When was the last time that you went to the dentist? Did you know that diseased gums can prevent or delay a kidney transplant? There are many reasons why an individual does not go to the dentist—fear, lack of funds, one may think that dental appointments are not as important as medical appointments, no dental insurance and other factors. It is important to adopt the mindset that diseased gums can infect the entire body.  Infection is something that all patients should avoid. Education about the prevention of infection is vital. Timely dental appointments and daily dental hygiene can help to prevent dental disease and/or dental infections.

Please contact your providers and medical professionals when seeking advice to obtain a dentist, and if they know of any dental assistance programs for funding and/or dental care if needed. Medicare and Medicaid have special provisions for certain dental issues with renal patients but please contact your providers to determine if your diagnoses qualify.

The following information has been compiled from DaVita (www.davita.com) and The Mayo Clinic (www.mayoclinic.org).

(Retrieved from: https://davita.com/education/articles/dental-health-for-people-with-kidneydisease)

Dental Health for People with Kidney Disease

Good dental health isn’t just about preventing cavities and keeping your gums healthy. Both tooth decay and gum disease can lead to infections that can cause problems for people with kidney disease and those who have diabetes.

Tooth decay

Tooth decay and gum disease are caused by plaque. Plaque is a sticky film of bacteria that coats the teeth. The sugars and starches of the food you eat react with the plaque, causing it to release acids. These acids wear away the hard tooth enamel, eventually leading to cavities and tooth decay.

Symptoms of advanced tooth decay include:

  • Toothache: Mild to severe, throbbing pain
  • Visible holes or pits in the teeth
  • Sensitivity to hot, cold or sweet foods and drinks
  • Swelling around the jaw

Gum disease

Gum disease starts when plaque accumulates and hardens over time. This hardened plaque is called tartar. Tartar settles at your gum line and can make your gums sensitive and irritated. If you notice your gums bleed after brushing your teeth, this is a symptom of gingivitis, an early stage of gum disease. Left untreated, tartar can build up to the point where the gums pull away from your teeth. This gap forms pockets that let in food and bacteria, which can cause infections. This stage of gum disease is called periodontitis.

Early signs of gum disease include:

  • Bleeding from the gums (gingivitis)
  • Red, swollen, tender gums
  • Gums that have pulled away from the tooth (receding gums)
  • Bad breath

Recommended dental hygiene

Both tooth decay and gum disease can be treated and are preventable if caught in its early stages. The American Dental Association recommends the following:

  • Brushing twice a day
  • Flossing once a day
  • Visiting your dentist twice a year for checkups

Brushing your teeth will help remove excess plaque, as well as any acids that can harm your tooth enamel. Flossing will help clear the excess plaque and food debris from between the teeth, preventing the build up that can lead to tartar.

A professional teeth cleaning is part of good dental hygiene and should be performed at your checkups to the dentist.

Special considerations for those with kidney disease

A study in the Journal of Clinical Periodontology reported that people with kidney disease and those on dialysis are more likely to have periodontal disease and other oral health problems than the general population. Buildup of bacteria in the mouth can cause infection. Because people with kidney disease have weakened immune systems, they are more susceptible to infections.

Bone loss in the jaw can occur in those with kidney disease. Calcium imbalance contributes to loss of calcium from the bones resulting in weak bones. Weak bones can cause teeth to become loose and potentially fall out. The best way to help prevent bone loss is to make sure calcium and phosphorus levels stay within the goal range.

Kidney patients are advised to tell their kidney doctor when a dental procedure is required. The doctor may recommend antibiotics be taken prior to the procedure to help guard against infection. The dentist should be made aware that their patient has kidney disease or is on dialysis. Ideally, dental procedures, such as tooth extraction, should occur on a non-dialysis day for those on hemodialysis. Heparin, administered during hemodialysis, may cause some people to have extra bleeding.

During workup for a kidney transplant a person will undergo a thorough oral exam. Infections from gum disease or advanced tooth decay can prevent someone from being eligible or delay the transplant until dental work is completed.

