Premature tooth loss is common among end-stage renal disease patients (ESRD) on hemodialysis (HD), and severe periodontal disease may be a contributing factor, researchers concluded based on a small study.

A team of investigators led by Pedro Diz, MD, of the School of Medicine and Dentistry  at Santiago de Compostela University in Spain, compared with 44 adult ESRD patients on HD with 44 age- and sex-matched control patients with a glomerular filtration rate above 90 mL/min/1.73 m2. The mean number of missing teeth was significantly higher in the ESRD patients than controls (13.9 vs. 9.7), Dr. Diz and colleagues reported online in Oral Diseases. The researchers detected 6 (13.6%) fully edentulous patients in the study group compared with only 1 (2.2%) in the control arm.

In addition, the investigators found that the mean number of decayed teeth was similar in both groups, although the mean number of teeth with fillings was significantly lower in the HD group. When the researchers considered the active and inactive (filled) caries the total number of decayed teeth was significantly lower in the HD patients. “Our results indicate that tooth loss in patients with ESRD is not the result of a higher prevalence of caries,” the authors wrote.

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Instead, the researchers believe periodontal disease may have a relevant role in the etiology and pathogenesis of premature tooth loss in ESRD patients. The study group had significantly higher levels of supragingival bacterial plaque, dental calculus deposits, and gingival inflammation than controls.