Oral Disease Burden and Utilization of Dental Care Patterns Among Pediatric Solid Organ Transplant Recipients


  • Source of funding: This study was supported by NIDCR/NIH grants K23 DE00443, R03 DE14939, and U54 DE14251.

Caroline H. Shiboski, Department of Orofacial Sciences, Box 0422, Room S612, 513 Parnassus Avenue, University of California San Francisco (UCSF), San Francisco, CA 94143-0422. Tel.: (415) 476-5976; Fax: (415) 476-4204; e-mail: caroline.shiboski@ucsf.edu. Caroline H. Shiboski, Sumathi Krishnan, and Pamela Den Besten are with the Department of Orofacial Sciences, School of Dentistry, UCSF. Phyllis Kawada, Megan Golinveaux, and Ann Tornabene are in private practice but were residents in the Pediatric Dentistry Residency Program at UCSF when this work was conducted. Robert Mathias is with the Division of Pediatric Nephrology, Nemours Children's Clinic, Orlando, FL. Philip Rosenthal is with the Department of Pediatrics, Division of Gastroenterology, School of Medicine, UCSF.


Objectives: We conducted a study among pediatric renal (RTRs) and liver transplant recipients (LTRs) to determine: a) the overall burden of oral disease; and b) the frequency with which this population utilizes dental care services in relation to sociodemographic factors and oral disease burden. Methods: In this cross-sectional survey, study procedures included the completion of a standardized questionnaire (by parents/guardians), oral mucosal examination, assessment of caries, gingival enlargement, and plaque index. Results: The 142 children (82 RTRs and 60 LTRs) enrolled from April 2002 to November 2005 were predominantly Latino (41 percent) and Caucasian (34 percent). Forty-three percent had at least one carious surface (in either a deciduous or permanent tooth), 19 percent had five or more carious surfaces, and 25 percent had gingival enlargement. We found only one case of oral candidiasis. Even though 72 percent of parents/guardians reported their child had a regular source of dental care, only 49 percent had a dental cleaning and 44 percent had dental radiographs in the past year, reflecting a low prevalence of preventive dental care. Among children with no regular source of dental care, there were statistically significantly higher proportions of Latinos, younger children, and families with an annual household income <$35,000. Conclusion: While the prevalence of oral mucosal disease and gingival enlargement was low, the prevalence of children with caries was high, and there was low use of preventive dental care. Strategies to improve this population's utilization of preventive dental care are needed.