Introduction: Dental care during pre-transplant workup is important to reduce potential sources of infection, following immunosuppression to prevent graft rejection. This study documents the prevalence of oral abnormalities and recommended treatment of patients assessed for small bowel and multivisceral transplantation.

Methods: We present a case series of 57 patients who underwent assessment for small bowel and multivisceral transplantation in a single centre in the UK (Cambridge) over the time period 2015-2018. This is a retrospective review of their formal assessment in a maxillofacial clinic and subsequent outcomes.

Results: Of all patients assessed, 18(32%) required no treatment or crown and polish only; 12(21%) required at least one filling; 27(47%) required at least one tooth extraction and 6(10.5%) required full dental clearance. Of the 28 patients accepted and listed for transplantation, 11(39%) required no treatment or crown and polish only; 4(14%) required at least one filling; 13(46%) required at least one tooth extraction and 4(14%) required full dental clearance.

Conclusion: This is the first reported study of the dental health of patients referred for small bowel and multivisceral transplantation. Overall these patients have poorer dental health compared with published data for patients referred for liver transplantation1 and over half of those accepted for transplantation required procedural intervention prior to listing. Many patients have intestinal failure at the time of referral. We hypothesise that long-term use of hypertonic fluids may partly account for the poor results described and that patients with intestinal failure should be considered for regular dental review and timely intervention.

1 J Appl Oral Sci. 2012 Mar-Apr;20(2):241-5.