Fig. 6.1
Dental infections associated with the incidence of complications after liver transplantation. Patients who had no dental examination and treatment because of emergency operation had more posttransplant complications than those whose dental problems had been treated (Modified from Helenius-Hietala et al. 2013)
Nagao et al. (2014) reported that periodontal disease may worsen the progression of liver disease caused hepatitis virus infection by reducing platelet count, for example, with OR 5.80 (95 % CI 2.30–14.92). The periodontal pathogen Porphyromonas gingivalis has also been linked to the progression of liver disease in patients with nonalcoholic fatty liver (Yoneda et al. 2012). In addition, periodontitis has been shown to be associated with hepatocellular carcinoma (Tamaki et al. 2011). Periodontitis may further enhance alcohol-induced liver damage as shown in an animal experiment (Tomofuji et al. 2008). The importance of lipid and sugar metabolism of the liver was further emphasized in a study where periodontitis was associated with hepatic steatosis (Saito et al. 2006). In this investigation, the severity of periodontitis increased with elevated serum values measuring liver function.
Conclusion
Scientific evidence of the role of oral infections in renal and liver diseases is still weak. However, it is known that chronic oral infections such as periodontitis affect many systemic metabolic pathways and by causing endothelial dysfunction, for example, which is detrimental in all organs (Janket et al. 2008). Studies have shown that if eradication of dental infection foci has been neglected, the outcome of patients with kidney or liver disease may be compromised. Hence, maintaining good oral health and treating infection foci properly is highly important also in these patient groups (Table 6.1).
Table 6.1
Aspects of oral infections in patients with kidney and liver diseases
|
Chronic kidney disease
|
Liver disease
|
|---|---|
|
Streptococcal glomerulonephritis is the type of infection often caused by Viridans streptococci
|
Dental infections may cause liver abscesses
|
|
Periodontal disease is prevalent among the patients
|
Xerostomia affects detrimentally oral health
|
|
Periodontal pathogens have been associated with chronic kidney disease
|
Poor dental health associates with complications in liver transplantation
|
|
Treating oral and dental infections necessary before dialysis/kidney transplantation
|
Treating oral and dental infections necessary before liver transplantation
|
References
Ardalan MR, Ghabili K, Pourabbas R, Shoja MM. A causative link between periodontal disease and glomerulonephritis: a preliminary study. Ther Clin Risk Manag. 2011;7:93–8.PubMedCentralPubMed
Atkins RC. The epidemiology of chronic kidney disease. Kidney Int. 2005;67:S14–8.CrossRef
Chambrone L, Foz AM, Guglielmetti MR, Pannuti CM, Artese HP, Feres M, Romito GA. Periodontitis and chronic kidney disease: a systematic review of the association of diseases and the effect of periodontal treatment on estimated glomerular filtration rate. J Clin Periodontol. 2013;40:443–56.CrossRefPubMed
Del Mar CB, Glasziou PP, Spinks AB. Antibiotics for sore throat. Cochrane Database Syst Rev. 2004;(2):CD000023.
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