Dental Health in Kidney Disease Patients

Oral Effects

People with kidney disease often have other health issues. They often have compromised immune systems, so they may be more likely to get infections.

People with renal (kidney) problems may have a bad taste in their mouths and bad breath (halitosis). This occurs because the kidneys fail to remove urea from the blood. The urea breaks down to form ammonia, which has a foul smell. Bone changes also can occur because the body cannot absorb calcium properly. Therefore, people with kidney disease are at risk for losing bone from their jaws. Their teeth may become loose and eventually fall out.

Kidney disease itself causes some of these symptoms. Others are caused by medicines and treatments for the disease.

  • Anorexia (an eating disorder)
  • Anemia (a blood disorder)
  • High blood pressure and heart disease
  • Dry mouth (xerostomia)
  • Periodontal (gum) disease, which leads to loose teeth, and eventually to tooth loss
  • Inflammation of the mouth and salivary glands

Kidney disease itself causes some of these symptoms. Others are caused by medicines and treatments for the disease.

At the Dentist

If you are on dialysis (either hemodialysis or peritoneal dialysis), you and your dentist should plan to schedule your dental treatments on the day after a dialysis treatment. If you have a shunt, you may be given a blood thinner, which can increase the risk of bleeding. Because of the shunt, you may be at higher risk for certain infections. For this reason, your doctor may prescribe antibiotics for you to take before dental treatment.

Tell anyone who takes your blood pressure that you have a shunt. The blood pressure cuff should not be placed on the arm with the shunt. Your blood pressure should be taken on the other arm, or on a leg.

Before you receive treatment, give your dentist a list of your medicines and their doses. Your dentist will consider the medicines you take before prescribing other drugs. Some medicines may make kidney failure worse. Some may build up in the body until the next dialysis. Kidney disease can affect your blood counts. Give a copy of your most recent blood tests to your dentist as often as it is available.

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NHS Dental Treatment for Renal Patients

If you are looking for a NHS dentist in England, you can call NHS Direct on 0845 4647 or visit the NHS Choices website (www.nhs.uk) to find the NHS dental practices closest to where you live or work. If you have any subsequent difficulty accessing NHS dentistry in your area or have any special needs, NHS Direct and NHS Choices will be able to provide you with details of a local helpline number to support you in accessing NHS dental care.

Useful dental information websites are www.dentalhealth.org, www.bdasmile.org and the dental health area of the NHS Choices website (www.nhs.uk/Livewell/dentalhealth/Pages/Dentalhome.aspx)