Defense Date
2026
Document Type
Thesis
Degree Name
Master of Science in Dentistry
Department
Dentistry
First Advisor
Janina Golob Deeb
Second Advisor
Caroline Carrico
Third Advisor
Rafael Siqueira
Fourth Advisor
Jasmohan Bajaj
Abstract
Background: Poor oral health is associated with adverse outcomes in patients with cirrhosis, partly due to an altered oral-gut-liver axis and immune dysfunction exacerbated by a lack of access to dental care. Current clinical practice primarily evaluates oral health at the time of liver transplant assessment, leaving most patients without routine dental care. This study aimed to identify barriers to dental care utilization and assess the oral health status in patients with cirrhosis.
Methods: Adult non-edentulous outpatients with cirrhosis were enrolled. Participants received a complimentary dental examination and cleaning and completed a questionnaire assessing barriers to dental care. Oral health status was evaluated using the Decayed, Missing, or Filled Teeth (DMFT) Index. Periodontal status was assessed using probing depth (PD), bleeding on probing (BOP), and clinical attachment loss (CAL).
Results: A total of 126 patients with cirrhosis were enrolled, of whom 77% (n=97) attended a complimentary dental examination and cleaning. More than half of participants reported painful oral symptoms (56%) and discomfort when eating (52%). The most commonly reported barriers to dental care were low prioritization of dental care (70%), competing medical concerns (62%) and high copays (45%), whereas logistical barriers were less frequently reported. Clinical findings demonstrated high burden of oral disease, with a mean DMFT score of 16.5 and 71% had at least one site ≥4 mm. Periodontitis was diagnosed in 64 (66%) patients, with most classified as Stage III (69%). Nearly all participants (98%) reported that they would seek regular dental care if covered by insurance.
Conclusion: Patients with cirrhosis demonstrate a high burden of dental and periodontal disease and face significant barriers to accessing care, particularly related to cost and competing medical priorities. Despite high reported willingness to seek care, utilization remains limited, underscoring the need to improve access to affordable dental services in this population
Rights
© Sara Khraibut
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
5-7-2026