is there association between chronic kidney disease and dental caries? A case-controlled study. Med Oral Patol Oral Cir Bucal 24:211–216. https://doi.org/10.4317/medoral.22737

    Article  Google Scholar 

  32. Tadakamadla J, Kumar S, Mamatha GP (2014) Comparative evaluation of oral health status of chronic kidney disease (CKD) patients in various stages and healthy controls. Spec Care Dentist 34:122–126. https://doi.org/10.1111/scd.12040

    Article  Google Scholar 

  33. Pakpour AH, Kumar S, Fridlund B, Zimmer S (2015) A case-control study on oral health-related quality of life in kidney disease patients undergoing haemodialysis. Clin Oral Investig 19:1235–1243. https://doi.org/10.1007/s00784-014-1355-6

    Article  Google Scholar 

  34. Andrade MR, Salazar SL, de Sá LF, Portela M, Ferreira-Pereira A, Soares RM, Leão AT, Primo LG (2015) Role of saliva in the caries experience and calculus formation of young patients undergoing hemodialysis. Clin Oral Investig 19:1973–1980. https://doi.org/10.1007/s00784-015-1441-4

    Article  Google Scholar 

  35. Silva TMC, Alves LAC, Garrido D, Watanabe A, Mendes FM, Ciamponi AL (2019) Health and oral health-related quality of life of children and adolescents with chronic kidney disease: a cross-sectional study. Qual Life Res 28:2481–2489. https://doi.org/10.1007/s11136-019-02196-8

    Article  Google Scholar 

  36. Pitts NB, Twetman S, Fisher J, Marsh PD (2021) Understanding dental caries as a non-communicable disease. Br Dent J 231:749–753. https://doi.org/10.1038/s41415-021-3775-4

    Article  Google Scholar 

  37. Sezer B, Çarıkçıoğlu B, Kargül B (2022) Dental age and tooth development in children with molar-incisor hypomineralization: a case-control study. Arch Oral Biol 134:105325. https://doi.org/10.1016/j.archoralbio.2021.105325

    Article  CAS  Google Scholar 

  38. Ibarra-Santana C, Ruiz-Rodríguez Mdel S, Fonseca-Leal Mdel P, Gutiérrez-Cantú FJ, Pozos-Guillén Ade J (2007) Enamel hypoplasia in children with renal disease in a fluoridated area. J Clin Pediatr Dent 31:274–278. https://doi.org/10.17796/jcpd.31.4.m97777625k278261

  39. Andrade MR, Mendes PC, Primo LG (2013) Dental findings in a child with chronic renal failure secondary to cystinosis. Gen Dent 61:16–17

    Google Scholar 

  40. Al-Nowaiser A, Roberts GJ, Trompeter RS, Wilson M, Lucas VS (2003) Oral health in children with chronic renal failure. Pediatr Nephrol 18:39–45. https://doi.org/10.1007/s00467-002-0999-7

    Article  Google Scholar 

  41. Caliento R, Sarmento DJS, Silva ÉMP, Tozetto-Mendoza TR, Tobouti PL, Benini V, Braz-Silva PH, Gallottini M (2018) Oral shedding of HSV-1 and EBV and oral manifestations in paediatric chronic kidney disease patients and renal transplant recipients. Acta Odontol Scand 76:539–544. https://doi.org/10.1080/00016357.2018.1437218

    Article  Google Scholar 

  42. Akcalı A (2000) Lang NP (2018) Dental calculus: the calcified biofilm and its role in disease development. Periodontol 76:109–115. https://doi.org/10.1111/prd.12151

    Article  Google Scholar 

  43. Al Nowaiser A, Lucas VS, Wilson M, Roberts GJ, Trompeter RS (2004) Oral health and caries related microflora in children during the first three months following renal transplantation. Int J Paediatr Dent 14:118–126. https://doi.org/10.1111/j.1365-263x.2004.00534.x

    Article  CAS  Google Scholar 

  44. Sarmento DJS, Caliento R, Maciel RF, Braz-Silva PH, Pestana JOMA, Lockhart PB, Gallottini M (2020) Poor oral health status and short-term outcome of kidney transplantation. Spec Care Dentist 40:549–554. https://doi.org/10.1111/scd.12512

    Article  Google Scholar 

  45. Schmalz G, Patschan S, Patschan D, Ziebolz D (2020) Oral health-related quality of life in adult patients with end-stage kidney diseases undergoing renal replacement therapy - a systematic review. BMC Nephrol 21:154. https://doi.org/10.1186/s12882-020-01824-7

    Article  Google Scholar 

  46. Chankanka O, Levy SM, Warren JJ, Chalmers JM (2010) A literature review of aesthetic perceptions of dental fluorosis and relationships with psychosocial aspects/oral health-related quality of life. Community Dent Oral Epidemiol 38:97–109. https://doi.org/10.1111/j.1600-0528.2009.00507.x

    Article  Google Scholar 

  47. Ruokonen H, Nylund K, Meurman JH, Heikkinen AM, Furuholm J, Sorsa T, Roine R, Ortiz F (2019) Oral symptoms and oral health-related quality of life in patients with chronic kidney disease from predialysis to posttransplantation. Clin Oral Investig 23:2207–2213. https://doi.org/10.1007/s00784-018-2647-z

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Dentistry, School of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Turkey

    Berkant Sezer

  2. Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey

    Remziye Kaya, Nur Kodaman Dokumacıgil & Betül Kargül

  3. Department of Biostatistics, School of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey

    Duygu Sıddıkoğlu

  4. Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Marmara University, Istanbul, Turkey

    Serçin Güven, Nurdan Yıldız & Harika Alpay

Authors
  1. Berkant Sezer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Remziye Kaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nur Kodaman Dokumacıgil
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Duygu Sıddıkoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Serçin Güven
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nurdan Yıldız
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Harika Alpay
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Betül Kargül
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study conception and design: SB, AH, and KB. Acquisition of data: SB, KR, KDN, GS, and YN. Analysis and interpretation of data: SB and SD. Drafting of manuscript: SB. Critical revision: SB, SD, GS, YN, AH, and KB.

Corresponding author

Correspondence to Berkant Sezer.

Ethics declarations

Ethics approval

The present study was approved by the Marmara University School of Medicine Clinical Research Ethical Committee (with protocol number: 09.2021.290). The study was carried out within the ethical principles of the Declaration of Helsinki.

Consent to participate

Before starting the study, the patients’ parents or caregivers were informed about the study and signed informed consent forms.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Graphical Abstract (PPTX 150 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sezer, B., Kaya, R., Kodaman Dokumacıgil, N. et al. Assessment of the oral health status of children with chronic kidney disease. Pediatr Nephrol 38, 269–277 (2023). https://doi.org/10.1007/s00467-022-05590-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-022-05590-6

Keywords

Search

Navigation