Removing all tooth for dialysis patients

[jo]

We took my mom to an oral surgeon who said most of her tooth has been infected and all of her tooth needs to be removed in order to do a kidney transplant sometime in the future. Is this common for people on dialysis? He says he could remove all of her tooth in 2 visits, but we are a little bit concerned about this. Are there any complications after removing all of her tooth especially because she is diabetic and is on dialysis? Any feedback from anyone would be appreciated. Thanks.

[kristina]

Hello jo,
My dentist told me many years ago that because of my kidney issues I really should brush my teeth about half an hour after every meal
to make sure I won't develop any teeth-problems and I have done so ever since, except on very rare occassions when there was no possibility...
This discipline has served me very well over many years and hopefully it continues like that for many years to come with all my teeth intact  ...
... Could your mother ask another dentist for his opinion? Of course, I don't know details, but to me it sounds a bit harsh what this dentist told her...
Best wishes and good luck from Kristina.

[cassandra]

Hi Jo, I agree with Kristina, and would go for a second opinion.

Good luck, and love, Cas

[jo]

Thanks. We will get a second opinion. The dentist says most of her tooth has been infected and it is better to remove everything now than to deal with problems after the transplant. I am really worried.

[Charlie B53]

Sounds as if Mum may have a peridontal infection of the roots, possibly the bone.

Cousin was soo  sick the ER couldn't figure out what was wrong with her.

One if the Interns happened to have had a dental residency and caught a whiff of her breath.  He immediately knew her problems were in her teeth and gums.  Called in an oral surgeon, removed ALL teeth and scraped the bone and sockets clean.  Massive strong anti-biotics and walked out fine in just a few days.

She is very lucky that Intern happened to be on shift in that ward.  It would have killed her within a few more days, or less.

Now she has beautiful teeth, plates.

[jo]

Sounds as if Mum may have a peridontal infection of the roots, possibly the bone.

Cousin was soo  sick the ER couldn't figure out what was wrong with her.

One if the Interns happened to have had a dental residency and caught a whiff of her breath.  He immediately knew her problems were in her teeth and gums.  Called in an oral surgeon, removed ALL teeth and scraped the bone and sockets clean.  Massive strong anti-biotics and walked out fine in just a few days.

She is very lucky that Intern happened to be on shift in that ward.  It would have killed her within a few more days, or less.

Now she has beautiful teeth, plates.

The oral surgeon says most of her tooth has been infected and some of her tooth contains cavities. He says she is carrying the infection right now and whatever she eats carries that infection too. Hence, he suggested everything to be removed to avoid complications after transplant in case a transplant is done in the future.

[Charlie B53]

It may still be wise to get a second opinion.

Many Dentists will tell you, if your mouth isn't health YOU are not health.

The infection((s) can, and will cause other problems in the body.

Lot of Dr's will tell new heart patients, BEFORE having teeth cleaned or cavities drilled, to start a course of anti-biotics.  Some of those nasties can be released during dental work, travel through the blood system and set up an infection in a heart valve.  NOT good.

Get that second opinion.  Ask questions if there is ANYTHING that you do not totally understand.

[jo]

It may still be wise to get a second opinion.

Many Dentists will tell you, if your mouth isn't health YOU are not health.

The infection((s) can, and will cause other problems in the body.

Lot of Dr's will tell new heart patients, BEFORE having teeth cleaned or cavities drilled, to start a course of anti-biotics.  Some of those nasties can be released during dental work, travel through the blood system and set up an infection in a heart valve.  NOT good.

Get that second opinion.  Ask questions if there is ANYTHING that you do not totally understand.

Sure, I will definitely do that. Thanks.

[PrimeTimer]

I use to be a dental assistant many many moons ago. If I am remembering correctly, I believe dentists will tell you that whenever oral infection is present, people who are diabetic or who have had heart surgery in the past should be put on antibiotics before any kind of dental work is performed (this includes teeth cleaning). Depending on how widespread the infection is, it is not not necessarily uncommon for an oral surgeon to suggest that all remaining teeth be removed if all teeth are infected, including surrounding bone. Sounds harsh and it is but if there is a lot of infection and rotting going on that could be life threatening, extreme measures could be warranted.

