Dr.vaibhavi S.patel  

Everyday life is already a struggle for people living with kidney disease and dialysis treatments. The fact that gum disease and dental hygiene issues are both a contributing factor to and a side effect of severe kidney problems is almost cruel.

Although their teeth would seem to be the least of their problems, dialysis patients cannot overlook the importance of good dental hygiene, regular checkups, and a coordinated effort to maintain teeth and gums while not interfering with dialysis treatment. Recent research by the University of Birmingham in England (reported by Medical News Today) found the death rate from any cause for people with chronic kidney disease was 32 percent, but it jumped to 41 percent of patients who also had periodontitis. A healthy mouth can not only improve quality of life for dialysis patients, but also extend it.

The Kidney Link to Poor Teeth

Poor oral health and kidney problems have a direct—and unfortunate—relationship. A 2008 study by the Journal of Periodontology, published by the American Academy of Periodontology, found a link between adults missing teeth and the prevalence of kidney disease. Gum disease is essentially inflammation, and chronic inflammation in one part of the body can lead to infections elsewhere, including the kidneys.

Why Good Oral Health Matters for Dialysis Patients

Even more concerning, chronic kidney disease can negatively impact oral health in a variety of ways. Bad breath, dry mouth, bone loss in the jaw, inflammation, and other problems are side effects of kidney problems or the treatments for those problems. This can lead to a vicious cycle of symptoms and conditions. For example, dry mouth reduces the amount of saliva in the mouth, thus leading to greater risk of plaque and worsening gum disease. This heightened gum disease can worsen the effects of kidney disease . . . which can lead to more dry mouth. The stakes are higher for dialysis patients, who can’t afford to let other areas of their health—including their mouth—suffer, but are more inclined to develop such concerns because of their condition. Moreover, poor oral health can disqualify patients with severe kidney disease from receiving a transplant.

The Challenge with Dialysis

Routine oral procedures to address gum disease and tooth decay become far riskier for dialysis patients. Dialysis inherently weakens the recipient’s immune system, so any other invasive procedures increase the chance of infection. Furthermore, dialysis patients might be taking an anticoagulant to prevent blood clots during the procedure, and these drugs can lead to severe bleeding from even the simplest of cuts. Therefore, a tooth extraction or root canalcould become dangerous if a serious hemorrhage occurs—the patient can bleed out. Procedures that normally could be done in a dentist’s or oral surgeon’s office may require a trip to the hospital, where the environment may be more prone to infection-causing bacteria.

Staying Healthy, Staying Safe

Serious dental problems can’t go unchecked, especially with dialysis patients, whose overall health can further deteriorate if gum disease or tooth decay is ignored. Care and coordination must be taken so that a dental procedure doesn’t interfere with critical dialysis schedules. Often, doctors will prescribe antibiotics for patients who will be visiting the dentist in order to reduce the risk of infection. Going off blood thinners is usually not recommended, so patients may be advised to schedule more advanced dental procedures on days when they don’t have dialysis.

Coordinating with your doctors and your dentist is key to getting the dental treatment you need while maintaining your renal health. Perhaps more importantly, schedule regular dental checkups and practice good oral hygiene. Undoubtedly, dialysis is a challenging lifestyle; keeping your mouth healthy is one small way to reduce some of its difficulty.