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It is with great interest that we read the article “Patients with kidney failure who cannot access dialysis in rural and remote areas of Canada should be prioritized for kidney transplantation” [1]. The authors outline the diminished quality of life for patients on dialysis and the barriers to kidney transplant. We argue that access to dental care also has a significant impact on access to kidney transplant. Significant scientific literature is available to support dental treatment and removal of possible oral infections foci prior to several organ transplantation surgeries [2–5].
Infection can occur in transplant recipients due to their immunosuppressed state. To prevent such complications, pre-operative dental treatment is often required. An uncontrolled oral infection can lead to abscesses and life-threatening sepsis. In this context, minimal pre-treatment dental care is a prerequisite for essential medical care.
In Canada, the cost incurred by such dental treatment is paid by patients and some are denied access due to limited financial resources.
There is a clear cost savings benefit for coverage of urgent dental care for patients awaiting selected medical treatments. While in Canada, socio-economic status and limited financial means should not play a role in access to healthcare, our hospital experience proves otherwise. The current limited access to dental care implies limitation to adequate medical care and delay in treatment for some patient...
Show MoreCompeting Interests: None declared.References
- Aaron J. Trachtenberg, Aviva Goldberg. Patients with kidney failure who cannot access dialysis in rural and remote areas of Canada should be prioritized for kidney transplantation. CMAJ 2021;193:E1772-E1773.
- Smith MM, Barbara DW, Mauermann WJ, Viozzi CF, Dearani JA, Grim KJ. Morbidity and mortality associated with dental extraction before cardiac operation. Ann Thorac Surg 2014;97:838–44. https://doi.org/10.1016/j.athoracsur.2013.10.034.
- Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al. Prevention of Infective Endocarditis. Circulation 2007;116:1736–54. https://doi.org/10.1161/CIRCULATIONAHA.106.183095.
- Kwak E-J, Kim D-J, Choi Y, Joo DJ, Park W. Importance of oral health and dental treatment in organ transplant recipients. Int Dent J 2020;70:477–81. https://doi.org/10.1111/idj.12585.
- Guggenheimer J, Mayher D, Eghtesad B. A survey of dental care protocols among US organ transplant centers. Clin Transplant 2005;19:15–8. https://doi.org/10.1111/j.1399-0012.2005.00251.x.