We should always keep in mind that patients with kidney transplants are prescribed immunosuppressive therapy. Dental treatment for these individuals involves caution. If you need medical or dental care, it is important to inform your dentist or doctor that you have a pacemaker and show them your medical device implant card. The healthcare team can then contact your cardiologist and work together to find the best treatment for you and your device. When undergoing dialysis, the patient receives heparin to prevent blood clotting outside the body.
Sudden death is the most common cause of death in dialysis patients, but infection is also a common cause of morbidity and mortality in those receiving hemodialysis treatment. The persistent presence of uremic syndrome, even in hemodialyzed patients, has been described as one of the main factors contributing to the numerous systemic complications observed in these individuals. Therefore, it is essential to bear in mind that dental intervention should not be performed on patients with kidney failure unless it is an urgent case, and this should only be done after consulting the nephrologist or urologist. Due to vascular access, patients are at greater risk of suffering from endarteritis and endocarditis, which occur in approximately 2.7% of patients during hemodialysis and in 9% of those with vascular access infection. Consequently, in patients who have undergone kidney transplant operations, prophylactic antibiotics should be administered after consulting with the patient's physician.
In terms of patient blinding and performance bias, there are protocols for administering a simulated TENS using identical machines and the simulated version does not deliver electrical current. In addition, in the context of kidney transplantation, dental infection is a potential threat to both organ transplant candidates and recipients, since dental disease is a pervasive condition and is also likely to be more serious and untreated in the transplanted population. Because of the significant increase in the incidence and severity of periodontitis in the hemodialysis population, dentists should take into account that lack of oral hygiene may increase the patient's risk of suffering from a local or disseminated infection due to persistent daily episodes of bacteremia in the oral cavity. In the last twenty years, there has been a greater perception of the importance of oral health in patients with ESRD (End-Stage Renal Disease) and in candidates for a transplant among the scientific community. In diabetic patients on dialysis, hypoglycemic agents and nutritional alterations can cause hypoglycemia in a context of decreased gluconeogenesis, reduced insulin elimination by the kidney and improved insulin sensitivity after the start of renal replacement therapy. In this context, oral diseases represent a potential and preventable cause of poor health outcomes in people with ESRD due to their relationship to infection, inflammation and malnutrition. As for mucosal diseases, ulcerations affected 8.6% of patients in stage 5D and 1.3% of transplant recipients, and candidiasis affected 22.2% of patients in stages 1 to 5, 19% of adults with CKD (Chronic Kidney Disease) in stage 5D and 13.3% of patients with kidney transplants. The average plaque index was 1.14 and 1.62 in two populations with CKD in stages 1 to 5 and 2.19 in kidney transplant recipients.
This, in turn, represents a threat that involves serious complications in the case of dental interventions in these individuals.