Oral health protocol for liver transplant patients

Chronic liver disease and cirrhosis were the ninth leading cause of death in Brazil in 2011. Infectious complications are major factors for morbidity and mortality in liver transplant recipients. Oral infection is a cause of systemic infection for both liver transplant candidates and recipients. Liver transplant patients are at high risk of oral infection and preventive measures are mandatory. Oral treatment is feasible to the majority of patients awaiting liver transplantation. However, protocols for oral lesions management in liver transplant patients are not established in literature yet. The aim of the present study is to describe an oral health protocol for liver transplant patients based in our 12 years of experience in diagnosing and treating oral disease in the Liver Transplantation Clinic, Federal University of Bahia, Brazil. This protocol was developed by a multidisciplinary team of transplant surgeons, hepatologists, transplant nurses and dentists. All patients are evaluated by the hepatology team that assess liver disease severity and refer them to oral care. The oral assessment is carefully carried out. Additional complementary examinations are necessary to conclude diagnosis and proceed to an individual treatment plan. When oral surgery is necessary, coagulation factors, liver disease severity and the extent of surgical procedure are evaluated for each patient.