Dental Health for People with Kidney Disease

Good dental health isn’t just about preventing cavities and keeping your gums healthy. Both tooth decay and gum disease can lead to infections that can cause problems for people with kidney disease and those who have diabetes.

Tooth decay

Tooth decay and gum disease are caused by plaque. Plaque is a sticky film of bacteria that coats the teeth. The sugars and starches of the food you eat react with the plaque, causing it to release acids. These acids wear away the hard tooth enamel, eventually leading to cavities and tooth decay.

Symptoms of advanced tooth decay include:

• Toothache: Mild to severe, throbbing pain
• Visible holes or pits in the teeth
• Sensitivity to hot, cold or sweet foods and drinks
• Swelling around the jaw

Gum disease

Gum disease starts when plaque accumulates and hardens over time. This hardened plaque is called tartar. Tartar settles at your gum line and can make your gums sensitive and irritated. If you notice your gums bleed after brushing your teeth, this is a symptom of gingivitis, an early stage of gum disease. Left untreated, tartar can build up to the point where the gums pull away from your teeth. This gap forms pockets that let in food and bacteria, which can cause infections. This stage of gum disease is called periodontitis.

Early signs of gum disease include:

• Bleeding from the gums (gingivitis)
• Red, swollen, tender gums
• Gums that have pulled away from the tooth (receding gums)
• Bad breath

Recommended dental hygiene

Both tooth decay and gum disease can be treated and are preventable if caught in its early stages. The American Dental Association recommends the following:

• Brushing twice a day
• Flossing once a day
• Visiting your dentist twice a year for checkups

Brushing your teeth will help remove excess plaque, as well as any acids that can harm your tooth enamel. Flossing will help clear the excess plaque and food debris from between the teeth, preventing the build up that can lead to tartar.

A professional teeth cleaning is part of good dental hygiene and should be performed at your checkups to the dentist.

Special considerations for those with kidney disease

A study in the Journal of Clinical Periodontology reported that people with kidney disease and those on dialysis are more likely to have periodontal disease and other oral health problems than the general population. Buildup of bacteria in the mouth can cause infection. Because people with kidney disease have weakened immune systems, they are more susceptible to infections.

Bone loss in the jaw can occur in those with kidney disease. Calcium imbalance contributes to loss of calcium from the bones resulting in weak bones. Weak bones can cause teeth to become loose and potentially fall out. The best way to help prevent bone loss is to make sure calcium and phosphorus levels stay within the goal range.

Kidney patients are advised to tell their kidney doctor when a dental procedure is required. The doctor may recommend antibiotics be taken prior to the procedure to help guard against infection. The dentist should be made aware that their patient has kidney disease or is on dialysis. Ideally, dental procedures, such as tooth extraction, should occur on a non-dialysis day for those on hemodialysis. Heparin, administered during hemodialysis, may cause some people to have extra bleeding.

During workup for a kidney transplant a person will undergo a thorough oral exam. Infections from gum disease or advanced tooth decay can prevent someone from being eligible or delay the transplant until dental work is completed.

Special considerations for those with diabetes

Diabetes is one of the major causes of chronic kidney disease. If your renal disease is caused by diabetes, you should know that those with diabetes are more prone to having the following dental problems:

• Cavities (tooth decay)
• Gum disease (periodontal disease)
• Problems with the salivary glands
• Fungal infections
• Infections and delayed healing

One of the symptoms of diabetes is dry mouth. Dry mouth can lead to an increase in plaque and sugar in the mouth, which can mean an increase in tooth decay and gum disease.