Dental Concern of Children with Renal Diseases - A Narrative Review
Renal failure leads to a drop in glomerular infiltration rate which results in progressive hypertension, fluid retention and build-up of metabolites that are not excreted normally. Disorders of the kidneys can be classified into the following diseases or stages: disorders of hydrogen ion concentration (pH) and electrolytes, acute renal failure (ARF), chronic renal. Failure (CRF) and end-stage renal failure to uremic syndrome. Burning sensation of the lips and tongue. Children usually exhibit growth retardation, bleeding tendency due to capillary fragility and thrombocytopenia is positive, pale and anaemic. Caries rate is lower in children with end stage renal disease, possibly caused by ammonia being released in saliva. Teeth calcifying during renal failure will exhibit chronological hypoplasia or hypomineralisation and teeth may be brown or green due to incorporation of blood products such as biliverdin. Pale oral mucosa, uremic stomatitis, enamel hypoplasia and dry mouth due to decreased salivary secretion. Drugs to be avoided are paracetamol, pencillin, tetracycline and chloramphenicol. Bleeding is a prime concern. Appropriate precautions should be taken, including aggressive local hemostatic measures. Extractions, placement of orthodontic brackets, removal of calculus, periodontal treatment, endodontic procedures, implants, periapical surgery, reimplantation procedures done under antibiotic prophylaxis. Avoid aspirin and NSAIDs. Other analgesics should be prescribed. This article discuss about aetiology, clinical features and management of children with renal diseases.
Nirmala SVSG, Minor Babu and Saikrishna Degala