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Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study

Author

Listed:
  • Chih-Chien Chiu

    (Division of Infectious Disease, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan City 325, Taiwan
    Division of Infectious Disease and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan)

  • Ya-Chieh Chang

    (Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan City 325, Taiwan
    Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan)

  • Ren-Yeong Huang

    (Department of Periodontology, School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan)

  • Jenq-Shyong Chan

    (Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan City 325, Taiwan
    Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan)

  • Chi-Hsiang Chung

    (School of Public Health, National Defense Medical Center, Taipei 114, Taiwan)

  • Wu-Chien Chien

    (School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
    Department of Medical Research, Tri-Service General Hospital, Taipei 114, Taiwan
    These authors contributed equally to this work.)

  • Yung-Hsi Kao

    (Department of Life Sciences, National Central University, Taoyuan City 320, Taiwan
    These authors contributed equally to this work.)

  • Po-Jen Hsiao

    (Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan City 325, Taiwan
    Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
    Department of Life Sciences, National Central University, Taoyuan City 320, Taiwan
    These authors contributed equally to this work.)

Abstract

Objectives Dental problems occur widely in patients with chronic kidney disease (CKD) and may increase comorbidities. Root canal therapy (RCT) is a common procedure for advanced decayed caries with pulp inflammation and root canals. However, end-stage renal disease (ESRD) patients are considered to have a higher risk of potentially life-threatening infections after treatment and might fail to receive satisfactory dental care such as RCT. We investigated whether appropriate intervention for dental problems had a potential impact among dialysis patients. Design Men and women who began maintenance dialysis (hemodialysis or peritoneal dialysis) between January 1, 2000, and December 31, 2015, in Taiwan (total 12,454 patients) were enrolled in this study. Participants were followed up from the first reported dialysis date to the date of death or end of dialysis by December 31, 2015. Setting Data collection was conducted in Taiwan. Results A total of 2633 and 9821 patients were classified into the RCT and non-RCT groups, respectively. From the data of Taiwan’s National Health Insurance, a total of 5,092,734 teeth received RCT from 2000 to 2015. Then, a total of 12,454 patients were followed within the 16 years, and 4030 patients passed away. The results showed that members of the non-RCT group (34.93%) had a higher mortality rate than those of the RCT group (22.79%; p = 0.001). The multivariate-adjusted hazard ratio for the risk of death was 0.69 (RCT vs. non-RCT; p = 0.001). Conclusions This study suggested that patients who had received RCT had a relatively lower risk of death among dialysis patients. Infectious diseases had a significant role in mortality among dialysis patients with non-RCT. Appropriate interventions for dental problems may increase survival among dialysis patients. Abbreviations: CKD = chronic kidney disease, ESRD = end-stage renal disease, RCT = root canal therapy.

Suggested Citation

  • Chih-Chien Chiu & Ya-Chieh Chang & Ren-Yeong Huang & Jenq-Shyong Chan & Chi-Hsiang Chung & Wu-Chien Chien & Yung-Hsi Kao & Po-Jen Hsiao, 2021. "Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study," IJERPH, MDPI, vol. 18(1), pages 1-12, January.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:1:p:326-:d:474750
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    References listed on IDEAS

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    1. Ren-Yeong Huang & Yuh-Feng Lin & Sen-Yeong Kao & Yi-Shing Shieh & Jin-Shuen Chen, 2014. "A Retrospective Case-Control Analysis of the Outpatient Expenditures for Western Medicine and Dental Treatment Modalities in CKD Patients in Taiwan," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-9, February.
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