Fatores associados à prevalência de edentulismo em pacientes com doença renal crônica em hemodiálise: um estudo transversal em Minas Gerais

Abstract

Individuals with chronic kidney disease may have, in addition to systemic consequences results from the disease, poor oral health compared to the general population. Most common oral manifestations are periodontal disease, caries, calculus, mouth dry and tooth loss. The lack of information related to dental care and the influence of oral health on overall health, low motivation for dental care and greater concern for systemic health are factors that may be related to precarious oral hygiene in a large part of this population. The study aimed to identify the prevalence of edentulism in people with chronic kidney disease on dialysis and factors associated. A cross-sectional study was performed in 650 patients, aged 18-90 years treated in two dialysis centers located in Belo Horizonte and Contagem, southeastern of Brazil. While participants performed a hemodialysis session, data were collected using a structured questionnaire and clinical exam. The questionnaire included general characteristics, behavior habits and medical and dental history of the participants. Clinical exam identified the presence of edentulism and oral mucosal alteration. Intra and inter-examiner calibration, test-retest reliability and a pilot study were previously performed the main study. The study was approved by the Human Research Ethics Committee of the Federal University of Minas Gerais. The results showed that the mean age of patients was 53.9 years (+14.3). Most of the sample consisted of males (55.2%), black or brown (80.2%), upper/middle class (84.0%) and less than 8 years of study (72.3%). Edentulism was identified in 183 participants (28.2%) and 140 of them reported using removable prosthesis (76.5%). Duration of hemodialysis, use of medications and presence of other diseases were not associated with edentulism. Individuals with lower education levels (OR= 3.99; 95% CI: 2.34 to 6.79), who reported to have had no visit with the dentist in the last 6 months (OR= 2.49; 95% CI: 1.52-4.08), which demonstrated a positive perception of smile (OR= 2.00; 95% CI: 1.35-2.97) and who were identified with some alteration of mucosa (OR= 4.17; 95 % CI: 2.83-6.13) were more likely to be edentulous. Low levels of education, lack of dental visit in the last six months, positive perception of smile and presence of oral mucosal alterations were associated with edentulism in patients with chronic kidney disease undergoing hemodialysis.