ESRF and the health of the teeth?

[kristina]

Has anyone noticed any change
in the health of their teeth
when they are in ESRF?
I am still pre-dialysis and I wonder
if I have to take special precaution?
Thank you, Kristina.

[Hanify]

Yes definitely.  But I also have a bone cancer so I'm never sure whether it's the dialysis or the cancer.  Lucky me I guess ha ha.
I think some people have talked about getting teeth removed before they go on dilaysis so they don't have that complication later.  Definitely go and see a dentist now.  (If you can afford it!!!)
Cheers
Bern

[kristina]

Thanks for your reply, Bern,
but I don't understand why anyone would want
their teeth removed, why would they have it done,
and what are the reasons?
Is it difficult in dialysis to have dental treatment,
is it more complicated?
Thanks again, Kristina.

[Hanify]

I think they were people who still had wisdom teeth but had never bothered before.  I'm not sure what it is about dialysis that makes removing teeth harder - maybe it's just that our immune systems are usually not that great, and getting your teeth out could lead to infection?

[kristina]

Thanks again.
I was reading that two drops of tea-tree-oil
on the toothbrush/toothpaste helps to
prevent infections and I wonder
if anyone has tried this and found
it effective?
Thanks, Kristina.

[MissyKew]

Kristina,

Many of us who are on Medicare also have Medicaid that picks up what Medicare doesn't pay.  Medicare does not cober dental health.  Medicaid does.  under Medicaid, they will  drill and fill.  They are supposed to do root canals too.  However, most dentists who accept Medicaid refuse to do root canals because they do not get reimbursed very well for them.  The truth is that they make the most money for pulling teeth so generally, you have no choice beut to get the teeth pulled.  It sucks.

The reason dental work is a problem on dialysis is because your immune system is bad.   Bacteria from your teeth can be released into the blood stream where it can take up residence on the heart valves and you can become very sick and even end up needing a heart valve replacement.  Because of this, dentists want to pretreat patients like us with prophylactic antibiotics to try to prevent that from happening.

[RightSide]

Sure,
my teeth started falling apart, just like my bones.

My high PTH levels started sucking the calcium out of my body. And calcium is found in bones and teeth.  Both started softening up.

The solution, of course, is medication to lower the PTH level.

And if you're thinking about a kidney transplant, remember that they won't allow a kidney transplant to proceed if you have tooth abscesses or a high likelihood of these--due to immunosuppressants.  For this reason, my own dentist has advised me to stay away from implants, in case I would need to repair these after starting immunosuppressants.  He has recommended dentures for me instead.

So in general, I would say:  Lower your PTH; and get your teeth fixed without implants.

[Goofy]

Does anyone know if people with kidney disease can whiten their teeth or do you think it would make them brittle?

[jbeany]

One of my nurses said he has had several patients with bad teeth, and they repeated got infections in their caths.  Once the teeth were pulled, the cath infections stopped.
The link from mouth to blood stream is very close.  Any dialysis patient going to the dentist, even just for a cleaning, needs preventive antibiotics.  Brush at least twice a day, and yes, you really do need to floss!

Goofy, I've used the over the counter whitners, like Crest white strips.  I don't think most of the store bought versions are strong enough to make your teeth brittle, and they mostly clear only the top layer of stains of.  I'm a blueberry fanatic, so I need the stain remover!  I never see the dramatic results they show on tv, but they do lighten the color quite a bit.

[Hanify]

I've never been told to have antibiotics before going to the dentist.  I just went last week. Should I ask my dentist or my neph about it?  I mean should the dentist automatically know?

[MissyKew]

My dentist knew.  If you are going to have dental work, in my opinion, you should definitely ask one of your docs for a script for antibiotics.  A lot of dentists won't work on you if you haven't had the antibiotics.

[RichardMEL]

same here - never been told to have antibiotics when cleaning or anything like that. However dental health has been stressed by the transplant folks at info sessions I've been to. For that reason I had my wisdom teeth removed prior to starting Dialysis to get that major dental thing out of the way (it was recommended). Post transplant, as others have said, you need to keep the risk of infection as low as possible - which means top focus on dental hygene!

[kristina]

Thank you very much for all your replies, it is very much appreciated.

I shall focus even more on my dental hygiene now because
bad teeth might lead to some other problems elsewhere in my body.

I had no idea how serious this could be
in connection to renal problems and the surrounding issues.

Thanks again for your thoughts, Kristina.

[cariad]

I am post-transplant and ignored the antibiotics rule with dental cleanings, mostly because I forgot. I was on penicillin for nearly 20 years post-transplant, so never had to learn those rules. Sometimes dentists would ask about it, sometimes they wouldn't.

