Sharea Ijaz, Tanzeel Qurrat Ijaz, Arshad Kamal Butt, Ayyaz Ali Khan.
Oral Manifestations of Hospitalized Cirrhotics at Shaikh Zayed Hospital, Lahore: A Pilot Study.
Proceeding Shaikh Zayed Postgrad Med Comp Jan ;20(2):81-6.

Background: In Pakistan cirrhosis has reached alarming proportions due to spread of HCV and HBV viruses. Some of the oral manifestations of cirrhosis have been found to exhibit geographically variability. There is no research available on the oral health of these patients in Pakistan and their specific oral problems are not known. Objectives: This study examined a cohort of cirrhotic patients admitted at Shaikh Zayed hospital Lahore to assess their oral health status and needs. Materials and methods: Thirty consecutive patients admitted with diagnosis of cirrhosis were examined for oral health status. Extra oral examination included any visible lesions or abnormalities on the face, head or neck region, lymph node enlargement and TMJ dysfunction. Intra oral examination included measurement of caries (DMFT) and periodontal disease level (CPITN), oral mucosa! lesions, prosthetic status and prosthetic needs of the patients. All findings were recorded on the standard WHO oral health survey form. Results: The oral health of this cohort was poor compared to the general population. Xerostomia (20%), papillary atrophy (100%), oral Melanosis (90%), petechieal hemaorrhages (26%) and glossitis (53%) were found prevalent in the sample. Two females had oral lichen planus and one of the patients had oral ulceration. DMFT score (Mean=5.7) was not different from national average (Mean=8.02). Periodontal disease was more severe than general population. Less than 21 % of the sample wore prostheses and over 50% needed one. TMJ dysfunction was common but fewer patient complained of the condition that the number of patients with clinical signs. Conclusions: Oral health of cirrhotic population is worse than general population and they have significant oral health needs. Further research is required to investigate this relationship. Effective oral health education of patients' and physicians' is required to reduce the burden of oral disease thus improving quality of life for these patients.

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