Periodontal Status and Oral Hygiene Habits in End Stage Renal Disease (esrd) Patients Undergoing Dialysis

Chronic renal failure is a progressive disease caused by the damage of the functional unit of the kidney, the nephron. Periodontal diseases are common among renal failure patients; however this relationship is not clearly understood. The aim of this study was to evaluate the oral hygiene habits and its impact on periodontal status in end stage renal disease (ESRD) patients. Eighty ESRD patients attending the Tygerberg Hospital Renal Unit and stable on haemodialysis or peritoneal dialysis for at least 3 months participated in the study. Patient demographics, smoking status and type of dialysis were obtained from the patient’s file. Patients were asked to complete a questionnaire about their oral hygiene habits. The periodontal examination was done by a single blinded examiner. The periodontal examination included assessment of gingival index (GI), bleeding on probing (BoP), probing depths (PD) and clinical attachment loss (CAL). All periodontal examinations were confined to the six ‘Ramjford teeth’. The presence of one sextant showing GI ≥ 2, PD > 4 mm or CAL > 3 mm and positive bleeding on probing was considered diagnostic of periodontal disease. Mean age of the participants was 50.3 ± 9.06 years; with a median time on dialysis therapy of 24 months (range 3-156 months), Forty-six (57.5%) subjects were diagnosed as having periodontal disease. Forty subjects (50%) reported brushing twice a day (BD) and six (7.5%) three times a day (TDS). Most of them (85%) never used dental floss. Only 22.5% used mouth wash in their daily routine and majority of them (70%) visited their dentist only in case of some dental problem. There was statistically significant difference in the periodontal status with regards to brushing frequency, use of mouth wash and visit to dentist. However, no significant difference was found for the use of floss. Oral hygiene habits show significant impact on the periodontal status of ESRD patients.