The most common form of liver disease is hepatitis. This inflammation of the liver may be caused by viral infections or toxic substances, induced by drugs, or secondary to ischemia.
Hepatitis may result in cirrhosis and impaired liver function.
Increased bleeding tendencies and impaired drug metabolism are specific concerns for dental care providers.
Treatment for liver disease addresses the underlying cause.
Consequently, most treatments are for viral hepatitis and usually consist of different formulations of interferon, sometimes in combination with ribavirin, or of a single nucleoside reverse transcriptase inhibitor.
Interferon may reduce the absolute neutrophil count.
In cases of severe liver destruction, coagulation factors will not be produced, which will impair secondary hemostasis (fibrin production), which may cause increased bleeding tendencies requiring systemic anticoagulation intervention with fresh frozen plasma. A diminished number of platelets also may be produced, or platelet destruction in the spleen may be increased, resulting in increased bleeding tendencies.
Two of the major functions of the liver are detoxification of foreign substances and metabolism of drugs. A severely destroyed liver will not be able to perform these functions; this may limit the types of medications the patient can safely take.
Alcohol, even in small quantities, may cause increased bleeding tendencies in patients with severe liver disease.
Combinations of specific laboratory values and clinical signs and symptoms have been proposed to provide prognostic indicators to assess a patient’s degree of liver disease and severity.
In addition to the medications used to treat the hepatitis, the patient may be taking other medications to treat related conditions, such as hypertension or vitamin deficiencies.
- Medical Disorders
- Oral Health Care Considerations
- Laboratory Values
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- Hepatitis. MedlinePlus. U.S. National Library of Medicine. November 24, 2020.
- Liver Disease. National Institute of Diabetes and Digestive and Kidney Diseases.
- Autoimmune Hepatitis. National Institute of Diabetes and Digestive and Kidney Diseases.
- Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases.
- Nonalcoholic Fatty Liver Disease (NAFLD) & NASH. National Institute of Diabetes and Digestive and Kidney Diseases.
- Hemochromatosis. National Institute of Diabetes and Digestive and Kidney Diseases.
- Liver Diseases. MedlinePlus. U.S. National Library of Medicine. April 23, 2021.