Hepatitis: an insidious threat to oral health – Helen Minnery President BSDHT

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  Posted by: Dental Design      14th August 2018

It may be an illness that individuals will have heard of, but when asked about the effects and symptoms of hepatitis it’s likely that many people would be clueless. This is worrying for a number of reasons, as not only does the condition have many guises but some of the strains can be life threatening. Some manifestations of the disease can also impact an individual’s oral health, and therefore it is necessary for dental hygienistsand dental therapists to raise awareness of the issue and provide tailored care to those affected

What is hepatitis?

Hepatitis is a wide-ranging term that is used to describe the inflammation of the liver. Usually caused by viral infections or even excessive alcohol intake, these conditions are categorised into different types, have different causes and vary greatly in severity.

Whilst some of the strains are hardly serious and are likely to be fought off by the body’s natural defences, others are much more damaging and many have been linked to serious conditions such as cirrhosis and liver cancer if left untreated.[i]


What are the symptoms?

Due to the sheer variety of forms of hepatitis the symptoms too can be varied, and in some cases sufferers may not even exhibit any symptoms at all. Despite this, some common complaints include muscle and joint pain, a high temperature, a loss of appetite and a general sense of feeling unwell. As you can imagine these symptoms can be associated with a huge array of other illnesses, which is what makes diagnosing hepatitis so difficult in some cases.

However, more specific side effects can include jaundice, dark urine and grey, pale faeces, all of which provide a better visual indication of the problem. If left untreated some forms of hepatitis may also cause swelling of the limbs, confusion, and blood in stools and vomit.[ii]

Hepatitis C

Among all strains, hepatitis C is thought to pose the biggest threat to those living in the UK. It’s estimated that as many as 170 million people worldwide are infected with the chronic version of the condition,[iii]and as it often causes no symptoms or only mild flu-like symptoms, it means that many may be unaware that they are infected. The disease is spread through blood-to-blood contact and can cause severe problems such as liver failure. Furthermore, it has been linked to a number of conditions that can affect oral health as well.

Oral conditions

Alongside uncomfortable, unsightly conditions such as lichen planus[iv](red, white or erosive patches affecting the soft tissue in the oral cavity) hepatitis C is also linked to ailments that affect the salivary glands such as Sjögren’s syndrome.  Those affected with Sjögren’s syndrome produce less saliva, and therefore are at higher risk of tooth decay as saliva actively protects teeth by washing away harmful bacteria and neutralising plaque acids.[v]

Research also suggests that those with hepatitis C are more vulnerable to dental and oral diseases derived from biological mechanisms, and that these individuals are more likely to suffer mental side effects such as low self-esteem associated with the poor appearance of their teeth.[vi]

Even more worrying is that research suggests that this strain has also been linked to the development of mouth cancer, a voracious form of the disease that is responsible for around 200,000 deaths per year.[vii]

What can you do?

In light of these considerable threats it’s important that dental hygienists and dental therapists take action against hepatitis and provide patients who suffer from the disease with special care. By encouraging patients with the condition to visit regularly for routine appointments, you can help protect their teeth from caries in cases where they have xerostomia caused by Sjögren’s syndrome and also alert them to any signs of oral cancer that you may identify during check ups.

28 July2018 is World Hepatitis Day provided the perfect opportunity for individuals to get involved and help raise awareness of the disease. Operating under the slogan “Find the Missing Millions” this year’s campaign aimed to motivate the millions of people living with undiagnosed hepatitis to get checked so that they can receive the care they deserve and prevent unnecessary illness or deaths.

As hepatitis is often a silent danger and one that can affect both oral and general health alike, we need to take action. By helping to raise awareness and offering tailored care to those affected we can all make a real difference.

For more information about the BSDHT, please visit www.bsdht.uk,

call 01788 575050 or email enquiries@bsdht.org.uk


[i]NHS Choices. Hepatitis. Link: https://www.nhs.uk/conditions/hepatitis/ [Last accessed June 18].

[ii]NHS Choices. Hepatitis. Link: https://www.nhs.uk/conditions/hepatitis/ [Last accessed June 18].

[iii]Alavian, S., Mahboobi, N., Mahboobi, N., Karayiannis, P. Oral Conditions Associated with Hepatitis C Virus Infection. Saudi J Gastroenterol. 2013; 19(6): 245–251.

[iv]Carrozzo, M., Scally, K. Oral Manifestations of Hepatitis C Virus Infection. World J Gastroenterol. 2014; 20(24): 7534–7543.

[v]Stookey, G. The Effect of Saliva on Dental Caries. JADA. 2008; 139(2): 11S-17S.

[vi]Alavian, S., Mahboobi, N., Mahboobi, N., Karayiannis, P. Oral Conditions Associated with Hepatitis C Virus Infection. Saudi J Gastroenterol. 2013; 19(6): 245–251.

[vii]Alavian, S., Mahboobi, N., Mahboobi, N., Karayiannis, P. Oral Conditions Associated with Hepatitis C Virus Infection. Saudi J Gastroenterol. 2013; 19(6): 245–251.

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