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Oral health care for patients on dialysis.

Article Excerpt
When providing care for patients on dialysis, there are many issues that must be addressed and monitored very closely. Is oral health on that list? As a dietitian, it has always been on my list, as conventional wisdom indicates that individuals with few or no teeth cannot chew well enough to consume the varied diet necessary to ensure adequate calorie and protein intake, with adequacy of the latter posing the greatest problem. As a renal dietitian, however, I have found that it has even greater consequence. This issue rose toward the top of the list of concerns after one of my patients had all of her teeth extracted, after which, her albumin actually improved and normalized for the first time in her dialysis career. How could this be when the patient was not able to eat even a morsel of meat for a very long time? It became apparent that her ongoing dental problems were an under-appreciated source of inflammation such that a steady increase to 6 scoops of protein powder per day could afford no improvement in her albumin levels before her teeth were removed.

The issue of oral health in patients on dialysis has generated much interest, and numerous articles have been published on this subject, as well as specific recommendations being made in the dental community regarding how to treat these concerns. Oral concerns commonly found in patients on dialysis include halitosis, xerostomia, gingivitis, stomatitis, tooth decay, tooth loss, and jaw problems. Many of these problems...

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