Oral health in Latvian patients with phenylketonuria

Phenylketonuria (PKU) is an inborn error of metabolism that results in decreased metabolism of the amino acid phenylalanine. Untreated, PKU can lead to intellectual disability, seizures, behavioral problems, and mental disorders. The treatment of PKU entails a strict low protein diet and Phenylalanine free amino acid formula which is sweetened and might be with low pH level. Oral health is a key indicator of overall health, well-being and quality of life. It encompasses a range of diseases and conditions that include dental caries, periodontal disease, tooth loss. The aim of this study was to evaluate oral health in PKU patients in comparison to healthy controls. 33 PKU patients (10 males, 23 females) and age-sex matched control group are recruited for this study. The dental status was assessed by number of the filled, missing, abraded and carousal teeth. The Silness & Loe, CPITN, Teeth application indexes were detected, as well as caries risk and tartar removal necessity. Investigation of oral health showed a statistically significant difference in the number of abraded teeth between PKU patients and the control group, 1.21±1.88 and 2.61±2.98, respectively (p=0.026) and in number of carousal teeth – 3.97±4.02 and 1.85±2.62 (p=0.014). Both groups (patients vs controls) also showed a statistically significant differences (p<0.000) when detecting Silness & Loe index (grade 3: 9 vs 1), CPITN index (grade 4: 5 vs 0), teeth application indexes (grade 3: 13 vs 1), high caries risk assessment (16 vs 2) and tartar removal necessity (21 vs 16). PKU patients have significantly worse oral health in comparison to healthy controls, it could be explained by lifestyle and eating habit, use of amino acid formula and limited intellectual possibilities in older patients who have born before introducing newborn screening or partially treated patients.