Method: Completion of a questionnaire and a noninvasive oral examination was obtained from hemodialysis and peritoneal dialysis patients registered in the dialysis program at St. Paul's Hospital in Saskatoon, Saskatchewan, as of March 1, 1999. Information was also gathered from the medical chart. Medication history as well as history of diabetes, hypertension, and nondental prosthetic devices were also recorded.

Results: Of 226 dialysis patients in central and northern Saskatchewan, 147 were interviewed and examined. Of these, 94 (64%) were dentate, and the same number had been on dialysis for a mean of more than 2 years; about a third were diabetic, almost all were hypertensive and all had nondental prosthetic devices or arteriovenous fistulae, or both. Sixty (64%) of the dentate patients were candidates for kidney transplantation. Most of the dentate patients reported brushing once or more daily, but they flossed infrequently or never. Dental visits were infrequent, less than every 5 years in 59 (63%) of the dentate patients. Findings in the dentate group included increased tooth mobility, fractures, erosion, attrition, recession, gingivitis and a high plaque index. A patient's dentist was contacted if the patient had seen him or her since starting dialysis (31 of the 94 dentate patients). Most (81%) of the dentists were aware that they were treating a dialysis patient. Medication records were incomplete for 29% of the patients, and only 2 (6%) of the patients had received antibiotic prophylaxis despite the fact that all had prosthetic devices or arteriovenous fistulae.

Clinical Significance: We conclude that the dental health of dialysis patients is poor and requires greater attention.