23 Feb 2023 It is always said that your mouth is your body’s health mirror. Similarly if you maintain your body as well as your mouth then you definitely lead a salubrious life. There are several researches which have indicated that the oral mucosal lesions and periodontal disease is a common thing which is more pronounced in the liver cirrhosis patients which occurs due to a decreased salivary flow in the oral cavity.
Specifically, liver cirrhosis or scarring, also known as liver fibrosis, is mainly associated with hepatitis, chronic or long-term alcoholism. When this disease reaches to an advanced level this leads to the in functioning quality of life and due to this reason the liver functions ends up getting severely impacted which could be a life-threatening and even serious in several cases. This condition is happens due to chronic diseases or long-term alcoholism.
What Are the Oral Manifestations of Liver Cirrhosis?
Oral manifestations among the patients with cirrhosis mainly occurs due to bleeding, petechiae, hematomas, yellowish-colored or jaundice-type mucosa, gum bleeding, tongue inflammation or blastos, and inflammatory swelling of the salivary glands (sialadenosis). And all of these symptoms are mainly attributed to liver dysfunctionalities which means misbalance of liver functioning.
The condition of hyposalivation occurs due to the use of diuretic drugs and it also leads to the reduction of salivary. Not just that if the condition of fatty liver persists, then it also leads to heart burn. Well, along with that the other symptoms are severe chest pain, difficulties in swallowing, dry cough, hoarseness of voice or a sore throat and the sensation of having a lump in the throat. Whereas Angular cheilitis lesions is another most common problem that occurs in cirrhotic patients. During this condition, lesions or ulcers are formed during the corners of the mouth. This condition can cause a situation of discomfort, including temperature sensitivity or intolerance to hot and cold foods, pain, dry skin, and delayed wound healing among the patients.
During such a condition patients may often observe reddish or purple spots on the outside corners of the mouth that might or might not be accompanied by crusting, swelling, or cracking of the lips. If such a situation increases, then it often leads to an increased pain as well as a burning sensation in the mouth, and this situation further aggravates the inability to eat, drink, or even talk.
What Is the Pathophysiology of Dental Disease and Liver Cirrhosis?
Though alcohol is an addictive thing, for the regular consumers but it is not something new that it has got a very detrimental effect on the energy metabolism of the human body. The interference of alcohol with protein metabolism ends up resulting into a delayed tissue or wound healing.
Fatty liver is a disease that can direct effect your face and mouth. Fatty liver is the disease which occurs when the liver stores too much fat cells in the liver. Fatty liver disease occurs due to the heavy consumption of alcohol. But you can also develop NAFLD if your diet is high in calories and fat.
Fatty liver is a disease which can end up causing inflammation and in some cases it can end up damaging your healthy liver cells. There are some people who do not experience symptoms, whereas some would experience symptoms like fatigue and abdominal pain.
Whenever anyone suffers from fatty liver disease then the symptoms are seen on the face. Well, the possible symptoms of the disease includes:
#1. Puffiness:
If you are suffering from an advanced level of liver disease then it can eventually end up effecting your liver’s ability to make proteins, this in turn can end up impairing your blood flow and fluid removals. Due to this reason you might also notice that your face is appearing slightly puffier.
#2. Dark skin in the crease of neck:
Fatty liver disease also ends up contributing to an increased insulin resistance, and if such a situation occurs it means your body is unable to use the insulin properly. Due to an excessive buildup of insulin in your body, it can end up leading to a serious condition which is called acanthosis nigricans. When this condition occurs it leads to folding of skin, and this in turn leads to the darkening of skin.
#3. Rash around the mouth:
Fatty liver diseases can end up causing your body into such a condition then your body is not able to absorb certain nutrients effectively. And one such mineral is zinc, and many people those who are suffering from NAFLD zinc deficiency in their body. This condition often ends up creating a sense of irritation around the mouth. Whenever the irritation occurs it looks like rashes which has small fluid-filled or even solid-appearing bumps.
#4. Saliva:
People those who are suffering from cirrhosis of liver were seen to secrete saliva at much low levels than compared to average person. And these patients are often prescribed to take diuretics and this would help to manage the disease, as it doesn’t helps with dryness. Though the different medications helps to keep the patient alive but they also end up putting them at a risk of serious infection and this can ultimately begin from mouth. During this condition oral hygiene needs to be emphasized and along with proper home care techniques. One thing you need to keep in mind is that you need to gentle and careful when disinfecting takes place. Also, bad habit of smoking and drinking can end up significantly worsening lesions, as well as bone loss and other osteoporotic changes are a very common thong among these kind of patients.
#5. Findings:
Through research it was seen that oral mucosal lesions is something which is a far more common thing among the patients those who are already suffering from cirrhosis. This situation occurred as because of the amount of saliva which they have produced was something below average in compared to normal person. When the condition gets more severe, the person is more likely to have a decayed, missing, or filled teeth.
When the situation becomes harder it becomes a tough condition to treat the patient’s dental health, as the disease ends up becoming worsened with the passage of time. When the patient falls in such a situation, the physicians try to understand the situation as because doing this would end the problems.
What Are the Management Methods by Physicians and Dental Surgeons?
The likelihood of infections is higher in cirrhotic patients as because of the immune-suppressed conditions in these patients and this mainly varies depending upon the stage of the disease which the patient might be going through. This increases their further susceptibility to systemic or toxic infections which they have come across with. Dental treatment in cirrhotic patients is mainly straightforward and conservative. Surgical interventions cannot be made without the physician’s consent, routine blood examination, and neurologic factors. This is because the condition may involve bleeding, and caution should be undertaken before considering the stage of the disease and the need for antibiotic prophylaxis for these patients.
To reduce the complications that is derived from the spread of dental infection, a two times one half-yearly to yearly oral prophylaxis with restorative modalities will not cause any harm. It is very beneficial in preventing the aggravation of various lesions of gingiva and periodontal disease, especially in patients with advanced stages of liver cirrhosis.
Studies have also indicated that patients with liver cirrhosis, particularly the ones those who have valvular prosthesis or heart-related defects, and people with a history of drug abuse, and patients suffering from chronic renal failure, are at the highest risk for developing bacterial endocarditis. Research which is about preoperative antibiotic prophylaxis being effective before dental treatment remains elusive still date; however, some dentists have also recommend that this may lead to effective infection control prior to a surgical or a prophylactic dental procedure.
Due to the reduction in salivary secretion, the dentist must emphasize oral hygiene, especially with the proper home care techniques like brushing techniques, chemical or mechanical plaque control measures. The physician or dentist’s most important suggestion is to advise against both smoking and drinking alcohol as it can significantly end up impairing the oral and systemic quality of life, aggravating both oral and hepatic lesions.
FAQ’s:
#1. Can a tooth infection hurt your liver?
The association between severe dental infections and accelerated liver disease can be speculated to be due to dental infection-associated systemic inflammation, which may lead to liver injury too.
#2. Can tooth infection cause fatty liver?
Several researches have also indicated that periodontitis might end up resulting into the progression of several liver diseases, such as non-alcoholic fatty liver disease, cirrhosis and hepatocellular carcinoma, as well as affecting liver transplantation.
#3. Can cavities cause liver problems?
Periodontal disease and tooth loss are positively associated with liver diseases also including NAFLD, elevated transaminase level, liver cirrhosis and liver cancer.