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Oral hygiene vital to kidney, liver transplant patients, says expert

By Nina Garlo-Melkas, MSc - Health, Science Journalist

Tue. 2 January 2024


Oral infectious diseases expert Professor Jukka Meurman, in a recent interview with Dental News, has highlighted the importance of oral health in maintaining overall health, stressing that it becomes especially crucial for kidney and liver patients who undergo organ transplant because oral cavity bacteria can critically harm them by aggravating their condition.

Prof Meurman is an eminent figure in the field of oral infectious diseases. Presently, he holds the title of Professor Emeritus at the University of Helsinki, and serves as the Head Physician at the Department of Oral and Maxillofacial Diseases at Helsinki University Hospital, Finland. His contributions have earned him numerous prestigious honors and accolades. Notably, in 1991, he received the Echelon Argent of Ville de Paris, France, presented by President Chirac. The International Association for Dental Research (IADR) recognised his work with the Geriatric Oral Research Award in 2005. In 2009, he received his third  doctor honoris causa from the Medical University of Plovdiv, Bulgaria.

He is a member ad hominis of the Royal Society of Surgeons in Edinburgh (FDSRCS), an invited member of the German Leopoldina National Academy of Sciences (ML), and currently serves as the Chair of the Finnish Society of Sciences and Letters.

Prof Meurman said that individuals with kidney and liver diseases, especially those on immunosuppressive medication, are more susceptible to oral infections. Inflamed gums serve as a potential entry point for harmful bacteria into the bloodstream, leading to systemic problems.

Recent research points to the importance of maintaining robust oral hygiene, particularly in kidney and liver disease management. Transplant patients, prone to increased oral infection risks, stand to benefit significantly from proactive oral healthcare.

Poor oral health increases vulnerability to inflammation, compromising immunity and challenging the management of kidney and liver diseases for patients. He also suggests that dental infections may increase the risk of cancer.

Bacteraemia, a bacterial infection entering the bloodstream, poses a significant concern for individuals with chronic conditions. In severe instances, bacteraemia can escalate to sepsis, causing damage to organs. Since the oral cavity is a common site for regular bacterial growth, maintaining the health of mucous membranes, teeth, and gums is crucial, especially for those with weakened immune systems.

Dental procedures can act as triggers for bacteraemia, increasing the risk of bacterial endocarditis, particularly in individuals prone to heart disease. For those with compromised immunity, bacterial endocarditis can be exceptionally severe, necessitating immediate treatment.

Given the enduring susceptibility to infections for transplant patients, maintaining good oral hygiene is an ongoing commitment, starting well before any surgery.

Prof Meurman stresses the importance of identifying and addressing oral and dental infections before undergoing transplantation surgery, a process that may include extracting infected teeth. However, a tailored treatment approach considers the patient's commitment to sustaining oral health and aligns with the transplant schedule. In specific situations, efforts can be made to preserve and restore teeth, mitigating the need for extractions. The ultimate goal is to maintain oral health through routine oral hygiene practices, rather than addressing problems only when they escalate to a severe stage.

Oral health significantly influences a patient's quality of life. Dental issues can result in pain, discomfort, and heightened stress, impacting both overall well-being and the efficacy of treatments for underlying diseases.

Sustaining optimal oral health requires regular dental check-ups and oral hygiene practices, especially for individuals using immunosuppressive drugs. These medications can compromise the immune system's ability to combat oral bacteria, increasing the risk of gingivitis and periodontitis.

A positive shift in oral health is underway with Finnish researchers introducing an antibacterial oral health-enhancing device named Lumoral. Grounded in antibacterial photodynamic therapy, this approach successfully targets bacteria linked to tooth decay and gingivitis. Lumoral has earned endorsement from the Finnish Association of Oral Hygienists and is designed for home use. It serves as a complementary tool to conventional oral hygiene practices like brushing and flossing.

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