Dental considerations in patients with liver disease
- Autores: Marta Cruz Pamplona, María Margaix Muñoz, María Gracia Sarrión Pérez
- Localización: Journal of Clinical and Experimental Dentistry, ISSN-e 1989-5488, Vol. 3, Nº. 2 (Abril), 2011, págs. 127-134
- Idioma: inglés
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Resumen
Introduction: Liver diseases are very common, and the main underlying causes are viral infections, alcohol abuse and lipid and carbohydrate metabolic disorders. The liver has a broad range of functions in maintaining homeostasis and health, and moreover metabolizes many drug substances. Objective: An update is provided on the oral manifestations seen in patients with viral hepatitis, alcoholic and non-alcoholic liver disease, cirrhosis and hepatocellular carcinoma, and on the dental management of such patients. Material and methods: A Medline-PubMed search was conducted of the literature over the last 15 years using the keywords: “hepatitis”, “alcoholic hepatitis”, “fatty liver”, “cirrhosis” and “hepatocellular carcinoma”. A total of 28 articles were reviewed, comprising 20 literature reviews, a clinical guide, three clinical trials and four case series. Results: Oral clinical manifestations can be observed reflecting liver dysfunction, such as bleeding disorders, jaundice, foetor hepaticus, cheilitis, smooth tongue, xerostomia, bruxism and crusted perioral rash. In the case of infection caused by hepatitis C virus (HCV), the most frequent extrahepatic manifestations mostly affect the oral region in the form of lichen planus, xerostomia, Sjögren’s syndrome and sialadenitis. The main complications of the patient with liver disease are risk of contagion (for healthcare personnel and other patients), the risk of bleeding and the risk of toxicity due to alteration of the metabolism of certain drugs
