Cavity question (this is dialysis related!)

[paddbear0000]

This may sound weird, but here goes. Last year I had a cavity filled. Now, since starting dialysis 2 months ago, it has started bothering me quite regularly. Up until this point it has never  bothered me before. Has anyone else had this problem? My husband just thinks it's all in my head and I'm pretty sure my dentist thinks I'm a hypochondriac or something! 

[Romona]

Has your dentist checked it? Is it more a sensativity to hot or cold?

[jbeany]

How's your PTH?  What about your calcium levels?  It certainly makes sense that if your levels are shifting, it might make a cavity, which has probably already changed the nerve structure in your tooth, more sensitive.

[paddbear0000]

It's not sensitive to hot or cold, but rather just a sharp pain at random times. And yes, I did see the dentist. He said there's nothing visibly wrong with it, but he's never heard anyone have this complaint before. But then again, I am only the second dialysis patient he's ever had. My PTH and calcium are perfect. I don't know if it makes a difference or not, but it's not a metal filling. It's some kind of enamel colored filling. I don't remember what it's made out of though.

[rose1999]

I had this happen and it turned out I needed root canal treatment - although I'm not a dialysis patient so yours may be a different issue.  Mine would just start to hurt when I was walking in the fields for example (not a particularly hot or cold day) the pain would be in the filling and down into the jaw (lower tooth).  Can you get your dentist to do an xray to see what is going on beneath the tooth?

[Zach]

My PTH and calcium are perfect.

What do you mean by "perfect?"
Give us some numbers, please.

[kitkatz]

I am having jaw pain, but to maybe related to the TMJ I have.

[paddbear0000]

My PTH and calcium are perfect.

What do you mean by "perfect?"
Give us some numbers, please.

Calcium = 9.0
PTH = 72

I had this happen and it turned out I needed root canal treatment - although I'm not a dialysis patient so yours may be a different issue.  Mine would just start to hurt when I was walking in the fields for example (not a particularly hot or cold day) the pain would be in the filling and down into the jaw (lower tooth).  Can you get your dentist to do an xray to see what is going on beneath the tooth?

Yeah. I think I need to. I actually have another appointment in 2 weeks, so I'll just have him do one then.

[Romona]

I hope all goes well for you. Mouth pain stinks.

[Zach]

Calcium = 9.0
PTH = 72

Yes, your calcium is good.

As a person with CKD 5, the National Kidney Foundation recommends:
A PTH target range of 150 to 300 pg/mL (16.5 to 33.0 pmol/L).

GUIDELINE 13C. ADYNAMIC BONE DISEASE
http://www.kidney.org/Professionals/kdoqi/guidelines_bone/Guide13C.htm

13C.1 Adynamic bone disease in stage 5 CKD (as determined either by bone biopsy or intact PTH <100 pg/ml [11.0 pmol/L]) should be treated by allowing plasma levels of intact PTH to rise in order to increase bone turnover. (OPINION)

13C.1a This can be accomplished by decreasing doses of calcium-based phosphate binders and vitamin D or eliminating such therapy. (OPINION)
~~~~~~~~~~

How's your phosphorus?  It's all related to each other.
Make sure you discuss this issue with your nephrologist.

 

[BigSky]

It's not sensitive to hot or cold, but rather just a sharp pain at random times. And yes, I did see the dentist. He said there's nothing visibly wrong with it, but he's never heard anyone have this complaint before. But then again, I am only the second dialysis patient he's ever had. My PTH and calcium are perfect. I don't know if it makes a difference or not, but it's not a metal filling. It's some kind of enamel colored filling. I don't remember what it's made out of though.

Maybe the effects of fluid being removed or gained are putting some type of pressure on the nerves of the tooth?

[paddbear0000]

Calcium = 9.0
PTH = 72

Yes, your calcium is good.

As a person with CKD 5, the National Kidney Foundation recommends:
A PTH target range of 150 to 300 pg/mL (16.5 to 33.0 pmol/L).

GUIDELINE 13C. ADYNAMIC BONE DISEASE
http://www.kidney.org/Professionals/kdoqi/guidelines_bone/Guide13C.htm

13C.1 Adynamic bone disease in stage 5 CKD (as determined either by bone biopsy or intact PTH <100 pg/ml [11.0 pmol/L]) should be treated by allowing plasma levels of intact PTH to rise in order to increase bone turnover. (OPINION)

13C.1a This can be accomplished by decreasing doses of calcium-based phosphate binders and vitamin D or eliminating such therapy. (OPINION)
~~~~~~~~~~

How's your phosphorus?  It's all related to each other.
Make sure you discuss this issue with your nephrologist.

 

Last month, my PTH was 267, and before that, it was 1600 and something. But this cavity issue has been going on almost to the day I started dialysis. My phosphorus is 4.5. I don't take binders and my vitamin D 25-Hydroxy level is through the floor, at 6.1 (normal = 32-100).