Oro-Dental Health and Primary Nephrotic Syndrome among Vietnamese Children.

Hang Minh Luong,Hanh Tran Thi Duc,Son Minh Tong,Tra Thu Nguyen,Duc Minh Nguyen,Huong Thu Nguyen,Phung Thi Tran,Phuong-Nga Nguyen,Huy-Thinh Tran

doi:10.3390/children8060494

Abstract

Primary nephrotic syndrome (PNS) is common in children, affecting the soft and hard tissues of the oral cavity. This study aimed to investigate the percentage of dental caries, gingivitis, hypertrophic gingivitis, and developmental defects of enamel (DDE) in children with PNS. The association of PNS with these diseases and oral care behavior was also assessed. A total of 407 children with PNS and 407 age- and gender-matched controls were recruited. PNS was diagnosed based on blood and urinary tests. The Simplified Oral Hygiene Index (OHI-S), the Gingival Index (GI), the Gingival Overgrowth Index (GOI), the Decayed, Missing, and Filled Teeth Index (dmft/DMFT), and DDE were collected. The PNS patients showed significantly higher scores of OHI-S, GI, and dmft, and higher proportions of dental caries and DDE than those of the controls (p < 0.001). It is necessary to establish a periodic dental protocol for PNS patients to improve their oral health status.

Highlights

Nephrotic syndrome (NS) is a common chronic kidney disorder in children characterized by an excessive urinary protein level [1]
NS is associated with several renal diseases, the most common form in children is primary nephrotic syndrome (PNS) [2]
Chi-square analyses show that the PNS group has a 1.301-fold higher risk of gingivitis (p = 0.001), a 10-times higher risk of severe gingivitis (p = 0.000001), and a 14.25-times higher risk of gingivitis overgrowth (p = 0.000001) compared with the control group

Summary

Introduction

Nephrotic syndrome (NS) is a common chronic kidney disorder in children characterized by an excessive urinary protein level [1]. NS is associated with several renal diseases, the most common form in children is primary nephrotic syndrome (PNS) [2]. PNS is frequently treated with corticosteroids and can be classified into steroid-sensitive and steroid-resistant types based on the response to therapy [1]. Drugs used in NS treatment, such as cyclosporin or nifedipine, might be a causative factor of gingivitis and hypertrophic gingivitis [4,5,6]. Hypertrophic gingivitis is typical in patients treated with cyclosporin or nifedipine [7,8]. The prevalence of gingivitis in children with PNS is from 94.3% to 100%, with mostly mild and moderate forms [8]. The hypertrophic gingivitis occurs mainly at the buccal papillae, affecting aesthetics and oral hygiene, further leading to delayed tooth eruption and malocclusion [9]

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