الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Chronic kidney disease (CKD) is characterized by multiple organ involvement, including complications in the soft and hard tissues of the oral cavity, 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. Moreover, CKD has serious psychosocial consequences that significantly impair the quality of life (QOL) of the patient due to the demands and restrictions brought on by the clinical condition and treatment. This impact is further aggravated by oral disease impairments.
Unfortunately, very limited studies evaluated the oral condition of patients undergoing renal dialysis, particularly among children, with reference to their OHRQOL especially, in Egypt. Therefore, this study was conducted to assess the oral health conditions and the children’s perception regarding their oral health related quality of life, of both groups of children undergoing renal dialysis and a healthy control, in Alexandria.
The present study was based on a cross-sectional, analytical design and included 70 end-stage renal disease children undergoing dialysis, aged 6–18 years, recruited from Alexandria University Children’s Hospital (AUCH) and its outpatient-clinics (nephrology medicine) as well as from Sporting Student’s hospital (Health Insurance). The data were compared with that of a gender and age matched control group. Data were collected using an interview questionnaire (COHQoL) and oral examination. Thes mean df, DMF, GI, Pl.I and CSI scores were recorded. Enamel hypoplasia recorded according to Alaluusa et al criteria was also assessed.
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The results of the study showed that dry mouth and malodor were the most frequent patients’ complaints. Dialysis children had significantly higher plaque, gingival, CSI and enamel hypoplasia scores whereas mean DMFT was higher among healthy children. No statistical significant difference were observed between groups regarding dft.
Regarding oral health related behaviors, healthy children significantly brushed their teeth more frequently than children on renal dialysis, with only one third of the dialysis group brushed regularly. Only 40% of the healthy group used dental floss compared to nobody of the dialysis group. Regarding utilization of dental care, healthy children were significantly more regular users of the dental-care system than the dialysis group, with nearly half of the dialysis group never visited the dentist.
With regards to oral health related quality of life, Children on renal dialysis showed significantly higher scores than their healthy counterparts in all quality of life domains and total score.
Dental health status was found to be significantly affected among the dialysis children and got worsened with the duration of hemodialysis. This was mainly attributed to the oral health negligence on behalf of the patients. 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
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practitioners must be knowledgeable about the treatment priorities, operative concerns and precautions to be taken among this special population.