Wisdom Teeth and Transplant

[renalpenguin]

My dentist has been telling me for about a year and a half that my wisdom teeth are impacted and that I need them removed- but my nephrologist (sp?) has said to wait until I went into remission of my nephrotic syndrome. Now my kidneys are failing (guess I won't be going into remission!) and I'm working on getting a transplant list.

I was wondering- do I have to get my wisdom teeth removed before I get on the list?

[billybags]

We were only discussing this the other day, my husbands teeth are not to good. If he needed treatment a normal dentist would not touch his teeth because of the kidney failure and that my husband is on dialysis so he would have to see a NHS dentist. I don't know how your dentists treat kidney failure in the US.

[cariad]

It probably depends on your center. US centers almost always defer to the nephrologist, so if your nephrologist says to wait until after a transplant, they will likely echo that.

Are you experiencing any symptoms from the impacted teeth? I would bet that if you do not bring the issue to the hospital's attention, you will be listed with the teeth impacted. If you ask at the eval, "should I get my impacted teeth out first?" then they will almost certainly say yes, or that it is up to your nephrologist. Normally, they like all health issues cleared up before trying to get you a transplant. If you are experiencing symptoms, then I would insist on getting them out now. A good oral surgeon will be able to handle the kidney issue, and should consult with your nephrologist.

Good luck.

[lola]

Otto has had problems due to all the meds, needs to have his wisdom teeth pulled but he's totally freaked out. Otto is on the list and they want him to have it done.

[okarol]

I found this:

Dental Care

You may have received a dental consultation during your pre-transplant workup to be sure that any necessary dental work would be completed before transplantation. If so, it is not necessary to have routine dental work performed for at least six months following transplant. This includes having your teeth cleaned. However, if you have tooth or gum pain, you should see your dentist immediately.

After transplantation, you need to take an antibiotic when you have dental work done, including cleaning and polishing. You can obtain a letter from the Transplant Office for your dentist regarding your antibiotic prescription.

It is extremely important that you practice good oral hygiene after your transplant. Brush your teeth once or twice a day. You should floss your teeth after transplant, but flossing can irritate your gums and cause bleeding, so be gentle.

If your dental work was not completed before transplantation, you must see your dentist for evaluation within the first few months after your return home. Follow the procedure outlined below when you visit the dentist.

    * Make an appointment
    * Have the dentist examine your mouth and teeth, but do not allow either the dentist or a hygienist to pick, clean, or polish your teeth. If further cleanings or dental work are necessary, antibiotics must be taken.
    * Have the dentist take X-rays if necessary.
    * Schedule all necessary appointments as closely together as possible when your dentist knows what work needs to be done.

If you are on prednisone, the dose should be as low as possible when dental work is done to reduce the possibility of infection and bleeding, and to enhance the healing process. But do not avoid dental checkups just because your prednisone dose is still high. It is better to have healthy teeth and gums than to allow them to become infected.

[Chris]

I was told before my transplant I needed them out, but didn't have to get them out. I basically waited 9 years post transplant to have them taken out, partly due to fear, then cost. However other problems developed due to the meds from dialysis then post transplant that I needed a couple other teeth removed. I went to my transplant hospital to see the dentist and oral surgeon there, but it cost to much and no payment plan available. I then found a University dental program that does work based on income since they are a teaching hospital who also has  a transplant program. The ony problem I had afterwords is that they did the procedure in 2 steps. The took out the left side  and waited one month to do the other to see how well I healed, and then took out the other. The problem with that was that being on Amoxicillin for about a mnth and then restarting it allowed c-diff to develop.

If you can, follow your tx centers protocol and have it done beforehand, but if you wait till after, take more precautionary steps.