Special considerations for those with diabetes

Diabetes is one of the major causes of chronic kidney disease. If your renal disease is caused by diabetes, you should know that those with diabetes are more prone to having the following dental problems:

  • Cavities (tooth decay)
  • Gum disease (periodontal disease)
  • Problems with the salivary glands
  • Fungal infections
  • Infections and delayed healing.  One of the symptoms of diabetes is dry mouth. Dry mouth can lead to an increase in plaque and sugar in the mouth, which can mean an increase in tooth decay and gum disease.

(Retrieved from: https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/art-20047475)

Oral health: A window to your overall health

Your oral health is more important than you might realize. Learn how the health of your mouth, teeth and gums can affect your general health.

Did you know that your oral health offers clues about your overall health? Did you know that problems in the mouth can affect the rest of the body? Protect yourself by learning more about the link between your oral health and overall health.

What’s the link between oral health and overall health?

Like other areas of the body, the mouth is full of germs. Those germs are mostly harmless. But the mouth is the entry to the digestive tract. That’s the long tube of organs from the mouth to the anus that food travels through. The mouth also is the entry to the organs that allow breathing, called the respiratory tracts. So sometimes germs in the mouth can lead to disease throughout the body.

Most often the body’s defenses and good oral care keep germs under control. Good oral care includes daily brushing and flossing. Without good oral hygiene, germs can reach levels that might lead to infections, such as tooth decay and gum disease.

Also, certain medicines can lower the flow of spit, called saliva. Those medicines include decongestants, antihistamines, painkillers, water pills and antidepressants. Saliva washes away food and keeps the acids germs make in the mouth in balance. This helps keep germs from spreading and causing disease.

Oral germs and oral swelling and irritation, called inflammation, are linked to a severe form of gum disease, called periodontitis. Studies suggest that these germs and inflammation might play a role in some diseases. And certain diseases, such as diabetes and HIV/AIDS, can lower the body’s ability to fight infection. That can make oral health problems worse.

What conditions can be linked to oral health? Your oral health might play a part in conditions such as:

  • Endocarditis. This is an infection of the inner lining of the heart chambers or valves, called endocardium. It most often happens when germs from another part of the body, such as the mouth, spread through the blood and attach to certain areas in the heart. Infection of the endocardium is rare. But it can be fatal.
  • Cardiovascular disease. Some research suggests that heart disease, clogged arteries and stroke might be linked to the inflammation and infections that oral germs can cause.
  • Pregnancy and birth complications. Gum disease called periodontitis has been linked to premature birth and low birth weight.
  • Pneumonia. Certain germs in the mouth can go into the lungs. This may cause pneumonia and other respiratory diseases.

Certain health conditions also might affect oral health, including:

  • Diabetes. Diabetes makes the body less able to fight infection. So diabetes can put the gums at risk. Gum disease seems to happen more often and be more serious in people who have diabetes. Research shows that people who have gum disease have a harder time controlling their blood sugar levels. Regular dental care can improve diabetes control.
  • HIV/AIDS. Oral problems, such as painful mouth sores called mucosal lesions, are common in people who have HIV/AIDS.
  • Cancer. A number of cancers have been linked to gum disease. These include cancers of the mouth, gastrointestinal tract, lung, breast, prostate gland and uterus.
  • Alzheimer’s disease. As Alzheimer’s disease gets worse, oral health also tends to get worse.

Other conditions that might be linked to oral health include eating disorders, rheumatoid arthritis and an immune system condition that causes dry mouth called Sjogren’s syndrome.

Tell your dentist about the medicines you take. And make sure your dentist knows about any changes in your overall health. This includes recent illnesses or ongoing conditions you may have, such as diabetes.

How can I protect my oral health?

To protect your oral health, take care of your mouth every day.

  • Brush your teeth at least twice a day for two minutes each time. Use a brush with soft bristles and fluoride toothpaste. Brush your tongue too.
  • Clean between your teeth daily with floss, a water flosser or other products made for that purpose.
  • Eat a healthy diet and limit sugary food and drinks.
  • Replace your toothbrush every 3 to 4 months. Do it sooner if bristles are worn or flare out.
  • See a dentist at least once a year for checkups and cleanings. Your dentist may suggest visits or cleanings more often, depending on your situation. You might be sent to a gum specialist, called a periodontist, if your gums need more care.
  • Don’t use tobacco.

Contact your dentist right away if you notice any oral health problems. Taking care of your oral health protects your overall health.