{"id":7298,"date":"2026-07-14T06:00:00","date_gmt":"2026-07-14T06:00:00","guid":{"rendered":"https:\/\/www.belodonte.es\/?p=7298"},"modified":"2026-05-22T07:42:51","modified_gmt":"2026-05-22T07:42:51","slug":"hepatitis-salut-oral-manifestacions-bucals","status":"publish","type":"post","link":"https:\/\/www.belodonte.es\/ca\/hepatitis-salut-oral-manifestacions-bucals\/","title":{"rendered":"Hepatitis i salut oral: manifestacions bucals"},"content":{"rendered":"\n

L’hepatitis<\/strong> \u00e9s una inflamaci\u00f3 del fetge que pot tenir origen v\u00edric, autoimmune, t\u00f2xic o metab\u00f2lic. Les seves manifestacions no es limiten al sistema digestiu: la cavitat oral \u00e9s un dels territoris on la malaltia hep\u00e0tica deixa senyals cl\u00ednics rellevants, tant per l’impacte directe del virus sobre els teixits orals com per les alteracions sist\u00e8miques que genera.

Con\u00e8ixer aquestes manifestacions permet a l’especialista actuar abans que el diagn\u00f2stic hep\u00e0tic estigui establert, i al pacient ja diagnosticat, entendre per qu\u00e8 la seva salut oral requereix un seguiment espec\u00edfic. Des de Cl\u00ednica Belodonte, experts en Odontologia conservadora a Barcelona<\/a><\/strong>, parlem sobre aix\u00f2.<\/p>\n\n\n\n

Quina relaci\u00f3 existeix entre el fetge i la salut oral?<\/h2>\n\n\n\n

El fetge exerceix un paper central en la s\u00edntesi de prote\u00efnes de la coagulaci\u00f3, el metabolisme de f\u00e0rmacs, la regulaci\u00f3 immunit\u00e0ria i la producci\u00f3 de bilis. Quan la seva funci\u00f3 es veu compromesa per una hepatitis cr\u00f2nica, aquestes alteracions tenen repercussions directes sobre la cavitat oral.<\/p>\n\n\n\n

La reducci\u00f3 en la s\u00edntesi de factors de coagulaci\u00f3 augmenta el risc de sagnat davant qualsevol procediment invasiu, incloses les extraccions dentals. La immunosupressi\u00f3 associada facilita l’aparici\u00f3 d’infeccions oportunistes en la mucosa oral. I l’acumulaci\u00f3 de bilirubina pot provocar canvis de coloraci\u00f3 en els teixits orals, incloent-hi una pigmentaci\u00f3 groguenca de la mucosa que reflecteix la icter\u00edcia sist\u00e8mica.<\/p>\n\n\n\n

Quines manifestacions orals produeix l’hepatitis v\u00edrica?<\/h2>\n\n\n\n

Les hepatitis v\u00edriques, especialment l’hepatitis C cr\u00f2nica, s’associen a manifestacions orals espec\u00edfiques i ben documentades. La m\u00e9s rellevant \u00e9s el liquen pla oral (LPO), una malaltia inflamat\u00f2ria cr\u00f2nica de la mucosa que apareix en forma de lesions blanquinoses reticulars, erosions o \u00falceres doloroses en la cara interna de les galtes, la llengua i les genives.<\/p>\n\n\n\n

Diversos estudis assenyalen que entre el 20% i el 40% dels pacients amb hepatitis C presenten liquen pla oral, una prevalen\u00e7a significativament superior a la de la poblaci\u00f3 general. Tamb\u00e9 s’ha descrit m\u00e9s incid\u00e8ncia de s\u00edndrome de Sj\u00f6gren secundari (caracteritzat per sequedat bucal severa i ulls secs) en pacients amb hepatitis C, aix\u00ed com una associaci\u00f3 amb el carcinoma de c\u00e8l\u00b7lules escatoses oral en casos de llarga evoluci\u00f3 amb LPO erosiu.<\/p>\n\n\n\n

Quines precaucions ha de prendre el dentista davant un pacient amb hepatitis?<\/h2>\n\n\n\n

El maneig odontol\u00f2gic del pacient amb hepatitis requereix una s\u00e8rie de consideracions espec\u00edfiques que afecten tant la seguretat del pacient com a la de l’equip cl\u00ednic.<\/p>\n\n\n\n

Abans de qualsevol procediment invasiu, \u00e9s imprescindible con\u00e8ixer l’estat serol\u00f2gic del pacient, la funci\u00f3 hep\u00e0tica actual (mitjan\u00e7ant la revisi\u00f3 de l’anal\u00edtica recent, incloent-hi transaminases, temps de protrombina i recompte plaquetari) i el tractament antiviral en curs, ja que alguns antivirals d’acci\u00f3 directa interaccionen amb f\u00e0rmacs d’\u00fas habitual en odontologia com els anest\u00e8sics locals amb vasoconstrictors o els antiinflamatoris no esteroidals (AINE).<\/p>\n\n\n\n

