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

Sezer, Berkant; Kaya, Remziye; Dokumacıgil, Nur Kodaman; Sıddıkoğlu, Duygu; Güven, Serçin; Yıldız, Nurdan; Alpay, Harika; Kargül, Betül

doi:10.1007/s00467-022-05590-6

Cited by 12 publications

(9 citation statements)

References 40 publications

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“…[ 16‐23 ] The effects of CKD‐associated enamel hypoplasia on dental caries are not entirely clear due to mixed results from case reports; notably, several case studies report reduced prevalence of caries in children with CKD compared to healthy controls. [ 16‐23 ]…”

Section: Discussionmentioning

confidence: 99%

“…Early-onset forms of CKD due to genetic or environmental disruptions of renal function can disrupt enamel formation in primary and/or secondary dentition (depending on age of onset and severity of renal failure), resulting in enamel hypoplasia and discoloration that have a negative impact on esthetics and quality of life. [16][17][18][19][20][21][22][23] The effects of CKD-associated enamel hypoplasia on dental caries are not entirely clear due to mixed results from case reports; notably, several case studies report reduced prevalence of caries in children with CKD compared to healthy controls. [16][17][18][19][20][21][22][23] While many studies have examined the effects of renal failure and CKD-MBD on ROD in the postcranial skeleton in mice, very few reports have analyzed the associated dentoalveolar defects.…”

Section: Journal Of Bone and Mineral Researchmentioning

confidence: 99%

“…[16][17][18][19][20][21][22][23] The effects of CKD-associated enamel hypoplasia on dental caries are not entirely clear due to mixed results from case reports; notably, several case studies report reduced prevalence of caries in children with CKD compared to healthy controls. [16][17][18][19][20][21][22][23] While many studies have examined the effects of renal failure and CKD-MBD on ROD in the postcranial skeleton in mice, very few reports have analyzed the associated dentoalveolar defects. In the EC-5/6Nx model of CKD we previously described, 18-weekold dilute brown agouti/2 (DBA/2) mice underwent dietary alteration and two renal surgeries over the course of 14-15 weeks.…”

Section: Journal Of Bone and Mineral Researchmentioning

confidence: 99%

“…CKD has also been linked to developmental enamel defects in primary and secondary teeth. [17][18][19][20][21]66] Children with early-onset CKD were found to have increased debris, calculus, and incidence of developmental defects of enamel but lower incidence and severity of caries in several studies. [11,12,[17][18][19][20][21] The timing of induction of kidney damage is not critical when evaluating the mouse incisor, as this continuously erupting tooth presents all stages of odontogenesis at any given time.…”

Section: Journal Of Bone and Mineral Researchmentioning

confidence: 99%

“…[4][5][6][7][8][9][10][11][12][13][14][15] Early-onset forms of CKD affecting young children can disrupt amelogenesis in primary and/or secondary dentition, resulting in enamel hypoplasia and discoloration, with reduced caries indices but a negative impact on quality of life. [11,12,[16][17][18][19][20][21][22][23] Mechanisms underlying these oral defects remain poorly understood.…”

Section: Introductionmentioning

confidence: 99%

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Dentoalveolar Alterations in an Adenine‐Induced Chronic Kidney Disease Mouse Model

