Authors: Jodi M Smith Craig S Wong Eva B Salamonik Beth M Hacker Ruth A McDonald Lloyd A Mancl Bryan J Williams Alfaiyaz Ibrahim Frank A Roberts
Publish Date: 2006/08/26
Volume: 21, Issue: 11, Pages: 1753-1759
Abstract
Cyclosporine CSA is a commonly used immunosuppressive medication in pediatric transplantation Druginduced gingival overgrowth DIGO is a frequent side effect associated with CSA use and can impair the patient’s ability to achieve good oral hygiene This study tested the hypothesis that sonic tooth brushing and oral hygiene instruction can reduce the occurrence or severity of DIGO in CSAtreated pediatric renal transplant recipients Twentythree pediatric renal transplant patients with DIGO were randomly allocated to treatment or control groups The treatment group received oral hygiene instruction and use of a sonic toothbrush while the control group continued their usual home care with manual brushes Dental impressions and photographs of all subjects were taken at baseline and every 3 months for a year The casts and photographs were evaluated by a dental panel to compare the DIGO levels from baseline until the end of the study After 12 months the control group had significantly more severe DIGO than did the sonic tooth brushing and oral hygiene instruction group OR=45 95CI=12–160 P=003 Of the risk factors considered only male gender was significantly associated with worse outcome OR=61 95CI=23–161 P=003 The use of a powered toothbrush together with oral hygiene instruction may be an important component of health maintenance for pediatric transplant patients on CSAThe authors wish to thank Dr Kevin Underwood and the Optiva Corporation now Phillips Oral Healthcare for their generous donation of the sonic toothbrushes Suzanne Jones Marilyn Rothen Sara Rutherford Hannah Roberts the staff of the Children’s Hospital and Regional Medical Center Division of Pediatric Nephrology Seattle Washington USA and the faculty of the University of Washington Departments of Periodontics and Pediatric Dentistry Seattle Wash This work was supported by NIH grants K23DE00431 and P30DE09743
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