The human body systems are interconnected. That is why a disease’s effects on one organ may eventually spill over into another. Such a relationship exists between kidney disease and oral health too. Chronic renal disease results in oral health conditions and some oral health problems may adversely impact kidney function. A 2021-study by the University of Birmingham attributed these changes to oxidative stress because of an imbalance of the body’s oxygen-producing free radicals and its antioxidant cells. As a result, it damages tissues at a cellular level, thus causing inflammation. Contrarily, even a slight improvement in gum inflammation can benefit renal function and vice-versa.
What are the effects of kidney disease on oral health?
1. Dry Mouth
Also known as xerostomia, it may have several reasons when caused by a kidney-related problem. For example, limited water intake by kidney patients may decrease salivary flow, leading to a dry mouth. Other reasons include waste build-up in the blood and some medications. People with diabetes, as well as renal problems, are even more susceptible to dry mouth conditions.
2. Bad Breath
Mouth stench or halitosis is a typical symptom of oral health degeneration because of end-stage renal failure (ESRF). When the kidney can no more filter wastes from the blood, urea accumulates in the blood, leading to urea build-up in saliva. Then, urea breaks down and produces ammonia, which leaves a nasty odor in the mouth. Some patients may also experience a bad taste in the mouth.
3. Jaw bone loss
Kidney disease affects the body’s calcium levels as it increases the parathyroid hormone levels. Consequently, phosphate rises in the body, making the body calcium-deficient. Inadequate calcium causes bones and teeth to weaken over time. The risk of jaw bone loss because of kidney disease is high in patients with preexisting gum or teeth problems. Losing jaw bone makes teeth fall out, affects speech ability, makes eating and chewing difficult, and distorts facial appearance.
4. Gum diseases
A dry mouth and elevated levels of phosphate and urea attract bacteria into the bloodstream. In addition, microbes feeding on the high concentration of urea and phosphate affect your health. The harmful bacteria colonize the teeth and other hard-to-clean areas in your mouth and cause plaque formation. When unchecked, plaque turns into dental calculus, a hard substance that coats the teeth and can severely damage the surrounding gum tissue, causing gingivitis or periodontal disease.
In addition, the medications for kidney disease treatments also impede gingival fibroblasts, making gums prone to bruising and bleeding.
5. Uremic Stomatitis
Kidney disease-induced excessive urea in the blood leads to increased salivary ammonia. It triggers stomatitis, an inflammatory condition that affects the oral mucosa, i.e., mucous membranes in the mouth and lips. Bacterial infection in combination with uncontrolled production of ammonia causes swelling or lesions in oral tissues.
The damage in the oral cavity decides the type of uremic stomatitis, which includes:
- Ulcerative stomatitis
- Erythematosus membranous stomatitis
- Hyper-parakeratotic stomatitis
- Hemorrhagic stomatitis
It begins gradually and mainly affects patients with end-stage kidney disease.
6. Erosions in the teeth’s lingual surfaces
Patients with chronic kidney disease suffer from electrolyte imbalance and reflux diseases because of increased urea and phosphate levels. Frequent vomiting is a common manifestation of acid reflux caused by renal problems. It throws stomach juices and acids back into the mouth, thus repeatedly exposing teeth, gums, and tongue to acidic substances. Therefore, the tooth’s outer surface erodes bit by bit and makes the teeth fragile.
Dental care tips for kidney patients
- Brush and floss twice daily. Brush for a good two minutes, and cover all the surfaces on each tooth. Similarly, floss each tooth gap properly.
- Use fluoridated toothpaste as it prevents cavities and strengthens teeth against developing cavities. You may also use fluoride-based or non-fluorinated antimicrobial rinses.
- Chew sugar-free chewing gum as it may help increase saliva and alleviate the symptoms of dry mouth. Your dentist may also recommend a saliva substitute, such as Biotene.
- Go for regular dental exams every six months or earlier if you already suffer from an oral health condition or any other health problem that can affect your oral health. Regular oral health exams help detect cavities and gum disease before they worsen. Deep dental cleaning at regular intervals is also helpful as it prevents plaque or tartar deposits that lead to bacteria build-up, bad breath, sensitivity, and gum irritation.
- Clean partial or complete dentures or clear aligners daily. In case of dentures, remove them at night to prevent ulcers or sore spots.
- Do not delay procedures like a root canal or crown lengthening treatments in Chula Vista or your trusted dental practice if tooth decay has gone below the gum line.
What are the dental considerations in patients with renal dialysis?
The blood-thinning medications given during dialysis may cause excessive bleeding during a dental treatment if planned on the same day. Therefore, First, plan dental procedures on non-dialysis days.
If you are due for a kidney transplant, be extra cautious regarding your oral health. An oral health exam is a part of the kidney transplant evaluation process. The procedure is likely to get delayed in case of serious dental infections. Severe oral health problems like periodontitis affect the immune system. An already burdened immune system may not be able to handle the weakening effects of medications given to prevent rejection of a kidney transplant and increase the susceptibility to infections manifold. Therefore, screening patients before kidney transplant helps diagnose and treat infections, including dental, to prevent post-transplant complications.
Are dental procedures safe for kidney patients?
Yes! You must not neglect any dental health problem if you have kidney disease. Discuss with your dentist that you have kidney disease and if you are on dialysis. The dentist may prescribe antibiotics before a dental procedure to help reduce the infection risk. Follow your dentist’s instructions and regularly maintain oral hygiene after dental procedures.
Do you have more queries on oral health care and living with chronic kidney disease? Please comment below!