Date Published: October 9, 2018
Publisher: Public Library of Science
Author(s): Qi Yue, Fei-Ting Yin, Qian Zhang, Chao Yuan, Mei-Yan Ye, Xiao-Ling Wang, Ji-Jun Li, Ye-Hua Gan, Denis Bourgeois.
The aim of this study was to evaluate the carious status and the microbial profiles of supragingival plaque in patients with chronic kidney disease undergoing hemodialysis.
This study included 30 patients with chronic kidney disease undergoing hemodialysis as well as 30 control subjects. Dental examination was performed and the decayed-missing-filled-teeth was recorded. Supragingival plaque was taken and analyzed using 16S rRNA gene amplicon by Illumina MiSeq sequencing to detect microbial composition and community diversity and structure.
The level of decayed-missing-filled-teeth was higher in the hemodialysis group than that in the control group. Microbial analysis showed a decrease in α diversity and a increase in relative abundance and prevalence of many acidogenic and aciduric caries related species in the supragingival plaque samples of the hemodialysis patients, including Streptococcus mutans, Lactobacillus salivarius, Lactobacillus fermentum, Lactobacillus vaginalis, Scardovia wiggsiae F0424, and Actinomyces naeslundii.
Our results suggested that the hemodialysis patients were more susceptible to caries. More attentions for caries prevention and treatment should be paid to improve their life quality, and even to reduce their cardiovascular events and survival.
The association of oral diseases and systemic health is well documented [1–3]. Studies showed that oral diseases, including caries, periodontitis and mucosa diseases, etc., are highly prevalent and usually severe in CKD patients due to the malnutrition and uremia systemic changes. In turn, oral diseases also have great influence on CKD prognosis. A very recent multinational cohort study demonstrated that in CKD hemodialysis patients, poorer dental health (higher carious status) is associated with early all-cause mortality, whereas preventive dental health practices are associated with longer survival . These findings indicate that dental health may be a potentially preventative determinant of clinical outcomes in end-stage CKD patients. However, the carious status in CKD hemodialysis patients remains controversial, as both increased caries and decreased caries were reported in CKD hemodialysis patients [6–8]. There should be more CKD patients in China due to its huge population size, but only one study provided some oral status data from the Chinese CKD population .
The main results of this study were that the CKD hemodialysis patients showed higher dental caries status than the healthy control subjects, and that the diversity of bacterial community of the supragingival plaque was decreased and the abundance and prevalence of main caries pathogenic species and some caries-related species were also significantly increased in the supragingival plaque of the CKD hemodialysis patients. These results suggested that the CKD hemodialysis patients were more susceptible to dental caries, and therefore, more attentions for caries prevention and treatment should be paid to improve their life quality and even their cardiovascular events or survival.