الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Chronic kidney disease (CKD) is characterized by a number of systemic complications that result from a profound hydro-electrolytic, metabolic, and immunological imbalance. Despite the improvements in patient care and renal replacement therapy, the impact of CKD on patient’s morbidity and mortality is extremely high.
The main aim of this study was to assess the oral health status of a sample of Egyptian adult patients undergoing hemodialysis, in Alexandria. In addition, the effect of anxiety, stress and depression on their perceived oral health and oral health-related behaviors was also detected.
The present research was conducted on 466 adult patients with terminal chronic kidney disease, undergoing hemodialysis in different public and private hospitals, in Alexandria, namely Abokeer hospital, Raselteen hospital, El-Agamy hospital, Shark-ElMadina hospital, Elkabary hospital, Karmoz hospital, Gamal AbdelNaser hospital, El-Mowasah university hospital, Ahmad Maher hospital, Alexandria police hospital and petrol hospital.
All participants were subjected to an interview questionnaire as well as oral examination. Data were collected using a specially designed sheet inquiring about the socio-demographic, the general heath and the oral hygiene information as well as the oral health status of the study sample.
The results of the study showed that dry mouth and altered taste sensation were the most frequent patients’ complaints. About 53.4% perceived poor and very poor oral health. Furthermore, 62% of the participants were not satisfied with the appearance of their own teeth, 80.6% had extracted teeth and90.2% had periodontal disease. The mean PLI and GI scores were 0.99±0.75 and 0.65±0.57, respectively, whereas the mean DMFT score of the study participants was 8.63±8.12.
Regarding oral health related behaviors, 27.7% of the participants brushed their teeth once a day or less, 91.2% never used dental floss and 76.2% never used mouth rinse. Only 24.2% of the participants were regular users of the dental-care system (i.e. they had at least one dental visit in the last year) and 97% had seen the dentist only on emergency basis. The main reasons for not visiting the dentist were attributed to fear of dental pain and financial problems among 30.9% and 25.1% of the participants, respectively. A high percentage of dialysis patients suffered from anxiety (75.5%), stress (75.1%) and depression in everyday life (54.5%).
Dental health status was found to be significantly affected among the HD patients and got worsened with the duration of hemodialysis and the type of underlying kidney disease. This was mainly attributed to the oral health negligence on behalf of the patients contributing to the high prevelance of periodontitis and tooth loss. Further emphasis on the implementation of an effective oral health promotion program for medically compromised patients is, thus, advocated.
Awareness must be raised not only among dialysis patients, but also among their nephrologists and their dentists about the need for primary health care. Dentists will probably see more dialysis patients in the future, as there is an annual growth in the incidence of end-stage renal disease worldwide. Therefore, dental health practitioners must be knowledgeable about the treatment priorities, operative concerns and precautions to be taken among this special population.