THEN (cue ominous music) I went in for a routine cleaning in 2005. Stopped at the market on the way home, and when I arrived at the house, suddenly realized that I wasn't going to be able to carry the bags in. I phoned my husband and said I felt very unwell, he raced back from work, and I ended up with the most evil case of strep imaginable. This is also when I discovered that I am now allergic to both penicillin and zithromax. I take Levaquin before cleanings now, which makes me dead nauseous, but as my GP has said "Would you rather throw up or stop breathing?"

I wouldn't count on the dentists to know. This is not really their purview. It's best if you remember yourself, and get a prescription from your doctor.

[Maker]

I haven't heard this about taking antibiotics before going to the dentist...is this for even a routine cleaning?  I never have problems with my teeth but do get them cleaned every 6 months.   

[MissyKew]

Yes, even for routine cleanings.  I think it also depends on just how healthy a person is and how healthy their mouth may be.    Just check with your doc and or your dentist.

[Hanify]

I asked my renal team and they said no they don't advise antibiotics if it's just a clean or check up.  Only if it's something bigger.
I have another problem.  I get bisphosphonate -r pimidrinate once a month and while you are getting that - and for some time after you finish, you are not allowed to extract teeth.  Something to do with jaw disease.  I of course have a tooth that I would like to just pull out which has an abscess.  To get a root canal and proper cap will be $2000.  Ouch.  Anyone else on pimidrinate?  It's a bone hardner they often give to people with osteoporosis.

[kristina]

I am so sorry for your predicament, Hanify,
I wish I knew how to give some practical ideas,
I send you my best wishes
and good luck from Kristina.

[tubes]

I was told to take an antibiotic before seeing the dentist. Even if it is just a cleaning. My last dental appt. I forgot to get an antibiotic and the dentist gave me one when I went in. I also have my wisdom teeth. My dentist said I have a big mouth  and there is plenty of room. No reason to pull them.  So I guess that was a compliment.    Plus I've been told I have alot of fluoride in my teeth. So I was told that accounts for the white blotchiness of my teeth. 

Goofy, My dental office has a whitening program that I signed up for. It was $99 and a free tube of whitening every six months I go in for a cleaning.  They used that plaster stuff and made trays of my lower and top teeth. The first 2 tubes worked great. No sensitivity or anything. This last tube I can't use. It burns my gums something bad. So next time I go in I'm going to ask about it. And I've never heard about whitening making your teeth brittle. Thats new to me. Something I'm going to look into now.

~Robert

[RightSide]

Teeth are like bone--made of calcium.

My high PTH was sucking calcium out of my bones (causing them to weaken and give me pain). But it was also sucking calcium out of my teeth--my teeth just started falling apart inside my mouth.

[tyefly]

 Be sure to always check out your dentist......  there are some really bad ones..... I had inplants placed in 2005 and I almost died....   He cut my artery under my tongue and I almost bleed to death.....  throat completely closed up and had to have a  tracheostomy just to breath....  had that for 10 days...had emergency surgery and was in the hospital for two weeks.....  he over dosed me with numbing stuff....   and my doctors think that this is why I lost my kidneys.....    Had a law suit....   and found out that this dentist learned how to place inplants and do oral surgery by going to a conference and a book....   Can you believe that......  his web page looked good  and he sounded like he knew what he was doing......   I ended up spending over 22000.00 to fix everything that he did wrong..... it took 1.5 years to do  and won the law suit......   
   anyway......   I have been to the dentist all my life   and trust those guys...just like I trust my doctor now....but we need to learn all we can to protect our selves......   no matter what the subject is........
      Everyone needs to be carefull

[pdpatty]

Dental problems are a definate.
Had to have 2 teeth removed about 11 days ago. One was infected but dentiat did not give me antibiotics ,nether did the neph when I told her. She just said the dentist should have.

Mouth still hurts,wish it would heal up soon.

[pamster42000]

Always take an antibiotic before going to the denist. It's only a one time dose you take a couple of hours before you visit the denist but it may save you troubles down the road. I think even with cleaning because teeth can bleed during this procedure.
If your PTH levels are out of range I would be concerned about the teeth. Your teeth are made of calcium and when calcium is low the body counteracts and draws calcium from the body wherever it can.

[kitkatz]

Lordy! How dialysis gets every part of the body!

[kristina]

Lordy! How dialysis gets every part of the body!

I think trouble might start already when kidney function starts declining...before dialysis...

I thank you all for your kind replies and I shall look after my teeth more carefully...

I have noticed it helps to look and search for different toothbrushes etc., and I have found an electric toothbrush

which makes it much more easy to brush my teeth more thoroughly, it has a build-in timer to watch time etc.

and it has helped me a lot.  A Hygienist has told me it is equally important to 

lightly "scrape" the tongue because of bacteria entering the system.

I wonder whether anyone has heard of this and what do they think?

Thanks again, Kind regards from Kristina.