Mohamed,

Amadeu de Oliveira,

Kinoshita

et al. 2023

J of Bone & Mineral Res

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Chronic kidney disease (CKD) is characterized by kidney damage and loss of renal function. CKD mineral and bone disorder (CKD–MBD) describes the dysregulation of mineral homeostasis, including hyperphosphatemia and elevated parathyroid hormone (PTH) secretion, skeletal abnormalities, and vascular calcification. CKD–MBD impacts the oral cavity, with effects including salivary gland dysfunction, enamel hypoplasia and damage, increased dentin formation, decreased pulp volume, pulp calcifications, and altered jaw bones, contributing to clinical manifestations of periodontal disease and tooth loss. Underlying mechanisms are not fully understood, and CKD mouse models commonly require invasive procedures with high rates of infection and mortality. We aimed to characterize the dentoalveolar effects of an adenine diet (AD)‐induced CKD (AD–CKD) mouse model. Eight‐week‐old C57BL/6J mice were provided either a normal phosphorus diet control (CTR) or adenine and high‐phosphorus diet CKD to induce kidney failure. Mice were euthanized at 15 weeks old, and mandibles were collected for micro–computed tomography and histology. CKD mice exhibited kidney failure, hyperphosphatemia, and hyperparathyroidism in association with porous cortical bone in femurs. CKD mice showed a 30% decrease in molar enamel volume compared to CTR mice. Enamel wear was associated with reduced ductal components, ectopic calcifications, and altered osteopontin (OPN) deposition in submandibular salivary glands of CKD mice. Molar cusps in CKD mice were flattened, exposing dentin. Molar dentin/cementum volume increased 7% in CKD mice and pulp volume decreased. Histology revealed excessive reactionary dentin and altered pulp‐dentin extracellular matrix proteins, including increased OPN. Mandibular bone volume fraction decreased 12% and bone mineral density decreased 9% in CKD versus CTR mice. Alveolar bone in CKD mice exhibited increased tissue‐nonspecific alkaline phosphatase localization, OPN deposition, and greater osteoclast numbers. AD–CKD recapitulated key aspects reported in CKD patients and revealed new insights into CKD‐associated oral defects. This model has potential for studying mechanisms of dentoalveolar defects or therapeutic interventions. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

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Section: Discussionmentioning

confidence: 99%

Section: Journal Of Bone and Mineral Researchmentioning

confidence: 99%

Section: Journal Of Bone and Mineral Researchmentioning

confidence: 99%

Section: Journal Of Bone and Mineral Researchmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dentoalveolar Alterations in an Adenine‐Induced Chronic Kidney Disease Mouse Model

Mohamed,

Amadeu de Oliveira,

Kinoshita

et al. 2023

J of Bone & Mineral Res

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The association between dental caries and steroid-sensitive nephrotic syndrome in children

Gu,

Wang,

Shi

et al. 2023

Pediatr Nephrol

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Evaluation of UK paediatric nephrology teams’ understanding, experience and perceptions of oral health outcomes and accessibility to dental care: a mixed-methods study

Wallace,

Vernazza,

Emmet

et al. 2024

Pediatr Nephrol

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Background Oral health conditions are common in children and young people (CYP) with kidney disorders. There is currently limited literature on how confident paediatric nephrology teams feel to identify and manage oral health concerns for their patients. Method An exploratory mixed-method survey was distributed across all 13 UK specialist paediatric nephrology centres with responses received from consultants, registrars, specialist nurses and special interest (SPIN) paediatricians. Results Responses received from 109 multidisciplinary team members of 13/13 (100%) UK tertiary units. Ninety-two percent (n = 100) of respondents reported they had never received any training in oral health and 87% (n = 95) felt that further training would be beneficial to optimise care for patients and improve communication between medical and dental teams. Most respondents reported that they did not regularly examine, or enquire about, their patients’ oral health. Only 16% (n = 17) reported that all their paediatric kidney transplant recipients underwent routine dental assessment prior to transplant listing. Severe adverse oral health outcomes were rarely reported and only 11% (n = 12) of respondents recalled having a patient who had a kidney transplant delayed or refused due to concerns about oral infection. Seventy-eight percent (n = 85) felt that joint working with a dental team would benefit patients at their unit; however, 17% (n = 18) felt that current infrastructure does not currently support effective joint working. Conclusions Across the UK, paediatric kidney health professionals report lack of confidence and training in oral health. Upskilling subspecialty teams and creating dental referral pathways are recommended to maximise oral health outcomes for CYP with kidney diseases. Graphical abstract

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

Cited by 12 publications

References 40 publications

Dentoalveolar Alterations in an Adenine‐Induced Chronic Kidney Disease Mouse Model

Dentoalveolar Alterations in an Adenine‐Induced Chronic Kidney Disease Mouse Model

The association between dental caries and steroid-sensitive nephrotic syndrome in children

Evaluation of UK paediatric nephrology teams’ understanding, experience and perceptions of oral health outcomes and accessibility to dental care: a mixed-methods study

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