Oral health and salivary changes in chronic renal insufficiency patients: what to consider in the dental approach?

Abstract

The kidneys are multifunctional organs that play a fundamental role in maintaining the normal volume of body fluids, in electrolyte and acid-base balance and in the excretion of waste products and pharmacological compounds. Patients with Chronic Renal Insufficiency (CRI) have a high rate of systemic alterations and losing the kidneys' regulatory and excretory functions causes oral manifestations and numerous complications. Individuals undergoing hemodialysis often consider oral health maintenance to be a low priority. The current study aims to describe the common oral manifestations and salivary alterations in individuals with CRI undergoing hemodialysis treatment. 68 articles published in English from PubMed, Wiley Library, Science Direct and Scholar Google were examined to compose an integrative review. One of the first symptoms that occur in more than 90% of patients with kidney disease is uremic odor associated or not with uremic stomatitis, which is characterized by the presence of a red mucous membrane covered with a thin pseudomembrane. Hemodialysis patients are more susceptible to oral pathogens. It is necessary to be aware that oral surgeries on these patients, must be performed the day after hemodialysis treatment so that the drug has been metabolized and thus there are no major complications. Conservative dental care for patients with chronic renal failure seeks to restore oral health and eliminate potential sources of infection.