Clinical Evaluation of Oral Health Issues in patients of Chronic Kidney Disease

Background: Chronic kidney disease (CKD) is associated with multiple systemic complications that negatively affect oral health, including dental caries and periodontal disease. However, data on the factors influencing oral health status among CKD patients undergoing hemodialysis are limited. Objective: To assess oral health status and dental caries experience in patients with CKD receiving hemodialysis and to evaluate their associations with demographic, systemic, and clinical variables. Methods: This cross-sectional study enrolled 70 patients with chronic kidney disease undergoing maintenance hemodialysis, recruited from nephrology outpatient departments of tertiary care hospitals and referred to the Department of Periodontics, Udayan Dental College and Hospital, Rajshahi, between July 2024 and June 2025. Demographic and medical data were obtained, followed by comprehensive oral examination. Dental caries was assessed using the DMFT index, and salivary flow rate was measured by sialometry. Information on diabetes, hypertension, serum urea levels, duration of nephropathy, and lifestyle factors was recorded. Associations were analyzed using Spearman’s correlation and appropriate group comparison tests. Results: The mean participant age was 53.1 ± 13.6 years, with 51.4% males. Oral manifestations were present in 77.1% of patients, most frequently tongue coating, mucosal pallor, and extra-oral amyloidosis. Females had significantly higher missing teeth and DMFT scores. Hypertension was associated with increased decayed teeth, while serum urea showed a negative correlation with missing teeth and DMFT. Conclusion: Gender and hypertension are important determinants of dental caries in CKD patients on hemodialysis, whereas higher serum urea levels may have a protective role against tooth loss, highlighting the need for integrated oral healthcare in this population.