[Dental problems and their management in uraemic patients]

Bad dental status is very often observed in hemodialyzed patients due to the fact of a frequent poor oral hygiene and, in addition of the traditional risk factors, the consequences of uraemic state and its treatment. However , among such immunodepressed patients, oral and dental lesions represent a risk of septic complications. Moreover some works point out the prevalence of inflammation and denutrition due to dental lesions in the uraemic population, with potential atherosclerosis. Therefore, in order to anticipate all these adverse effects and to restore their mouth to health, patients have to be encouraged to have regularly a full dental evaluation and correction if not elimination of all potential sources of infection and other complications. To ensure the best treatment, a close collaboration has to be established with dental practitioners who must be aware and convinced of the complexity of such patients: immunodepression due to uraemic state and sometimes to drug therapy; importance of prophylactic antibiotic therapy surrounding dental cares; cautions to hemostasis circumstances; adjusted use of some medications. To illustrate this matter, we report here a study involving 96 hemodialyzed patients who were investigated by panoramic radiography and clinical cross- examination about their dental complaints and habits. We then expose our practices and detail our collaboration with their dentists in establishing a plan of dental treatment.