[chris73]

I had 6 teeth extracted b4 TX, two wisdom teeth were impacted.Had it done in two visits w/ just local anesthetic  I had to have it done  b4 TX..My dentist referred me to oral surgeon that moved me to the head of the line because of up coming transplant.Need to have this take care of asap!! you don't want anything from holding you from getting  TX...you may need a dental clearance form from dentist b4 TX.....hope this helps!!!  God Bless!!!  Chris

[draven]

my one wisdom tooth was giving me problem about 9 years ago. dentist recommended i have all 4 removed, which i did.

regarding the dental appointments post transplant, i have had a filling done and my teeth cleaned since my transplant.
i didnt take any antibiotics. but everything is going smoothly so no problems there.

[renalpenguin]

My doctor says I probably have to, but I'm going to my dentist first to see what he says- if I can get by without it I will (they aren't bothering me at all; x-rays are the only reason I even know they are coming in).

And if I did need them out pre-transplant, does anyone know how long recovery will take (considering I'm on steriods and Cellcept?) I'm really concerned about how long I have to be on a liquid/soft diet.

Thanks everyone! 

[cariad]

I was post-transplant (about 15 years) when I had my wisdom teeth extracted, so I was on a low dose of imuran and prednisone. I went to an oral surgeon and was put under general, the whole works. I rested the rest of that day and was back doing my gym workout the next day. I took codeine, but tried to avoid even that since codeine makes me nauseated.

The surgery is not a big deal. You may need an extra day to recover if you are not in the best of health, but most people I've known to get oral surgery are back at work/school/whatever the following day, or even later the same day.

Hope that helps. Good luck with the teeth!

[Chris]

Since I just had mine done in September and October, I stayed on a liquid diet for a few days as a precautionary measure since there was no stitches this time. I only had 3 wisdom teeth and on the first extraction, it was one wisdom tooth and 2 side teeth. The side teeth had sutures put in and they were the hardest to remove, while the wisdom teeth were a breeze compared to that. So my left side was sore and sensitive longer and stayed on liquid diet longer, then soft foods.

Just remember each person is different and your wisdom teeth removal maybe hard or easy.

[girliekick]

 i was going to do multiple tx listings(need all 4 w teeth cut out) one place required it, and would pay for nessary work, the other(where im listed) does not, when i asked about it, they strongly recommended i have anything that could lead to potential infection done pre tx. May be u could find an alternative way to pay for it. Thats what i am trying to do any how.
Best of luck
girl

[Phraxis]

I had a bunch (product of a misspent youth -couldn't keep my mouth shut) of dental work done prior to transplant at the transplant teams instructions. So for six weeks, i was in the dentist once or twice each week. It drove the D nurses crazy because I would get it done on D day, figured why wreck the entire week, and they were concerned with bleeding. never became an issue during D but wrecked all pillows, pillow cases, and some sheets. However, it resolved allot of outstanding issues and seems to have been the correct choice.

[okarol]

Jenna has 4 impacted wisdom teeth and is going to the oral surgeon for xrays and scheduling to have them removed. We're trying to get it done before she gets a fistula and so far her Brave Little Kidney is still chugging along at 3.5 creatinine. But it definitely should be done if/when she gets listed again.

[Chris]

Hard to say if all at once would be good to do, but depends on doctor. Mine wouldn't until he saw how I healed with one removed and then removed the other 2. With what happened to me, I wish they just removed all at once.
 
Bring lots of spare gauze, a big zip loc bag for garbage, and pain meds if you have any for ride home.

[girliekick]

they removed mine all at once

[RichardMEL]

I was all at once too. I figured if I have to have this done, just knock me out with a general and rip 'em all out and be done with it. I did OK actually - had very little swelling or pain (YAY!). The weidness was with the holes in the mouth that weren't there before, and it took awhile to get used to that....

I'm glad I got it done years ago though because I know that won't ever be an issue for me again specially now that I'm dealing with ESRD and potentially a transplant in the future.

[okarol]

Jenna had her consultation about getting her 3 wisdom teeth out, but now the oral surgeon wants instructions from the transplant team as far as pre-medication with antibiotics, and any other precautions that would be necessary to avoid problems with Jenna's remaining function.