Introduction:
Cystic fibrosis (CF) is a genetic disorder caused by a mutation in the gene that codes for the transmembrane cystic fibrosis transmembrane conductance regulator (CFTR). Depending on the age of the CF patient, dental examinations should be performed at least once every six months. However, considering the level of risk of oral diseases and the real status of the particular CF patients, therapeutic visits may be scheduled for earlier dates to provide well-fitting treatment.
How Does the Disease Cystic Fibrosis Impact Teeth?
People with CF are more likely than those without CF to experience severe and frequent enamel issues. Enamel formation is thought to be significantly influenced by alterations in the cystic fibrosis transmembrane regulator (CFTR) gene. The primary (infant) teeth of cystic fibrosis patients tend to have fewer enamel abnormalities than permanent teeth. This might be because the CFTR gene, which is present during tooth formation, prevents mineralization, the body's normal mechanism for repairing enamel. The body naturally repairs its enamel through mineralization.
The body's enamel is thought to be its toughest tissue, but it is extremely delicate. Acid is created when food-derived sugar interacts with plaque bacteria. This eventually results in the enamel breaking down. Several studies think that because persons with CF have changed saliva that contains more minerals, it prevents enamel from eroding. As a result, there are fewer cavities since the mouth becomes less acidic.
Persons with CF have higher levels of plaque and tartar than persons without CF but little to no gum disease symptoms. The bacteria that reside in plaque may subsequently manifest themselves in the lungs. The health of those with CF may be impacted by this.
Are Both Adults and Children Influenced in the Same Ways?
CF patients have less tooth decay, and people with CF may be less protected from cavities and gum infections as adults and teenagers. These alterations could be caused by a number of factors. Poor dental habits in youngsters may make them more susceptible to cavities as they get older. Younger children use fluoride treatments more frequently, brush their teeth more frequently, and visit the dentist more frequently. According to research, up to 90 percent of kids with cystic fibrosis clean their teeth at least twice daily, which may help prevent cavities. However, this data also reveals that adults with CF had poor oral hygiene in more than 65 percent of cases.
Additionally, medicines that are frequently provided to kids with CF focus on germs that are present in the mouth and lungs. However, during adolescence, antibiotic use frequently shifts. The majority of CF patients in their teens and early 20s frequently convert to inhaled antibiotics, which typically do not diminish oral bacterial populations.
What Are the Various Treatment Plans?
Treatments aimed at avoiding oral diseases should consider an individual patient's actual needs, systemic health, drugs taken, dietary and hygiene practices, and the risk of dental diseases. Oral disease etiology factors constitute a concern to CF patients throughout their lives; hence, oral health should be checked on a frequent basis. The dentist is responsible for thoroughly diagnosing a patient and developing an individualized preventive and therapeutic strategy that should be modified to a CF patient's changing needs and current state of health. Because there are numerous factors impacting oral health, the dates of dental visits should be decided upon individually. They should be often enough to meet the demands of CF patients who arise from the disease.
The success rate of removing bacterial plaque, the activity of oral diseases, the danger of caries or its progression, and the risk of periodontal and mucosal diseases are all considered. With inadequate oral hygiene, the following appointment needs to take place quickly, even as soon as after two weeks, in order to analyze and perhaps correct home dental care. The number of such visits will be determined by a certain CF patient's compliance, physical fitness, and well-being in relation to the disease's progression and oral hygiene outcomes. It is conditionally suggested to have periodic checkups at least every six months with regular oral cleanliness, decent dietary habits, and suitable fluoride supplementation.
Which Are the Various Medications Advised?
Frequent use of antibiotics or pancreatic enzymes is a crucial component of any CF therapy plan. According to research, the low rates of cavities and gum disease in patients with CF are most likely related to the long-term usage of these medicines. Antibiotics administered by persons with CF enter plaque and gum tissue, reducing germs. Pancreatic enzymes, which are used to treat cystic fibrosis, also help to reduce plaque and tartar buildup on teeth.
However, the antibiotic Tetracycline should be administered with caution. It can produce yellow, gray, or brown staining on teeth. As a result, children under the age of eight should not use Tetracycline due to the danger of permanent discoloration. Adults frequently avoid Tetracycline as well because alternatives are typically accessible.
Conclusion
A systemic condition called cystic fibrosis may also affect how the environment in the mouth cavity works. Dental caries develop in people with cystic fibrosis as a result of numerous factors that exhibit protective qualities while also raising the likelihood that the disease will progress. Children with chronic illnesses and those who exhibit particular healthcare demands should be considered a high-risk group. Most studies show that people with CF have a lower incidence of gingivitis, but they also have a higher propensity to develop dental calculus.
The regular removal of dental calculus will subsequently be the dentist's responsibility. Impaired oral cavity environment homeostasis may be the result of alterations in the composition and characteristics of saliva. The likelihood of mucosal inflammation and injury to hard tooth tissues increases with dysfunctions in salivary flow rate, pH, buffer capacity, and protective and antibacterial activity. As a result, it is important to plan routine dental checkups, suggest using remineralizing and antibacterial rinses, and, if necessary, artificial saliva products. Additionally, it is crucial to educate cystic fibrosis patients and their carers about potential oral health issues that can arise, as well as available treatments and preventative measures.