L’hepatitis B i C s\u00f3n malalties de transmissi\u00f3 sangu\u00ednia, per la qual cosa els protocols de control d’infecci\u00f3 est\u00e0ndard en qualsevol consulta dental s\u00f3n suficients per a protegir l’equip cl\u00ednic quan s’apliquen de manera rigorosa.<\/p>\n\n\n\n

Com afecta la cirrosi hep\u00e0tica a la salut oral?<\/h2>\n\n\n\n

La cirrosi \u00e9s la fase avan\u00e7ada de la malaltia hep\u00e0tica cr\u00f2nica i el seu impacte sobre la salut oral \u00e9s especialment significatiu. La trombocitop\u00e8nia (reducci\u00f3 del nombre de plaquetes) i el d\u00e8ficit de factors de coagulaci\u00f3 augmenten de manera considerable el risc hemorr\u00e0gic davant qualsevol intervenci\u00f3 oral.<\/p>\n\n\n\n

L’encefalopatia hep\u00e0tica pot alterar la higiene oral del pacient i afavorir l’acumulaci\u00f3 de placa bacteriana. La xerostomia (sequedat bucal) \u00e9s freq\u00fcent en aquests pacients, tant per la mateixa malaltia com per l’efecte secundari d’alguns f\u00e0rmacs. I la susceptibilitat m\u00e9s gran a infeccions oportunistes, com la candidiasi oral, requereix un seguiment muc\u00f3s actiu i tractament antif\u00fangic preventiu en determinats casos.<\/p>\n\n\n\n

En Cl\u00ednica Belodonte el protocol d’atenci\u00f3 a pacients amb malaltia hep\u00e0tica inclou la coordinaci\u00f3 amb el hepat\u00f2leg abans de qualsevol procediment quir\u00fargic oral.<\/p>\n\n\n\n

Pot la salut oral influir en l’evoluci\u00f3 de l’hepatitis?<\/h2>\n\n\n\n

La relaci\u00f3 entre salut oral i hepatitis no \u00e9s unidireccional. Existeix evid\u00e8ncia creixent que suggereix que la malaltia periodontal pot actuar com a factor modulador de la inflamaci\u00f3 sist\u00e8mica en pacients amb hepatitis cr\u00f2nica, agreujant el mal hep\u00e0tic a trav\u00e9s de l’alliberament continu de mediadors inflamatoris al torrent sanguini.<\/p>\n\n\n\n

Un estudi publicat en el Journal of Clinical Periodontology assenyala que els pacients amb hepatitis C i periodontitis greu presenten nivells m\u00e9s elevats de marcadors de fibrosi hep\u00e0tica que aquells amb una salut periodontal conservada. Aquesta troballa refor\u00e7a la necessitat d’incloure el control periodontal actiu com a part de l’abordatge integral del pacient hep\u00e0tic.<\/p>\n\n\n\n

Quines revisions orals necessita un pacient amb hepatitis?<\/h2>\n\n\n\n

Els pacients amb hepatitis cr\u00f2nica, independentment de la seva etiologia, es beneficien de revisions orals m\u00e9s freq\u00fcents que la poblaci\u00f3 general: cada sis mesos com a m\u00ednim, i trimestrals en fases de m\u00e9s immunosupressi\u00f3 o durant el tractament antiviral. Aquestes revisions han d’incloure una exploraci\u00f3 sistem\u00e0tica de la mucosa oral a la recerca de lesions compatibles amb liquen pla, candidiasi o leucopl\u00e0sia, a m\u00e9s del control de la salut periodontal i l’avaluaci\u00f3 del risc hemorr\u00e0gic abans de qualsevol procediment invasiu. La comunicaci\u00f3 fluida entre l’especialista en medicina oral o cirurgia maxil\u00b7lofacial i el hepat\u00f2leg \u00e9s imprescindible per a garantir un abordatge segur i efica\u00e7.<\/p>\n\n\n\n

Si tens hepatitis cr\u00f2nica i no has comunicat el teu diagn\u00f2stic al teu dentista o especialista oral, fes-ho en la teva pr\u00f2xima visita. \u00c9s informaci\u00f3 que canvia el protocol d’atenci\u00f3 i protegeix la teva seguretat. <\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

L’hepatitis \u00e9s una inflamaci\u00f3 del fetge que pot tenir origen v\u00edric, autoimmune, t\u00f2xic o metab\u00f2lic. Les seves manifestacions no es limiten al sistema digestiu: la cavitat oral \u00e9s un dels territoris on la malaltia hep\u00e0tica deixa senyals cl\u00ednics rellevants, tant […]<\/p>\n","protected":false},"author":3,"featured_media":7297,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[36],"tags":[],"class_list":["post-7298","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-odontologia-conservadora-2"],"yoast_head":"\nHepatitis i salut oral: manifestacions bucals - Cl\u00ednica Belodonte<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.belodonte.es\/hepatitis-salud-oral-manifestaciones-bucales\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hepatitis i salut oral: manifestacions bucals - Cl\u00ednica Belodonte\" \/>\n<meta property=\"og:description\" content=\"L’hepatitis \u00e9s una inflamaci\u00f3 del fetge que pot tenir origen v\u00edric, autoimmune, t\u00f2xic o metab\u00f2lic. 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