Oral aspects of chronic renal failure

Diseases such as diabetes mellitus, hypertension, chronic glomerulonephritis, uropathy and autoimmune diseases are considered the most frequent causes of renal failure. The aim of this study was to investigate oral manifestations caused by chronic renal failure. Oral manifestations of chronic renal failure include dysgeusia, stomatitis, decreased salivary flow rate, xerostomia and parotitis; moreover, dental oriented conditions include narrowing of pulp chamber, enamel abnormalities, tooth loss and periodontal disease. The most frequent dilemma in patients with Kidney failure is Renal Osteodystrophy. Chronic renal failure could be treated by renal replacement therapy, hemodialysis and peritoneal dialysis. These are methods of removing nitrogenous and other toxic byproducts of metabolized blood. Oral maladies due chronic renal failure occur because of immunosuppressive medications. However, this kind of therapy could be challenging as it causes gingival inflammation due to increased plaque deposition; which in turn affects the periodontal tissues. A good oral hygiene may reduce the risk of oral infections in chronic renal failure patients. The awareness about kidney related diseases is often neglected; however, the number of patients with oral manifestations related to chronic renal failure is miraculous

Halitosis

Halitosis is a broad term describing a range of unpleasant or offensive odours emitted in the breath, due to multiple causes.2 Volatile sulphur compounds may be the main source of oral malodor. The source may be oral or non-oral. Non-oral causes of bad breath are mostly related to systemic conditions and/or drugs prescribed by the physicians to treat medical conditions such as diabetes, liver disorder, kidney malfunctioning, pulmonary disease etc. Medications which reduce salivary flow like antipsychotics, narcotics, antidepressants, decongestants, antihistamines and antihypertensives may also be responsible.3 Oral causes of bad odor are mainly the gram-negative anaerobic bacteria, especially those localized at posterior surface of the tongue and within the surface of tongue and in throat. Oral malodours were drastically reduced after treating chronic periodontitis. Diagnosis can be confirmed by one of the 3 techniques which are; Organoleptic measurement, Gas Chromatography and Sulphide Monitoring. The treatment plan comprises elimination of the causative agent and improvement of the oral health status