Oral health in relation to manifestations and severity of cystic fibrosis: a cross-sectional study.

Abstract

Cystic fibrosis (CF) is an autosomal recessive disorder characterized by defective ion transport in epithelial cells, leading to the development of viscous mucus and glandular duct obstruction. Individuals with CF often present with gingival inflammation, dental enamel defects (DEDs), caries, and reduced salivary flow. This cross-sectional study of 82 patients with CF investigated the population's oral health in relation to systemic CF manifestations. Clinical oral examinations and medical record analyses were conducted for the entire sample, and panoramic radiographs were obtained for 26 patients. Data on oral hygiene practices, DEDs, gingival inflammation (gingival index [GI] score), caries, malocclusion, breathing pattern, and systemic health parameters were collected. The sample included 44 female and 38 male patients with a mean age of 11.5 years (range 8 months to 26 years). DEDs, predominantly affecting the permanent maxillary anterior teeth, were observed in 47.6% of the patients. Gingival inflammation was noted in 57.3% of the patients, and patients with higher GI scores reported reduced brushing frequency, experienced longer hospitalizations, and were more likely to develop exacerbation of pulmonary symptoms. Dental caries affected 17.1% of the cohort. Panoramic radiographs revealed nasal septum deviation (46.2% of the cohort), sinus opacification (38.5%), and dental agenesis (19.2%), primarily involving the premolars and the maxillary lateral incisors. Oral or mixed breathing was identified in 41.5% of the sample, and malocclusions were present in 28.0%. Fifteen patients with advanced lung disease exhibited infrequent toothbrush replacement, high plaque index scores, and severe gingival inflammation. While the prevalence of caries was relatively low in this small sample, the proportions of CF patients exhibiting DEDs, gingival inflammation, and occlusal abnormalities were high, particularly among those with advanced systemic disease. These findings underscore the importance of integrating dental care into the multidisciplinary management of CF to address patients' specific oral health challenges and improve overall quality of life.