Hepatology Disorders and Dental Impact

Study Notes

Understand epidemiology, manifestations, complications, and management of hepatology disorders affecting dentistry.
Develop skills to interpret clinical manifestations and investigations to create reasonable diagnosis and evidence-based management plans.
Recognize emergency situations in patients with hepatology disorders to ensure proper management and homeostasis.

Inflammation of the liver caused by viruses leading to acute or chronic forms.
Types include Hepatitis A, B, C, D, and E, plus other viruses like EBV and HSV.
Hepatitis A: RNA virus transmitted via the faecal-oral route with no carrier state; 15-50 days incubation; lifelong immunity after infection.
Hepatitis B: DNA virus transmitted sexually, percutaneously, and perinatally; 30-180 days incubation; carries a state; lifelong immunity with vaccination.
Hepatitis C: RNA virus spread percutaneously; 15-160 days incubation; high carrier rate (50-80%); no vaccine available.
Hepatitis D: Defective RNA virus needing Hepatitis B to infect; similar risk groups and incubation as B.
Hepatitis E: Defective RNA virus spread through faecal-oral route; 15-64 days incubation; no carrier state or prophylaxis.
Clinical features include flu-like symptoms, jaundice, abdominal pain, and hepatomegaly. Post recovery hepatomegaly may persist for months.
In dentistry, jaundice of the mucosa is observable during the icteric phase; precautions are vital as all patients are potentially infectious.

Resulting from chronic alcohol abuse, manifesting as fatty liver, alcoholic hepatitis, or cirrhosis.
Symptoms include jaundice, ascites, and various neurological signs like slurred speech or memory issues.
Diagnosis involves history-taking, clinical examination, and specific laboratory tests.
Dental care requires physician consultation, avoidance of hepatotoxic drugs, and attention to potential bleeding issues.

Chronic liver disease characterized by fibrosis and the formation of nodules leading to loss of function; often irreversible.
Common causes: viral infections (HBV, HCV), alcohol, drug-induced liver injury.
Symptoms include jaundice, ascites, and signs of liver failure such as spider nevi and oedema.
Diagnosis confirmed through liver biopsy and blood tests; management focuses on treating complications and potential liver transplant.

Malignancy of the liver, often linked to chronic HBV or HCV infections, or cirrhosis.
Symptoms: abdominal pain, weight loss, ascites, jaundice; notable male to female ratio of 3:1.
Diagnosis involves liver biopsy and alpha-fetoprotein levels; management typically requires surgical intervention or chemotherapy.

Yellow discoloration from elevated bilirubin levels; categorized into prehepatic, hepatic, and cholestatic jaundice.
Symptoms include yellowing of skin and sclera with varying underlying causes such as liver disease or biliary obstruction.
Clinical signs include spider nevi, ascites, and bleeding tendencies; in the dental context, awareness of bleeding risks and infectious controls is crucial.

Accumulation of fluid in the peritoneal cavity linked primarily to liver cirrhosis, but also other conditions like cardiac failure.
Symptoms include abdominal discomfort, increasing girth, and potential shortness of breath.
No specific oral manifestations; however, dental treatment considerations must include the patient’s overall health and potential need for consultations.