Dental Aspects and Neglect in Liver Disease

Dental Aspects

• Dental findings in liver disease
  • Alcoholic cirrhosis is often associated with poor oral hygiene, dental neglect, and dental erosion from gastric reflux.
  • Sialosis/parotid enlargement can occur.
  • Gingival enlargement may result from ciclosporin use after a liver transplant.
  • Children needing liver transplants may experience delayed tooth eruption and discolored/hypoplastic teeth.

Dental Neglect

• Neglect is a contributing factor.
• Poor oral hygiene (OH) is common.
• Increased incidence of tooth decay.
• Increased periodontal disease and inflammation.
• Lack of professional dental care is a problem.

Sialosis

• Images show the visual impact.

Gingival Overgrowth

• Images illustrate the clinical presentation of the condition.

Dental Management

• Increased bleeding risk is a concern.

• Risk of poor wound healing and infection exists.

• Problems metabolizing drugs can occur.

  • This presents challenges to managing medication.

• Infection control: Universal precautions, Hep B vaccination required for staff.

  • Liver transplant patients may need antibiotic coverage for invasive procedures due to their immune suppression.
  • Avoid elective dental procedures for at least six months after a transplant.

• Considerations for treatment:

  • Consider reducing local anesthetic (LA) dosage.
  • Alternative anesthetics like articaine might be preferable to lidocaine.
  • Avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Patients might not metabolize certain drugs efficiently, including antibiotics like tetracycline.

• Prevention is key:

  • Proactive oral hygiene (OHI) is essential.
  • Diet analyses to provide appropriate recommendations are necessary.
  • Prescribe fluoride supplements.
  • Support alcohol cessation.
  • Proactively address smoking cessation.

Summary

• Key functional aspects of the liver. Include the causes and symptoms of liver disease.
• Detail the range of dental implications impacting patients with liver disease.

Further Information

• Cite relevant resources.
  • Include the author, the book, the edition, and the pages.
  • List various URLs for support resources.
  • This includes a YouTube video. Also specific websites (hepatitis, liver trust, and NHS liver disease information)