DENTAL MANAGEMENT IN LIVER CIRRHOSIS

Abstract

Objective: To evaluate the dental management of patients with liver cirrhosis. Study design: Integrative review, with searches accomplished through the descriptors and Boolean operators: (liver cirrhosis OR hepatic cirrhosis OR hepatic cirrhoses OR liver fibroses OR liver fibrosis) AND (oral health OR dental treatment OR dental services OR dentistry OR diagnosis, oral OR mouth diseases OR mouth rehabilitation) in the PubMed and Bireme databases. A total of 2274 articles were found in PubMed, 307 articles were found in the Bireme, and 13 of them were selected for this review. Results: There is no consensus in the literature about the risk of bleeding after dental procedures in patients with cirrhosis, and most of the studies haven’t found any relation between the laboratory examinations carried out and the risk of bleeding. A platelet level of ≥ 100,000/mm3 is recommended for surgical procedures presenting greater risk of bleeding and a platelet level of 50,000/mm3 for procedures presenting a lower risk. Patients with cirrhosis who have a platelet level of > 40,000/mm3 and an international normalized ratio (INR) < 2.5 can be considered low risk for bleeding after tooth extraction. Conclusion: Dental management of the patient with cirrhosis has a series of specific features, which must be known so as to avoid possible complications. Objective: To evaluate the dental management of patients with liver cirrhosis. Study design: Integrative review, with searches accomplished through the descriptors and Boolean operators: (liver cirrhosis OR hepatic cirrhosis OR hepatic cirrhoses OR liver fibroses OR liver fibrosis) AND (oral health OR dental treatment OR dental services OR dentistry OR diagnosis, oral OR mouth diseases OR mouth rehabilitation) in the PubMed and Bireme databases. A total of 2274 articles were found in PubMed, 307 articles were found in the Bireme, and 13 of them were selected for this review. Results: There is no consensus in the literature about the risk of bleeding after dental procedures in patients with cirrhosis, and most of the studies haven’t found any relation between the laboratory examinations carried out and the risk of bleeding. A platelet level of ≥ 100,000/mm3 is recommended for surgical procedures presenting greater risk of bleeding and a platelet level of 50,000/mm3 for procedures presenting a lower risk. Patients with cirrhosis who have a platelet level of > 40,000/mm3 and an international normalized ratio (INR) < 2.5 can be considered low risk for bleeding after tooth extraction. Conclusion: Dental management of the patient with cirrhosis has a series of specific features, which must be known so as to avoid possible complications.