Universität zu Köln

Hoefer, Karolin, Turnowsky, Anna, Ehren, Rasmus, Taylan, Christina, Plum, Georg, Witte, Hanna, Noack, Michael J. and Weber, Lutz T. (2022). The impact of a needs-oriented dental prophylaxis program on bacteremia after toothbrushing and systemic inflammation in children, adolescents, and young adults with chronic kidney disease. Pediatr. Nephrol., 37 (2). S. 403 - 415. NEW YORK: SPRINGER. ISSN 1432-198X

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Abstract

Background Chronic kidney disease (CKD) still leads to high mortality rates, mainly due to cardiovascular disease. One important influencing factor is persisting low-grade chronic inflammation partly maintained by gingivitis that favors transient bacteremia during daily activities such as toothbrushing. Methods To examine whether intensive dental prophylaxis can restore oral health, reduce the prevalence of bacteremia and degree of systemic inflammation indicated by CRP levels, we conducted this pilot study examining 30 CKD patients aged 6-26 years, 15 receiving intensive prophylaxis (IP), 15 receiving treatment as usual (TAU) serving as control group. There were three appointments for examination, each 10 1 weeks apart (at baseline, after intervention periods one and two, when TAU also received IP, and the IP group stopped prophylaxis). Results The gingival index (GI) in the IP group decreased by 90% (GI 0.09; p=0.001), resulting in almost healthy gingiva. There was no significant change in CRP or prevalence of bacteremia. General prevalence of bacteremia after toothbrushing was 9.5% affecting 7 (26%) of the participants. In three participants, bacteremia dissolved after IP, in one after TAU. Two patients developed bacteremia >= 10 weeks after ending IP. We identified eight different bacterial species. Conclusions We were able to show that IP can effectively treat gingivitis. It might be a promising approach to reduce systemic inflammation and subsequently lower premature cardiovascular disease, despite the lack of statistical significance. Future research requires a larger patient cohort to enable matched treatment groups with long-term follow-up and molecular detection methods for bacteremia.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hoefer, Karolin UNSPECIFIED UNSPECIFIED UNSPECIFIED Turnowsky, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Ehren, Rasmus UNSPECIFIED UNSPECIFIED UNSPECIFIED Taylan, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Plum, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Witte, Hanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Noack, Michael J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Lutz T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-568263
DOI:	10.1007/s00467-021-05153-1
Journal or Publication Title:	Pediatr. Nephrol.
Volume:	37
Number:	2
Page Range:	S. 403 - 415
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-198X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language C-REACTIVE PROTEIN; PERIODONTAL THERAPY; CARDIOVASCULAR RISK; CULTURE; ATHEROSCLEROSIS; GINGIVITIS; THICKNESS; MARKERS Multiple languages Pediatrics; Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56826