| Oral Effects
People whose kidneys do not function properly occasionally receive
dialysis, a process that uses a machine to "clean" the blood.
The machine is usually connected to an artificial tube called a shunt,
which is surgically attached to a blood vessel in the patient’s
arm or leg. Many dentists may feel that they lack the knowledge and
experience to treat dialysis patients because kidney disease can cause
many complications.
People with renal (kidney) problems may have a bad taste in their mouths,
and they often have bad breath (halitosis). This occurs because the kidneys
fail to remove urea from the blood and the urea breaks down to form ammonia,
which is a foul-smelling substance. Bone changes also can occur because
the body cannot absorb calcium properly. People with kidney problems
can lose bone from their jaws, and their teeth may become loose and painful.
Many symptoms and complications of kidney disease can affect dental
treatment. These include anorexia (an eating disorder), anemia (a blood
disorder), high blood pressure and heart disease, as well as dry mouth
(xerostomia), periodontal
(gum) disease, loose teeth, tooth loss and inflammation of the mouth
and salivary glands. Kidney disease causes some of these symptoms; others
are caused by medications and other treatments.
At The Dentist
If you are on dialysis, you should plan to have dental treatment on the
day after receiving dialysis. People with shunts may be taking a blood
thinner, which can increase the risk of bleeding and hemorrhage. Because
of the shunt, they may be at higher risk for certain infections and should
take antibiotics before receiving dental treatment. Also, make sure that
appropriate dental staff members (anyone that may take blood pressure
readings) are aware of the location of your shunt, because the blood
pressure cuff can damage it. Your blood pressure should be taken on an
arm or leg without the shunt.
Before you receive treatment, give your dentist a detailed list of your
medications and their doses. He or she will take into consideration the
medications you are taking before deciding to prescribe any additional
medications. Some medications may worsen kidney failure and some may
build up in the body until the next dialysis. Because this type of 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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