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Association between dental infections and the clinical course of chronic liver disease

Authors

  • Fredrik Åberg,

    Corresponding author
    1. Transplantation and Liver Surgery Clinic, Helsinki University Hospital, Helsinki, Finland
    • Correspondence: Dr Fredrik Åberg, HUCH Meilahti Hospital, PB 372, 00029 HUS Helsinki, Finland. Email: fredrik.aberg@helsinki.fi

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    • These authors contributed equally to this study.
  • Jaana Helenius-Hietala,

    1. Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, Helsinki, Finland
    2. Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland
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    • These authors contributed equally to this study.
  • Jukka Meurman,

    1. Department of Oral Infectious Diseases, Institute of Dentistry, University of Helsinki, Helsinki, Finland
    2. Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland
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  • Helena Isoniemi

    1. Transplantation and Liver Surgery Clinic, Helsinki University Hospital, Helsinki, Finland
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  • Conflict of interest: None of the authors have any conflict of interest to disclose.
  • Funding: No grants were received for this study.

Abstract

Aim

Dental infections are implicated in several systemic diseases due to bacteremia and pro-inflammatory effects, but their possible role in liver disease is unclear.

Methods

We retrospectively analyzed the clinical course of liver disease in relation to dental health among 116 patients with liver cirrhosis who underwent dental examination before liver transplantation.

Results

The need for multiple tooth extractions, a surrogate marker of dental infections, was associated with reduced time from diagnosis of liver disease to the need for liver transplantation (P = 0.02). The association was independent of age, sex, liver disease etiology and Model for End-Stage Liver Disease (MELD) score (P = 0.04). Among 38 patients with accurate laboratory follow-up data, the number of tooth extractions correlated with the change in MELD score during the year preceding dental examination (r = 0.43, P = 0.03). Spontaneous bacterial peritonitis caused by Streptococcus viridans occurred only among patients with multiple dental infections.

Conclusion

Dental infections may influence the clinical course of liver disease, but prospective studies are needed.

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