**3. Hemodialysis and oral health**

Hemodialysis treatment modality is usually prescribed for prolonged duration with weekly frequency of once, twice, or more than twice a week, thus, creating a stressful environment for the patients [9]. This long-standing treatment modality has affected the survival rate among the patients positively. However, the chronic condition might influence the incidence of other systemic diseases in these patients primarily due to the lack of their ability to control water and electrolyte balance and filtrate waste products [10].

Further, oral health among these patients undergoing hemodialysis has been reported to be poor primarily due to their delicate state, neglect of oral hygiene, manifestations of systemic conditions, and immunosuppression [11, 12]. The specific effects of chronic renal disease and renal replacement therapy on periodontal tissues include gingival hyperplasia, increased level of plaque, calculus, and destructive periodontal disease. The findings have been reported by many studies [10, 13, 14]. It is interesting to note further that the dental diseases have coherent relation with the treatment duration of hemodialysis as well [8]. Very few studies have presented a cumulative data concerning the effect of duration of hemodialysis therapy on oral health of the patients undergoing hemodialysis. Hence the present chapter gives an insight of the oral health manifestations of hemodialysis and the underlying kidney disease correlating it with the duration of the treatment modality.
