Impaired renal function in chronic kidney disease (CKD) leads to a mineral imbalance with the development of bone mineral changes and soft tissue calcifications. At the tissue and cellular level, processes are mediated by osteoporosis, hypercalcemia, osteolysis, periodontitis with local destruction, and dental disorders. Bones on the tissue level are constantly being remodeled: they are continually resorbed, built or recovered. Bone demineralization may lead to rapid bone change, including in the maxillofacial area.
Heavily delayed and unequal accumulation of tartar in the hemodialysis patients is probably due to high levels of nitrogen-containing fractions in the saliva as well as chemical trauma to the oral mucosa.
The saliva detects slgA antibodies that are natural and reactive against various saprophytic bacteria. These antibodies can control oral microflora by limiting microbial adhesion to oral mucosa and teeth.
The urea released into the oral cavity is hydrolysed to ammonia, which is responsible for the bitter taste of the mouth (fetor uremicus) and the alkaline pH of the saliva.
Seventy patients - 32 men (45.71%) and 38 women (54.29%), at a mean age 58.9 (SD=14.46) were examined in the Dialysis Clinic. All of them had their sIgA and the degree of halitosis on a particular scale quantified.
Денчева, М,А.Киселова Продължително хемодиализно лечение и влиянието върху оралното здраве.С.,Проблеми на денталната медицина, 2009, том XXXV, част II,59-65
Йонова, Х,Д Ренална остеодистрофия, Издателство:Съяз на учените в България, 2007г.
Bayraktar G, Kurtulus I, Duraduryan A, Cintan S, Kazancioglu R, Yildiz A, Bural C, Bozfakioglu S, Besler M, Trablus S, Issever H. Dental and periodontal findings in hemodialysis patients. Oral Dis. 2007 Jul;13(4):393-7.
Cleber M Souza et al. Oral health in Brazilian patients with chronic renal disease. Rev Méd Chile 2008; 136: 741-746
Curd ML Bollen and Thomas Beikler. Halitosis: the multidisciplinary approach Int J Oral Sci. 2012 Jun; 4(2): 55–63.
Chomyszyn-Gajewska M1, Skrzypek A. Halitosis--diagnosis and treatment. Article in Polish Przegl Lek. 2013;70(2):65-8.
Danese MD, Belozeroff V, Smirnakis K, et al. Consistent control of mineral and bone disorder in incident hemodialysis patients. Clin J Am Soc Nephrol. 2008;3:1423-1429.
De Rossi SS, Glick M. Dental considerations for the patient with renal disease receiving hemodialysis. J Am Dent Assoc. 1996; 127(2):211-9
Dong,B.J.Clinicalcet:an oral calcimimetic agent for the management of hyperparathyroidism.Clin.Ther., 27, 2005, 1725-1751
Dudzik A, Chomyszyn-Gajewska M. Pseudohalitosis and halitophobia. Przegl Lek. 2014;71(5):274-6. Review. Polish.
Goodman WG, Quarles LD. Development and progression of secondary hyperparathyroidism in chronic kidney disease: lessons from molecular genetics. Kidney Int. 2008;74:276-288.
Harun A, et al. Systemic Consequences of Poor Oral Health in Chronic Kidney Disease Patients. J Am Soc Nephrol, 6, 2011, 218–226
Kalender B at al. Quality of life in chronic kidney disease: effects of treatment modality, depression, malnutrition and inflammation. Int J Clin Pract. 2007 Apr;61(4):569-76
Kelly WH at al. Radiographic changes of the jawbones in end stage renal disease. Oral Surg Oral Med Oral Pathol. 1980,50(4):372-81
Kantorowicz M, Chomyszyn-Gajewska M, Olszewska-Czyz I, Łazarz-Bartyzel K. Nutrition and periodontal diseases. Przegl Lek. 2013;70(1):28-30. Review. Polish.
Kantorowicz M, Olszewska-Czyż I, Kolarzyk E, Chomyszyn-Gajewska M. Influence of diet on oral health in young adults--pilot study. Przegl Lek. 2014;71(10):505-11.
Moraes Junior CS, de Mendonça RR, Hatem RO, Souza AL, Chaves A, Bastos MG, The cost of alkaline solutions in ambulatory hemodialysis: an analysis about wasteful from the processes control. Nefrol. 2014 Oct-Dec;36(4):502-11.
Parfrey PS et al. The clinical course of treated hyperparathyroidism among patients receiving hemodialysis and the effect of cinacalcet.Clin Endocrinol Metab,2013, 98(12),4834-44
Proctor R at al. Oral and Dental Aspects of Chronic Renal Failure. Journal of Dental Research; Mar 2005; 84, 3;pg 199
Sobrado Marinho JS at al. Oral health status in patients with moderate-severe and terminal renal failure. Med Oral Patol Oral Cir Bucal. 2007 Aug 1;12(4):E305-10.
Villa A1, Connell CL2, Diagnosis and management of xerostomia and hyposalivation. Abati S3. her Clin Risk Manag. 2014 Dec 22;11:45-51.