If they are talking about just one tooth, that probably means that there is not enough of the tooth left to use as a "base" to fit a crown over. They need to be able to drill away the cavity but still have enough "good surface" left to work with. Kind of like building a house on a foundation. In either case, for lifesaving purposes, the infection must be dealt with first. The Nephrologist should be told in advance about which antibiotics and anesthetic will be used by the oral surgeon. Sorry your mother is going through so much but once the infection is under control, she will feel so much better and hopefully you will too.   

I want to add that the surgeon may also want all her teeth removed because perhaps the ones she has are not strong enough to support partial dentures or bridges. If that's the case, hopefully she will discuss being fitted for full dentures after she heals. Sometimes they can fit a person for what they call "immediate dentures" but that is not an easy procedure.

[Simon Dog]

I believe dentists will tell you that whenever oral infection is present, people who are diabetic or who have had heart surgery in the past should be put on antibiotics before any kind of dental work is performed (this includes teeth cleaning).

I've got a life sentence of 2g amoxycillin 1hr before dental cleaning or colonoscopy due to my hip transplant.

[PrimeTimer]

I believe dentists will tell you that whenever oral infection is present, people who are diabetic or who have had heart surgery in the past should be put on antibiotics before any kind of dental work is performed (this includes teeth cleaning).

I've got a life sentence of 2g amoxycillin 1hr before dental cleaning or colonoscopy due to my hip transplant.

Bacteria loves to hang out under tissue, such as heart valves or in your case, where they opened you up and transplanted your new hip. Sepsis is no fun.

[stayingalive]

I was told at my clinic that if I was needing dental work to contact them also.  They feel I should start an antibiotic before any dental work commences.  Erring on the side of caution?

[iolaire]

I was told at my clinic that if I was needing dental work to contact them also.  They feel I should start an antibiotic before any dental work commences.  Erring on the side of caution?

Based on something I read here I asked my nephrologist about it and he agreed that I should take antibiotic even before my cleanings. 

That being said please get a second opinion before pulling all someone's teeth!  That's very final and you don't want to do it if its unnecessary!

[jo]

Thanks everyone for the response. I am trying to schedule an appointment to get a second opinion. Yes, they are planning to do immediate dentures once all the tooth is removed. The oral surgeon say he would use gas and try to avoid anesthesia as much as he can based on her medical conditions. I am very scared that they wanted to remove all of my mom's tooth out. Since she is diabetic and is on dialysis, will there be any infections or complications after the dental work? Any suggestions to prevent infections or complications after the procedure? Thanks.

[big777bill]

 If she does get a transplant in the future she will be on immunosuppressant medicine for the rest of her life. Making infection more likely. I had a liver transplant and my team suggested that I have all my teeth pulled. It was done in the OR under anesthesia. They pulled 25 teeth all together. It took about a good month to get over it but then a full set of dentures and I don't have to worry about infection. Get a second opinion but I would suggest considering what your dentist advised. Good luck.

[iolaire]

Any suggestions to prevent infections or complications after the procedure?

Talk to your nephrologist and others.  Likely she will be put on a strong antibiotic in advance. 

My nephrologist has given me antibiotics to take even before cleanings since all kinds of bad stuff are in the teeth area and you want to not let those loose in your blood.

[jo]

If she does get a transplant in the future she will be on immunosuppressant medicine for the rest of her life. Making infection more likely. I had a liver transplant and my team suggested that I have all my teeth pulled. It was done in the OR under anesthesia. They pulled 25 teeth all together. It took about a good month to get over it but then a full set of dentures and I don't have to worry about infection. Get a second opinion but I would suggest considering what your dentist advised. Good luck.

Thank you.

[jo]

Any suggestions to prevent infections or complications after the procedure?

Talk to your nephrologist and others.  Likely she will be put on a strong antibiotic in advance. 

My nephrologist has given me antibiotics to take even before cleanings since all kinds of bad stuff are in the teeth area and you want to not let those loose in your blood.

Thank you.

[Maggie and Jeff]

When I was young and healthy I had a wisdom tooth get infected.

It was just pulled out and I got sick nearly died 48 hours later.

Antibiotics before hand and someone to be with her for at least 48 hours afterward in case she needs a ride to the ER to get IV antibiotics.