Diseases of the Liver (Dental Manifestations (fetor hepaticus (distinct…
Diseases of the Liver
fetor hepaticus (distinct breath odor)
mucosal membrane jaundice
atrophic glossitis (atrophy of lingual papilla)
In adults, Vitamin D deficiency Hypophosphatemic Vitamin D-resistant rickets may be related to Liver Disease.
Neonatal Liver Disease - endogenous staining of teeth
Oral Pathology Text Book 6th Edition (Pages 173 and 268)
Hepatitis B (HBV)
TYPES: Acute or Chronic
Acute: lasting less than 6 months
Chronic: lasting 6 months or more. More common in children than adults.
RISKS: developing liver failure, liver cancer, kidney disease, inflammation of blood vessel, or cirrhosis.
WHAT: Liver infection that causes inflammation of the liver passed through blood, semen or other bodily fluids. AKA Serum Hepatitis - pertains to the blood!
PREVENTABLE: with vaccine, but no cure if already infected. Vaccine given in 3-4 injections over 6 months.
SYMPTOMS: appear 1-4 months after infection and present as nausea, fatigue, abdominal pain, fever, dark urine, joint pain, itching and jaundice (yellowing of eyes and skin).
Hepatitis C (HCV)
WHAT: viral infection spread through contaminated blood
TYPES: Acute or Chronic
Symptoms include: jaundice, fatigue, nausea, fever, muscle aches and can appear 1-3 months after exposure and can last 2 weeks-3 months
Treatment is antiviral drugs or occasionally spontaneous clearance
Asymptomatic acute Hepatitis C may be left untreated and lead to chronic form
Symptoms include: bleeding or bruising easily, fatigue, jaundice, lack of appetite, itchy skin, dark urine, fluid build-up in abdomen or legs, weight loss, spider angiomas
Treatment is antiviral drugs or transplant
RISKS: Health care workers, HIV, drug users, received a transfusion/transplant before 1992, received clotting factor before 1987, mom had HCV, been to prison, born between 1945 and 1965
COMPLICATIONS: cirrhosis or scarring of the liver, liver cancer, and liver failure
WHAT: A virus spread through fecal oral route. Usually through contaminated water.
WHERE: Most common in developing countries. People in the US normally contract it when visiting a country where HEV is an epidemic.
TREATMENT: Most people will recover completely
RISKS: HEV may affect the nervous system and cause pain in the arms and legs.
Hepatitis A (HAV)
WHAT: a highly contagious virus, contracted from contaminated food and water sources or close contact with an infected person
SYMPTOMS: appear a few weeks after infection and present as nausea, fatigue, abdominal pain, fever, dark urine, joint pain, itching and jaundice (yellowing of eyes and skin)
PREVENTABLE: Vaccination or injection of immuogloblin within 2 weeks of exposure.
TYPES: only acute. Does not become chronic and does not cause long term liver damage.
Alcoholic Liver Disease (ALD)
acute form of alcohol-induced liver injury that occurs with the consumption of a large quantity of alcohol over a prolonged period
can range in severity from asymptomatic derangement of biochemistries to liver failure and death
WHAT: one of the most severe diseases of the liver: replacement of normal liver tissue with non-living scar tissue - can take years to develop.
If left untreated, the liver lose function and eventually fail.
Leading causes are chronic alcoholism and Hepatitis C
occurs after acute alcohol ingestion and is generally reversible with abstinence
not believed to predispose a patient to any chronic form of liver disease if abstinence or moderation is maintained
Hepatitis D/Delta Hepatitis
WHAT: Incomplete virus that requires the help of HBV to replicate; can be acute or long term; transmitted through percutaneous or mucosal contact with infected blood
TREATMENT: There is no treatment or vaccine for HDV, but can be prevented by preventing HBV with HBV vaccine
WHO: Can only occur in people infected with HBV
Dental Hygiene Implications
Standard precautions should be followed
acute patients should not be treated unless dental emergency
Medical History should be thoroughly checked and recorded
Use of ultrasound rather than radiographs
5-6% fatty liver is abnormal
Helps to definitively diagnosis
Most commonly used in Fatty Liver Disease
Liver Diseases and Dental Caries
Prone to dental caries due to bacterial infections and compromised function of the immune system
Medications can cause decrease in saliva flow