Dental Work On Chronic Kidney Disease Patients Doing Dialysis Risk Hemorrhage, Heart Attack & Stroke

Have you seen the dentist lately? A Chronic Kidney Disease patient who is conducting Dialysis emailed KidneyBuzz.com to ask, "What should I do before going to see my dentist? I have to have 4 teeth removed, but I am concerned about bleeding-out afterword because I am taking Heparin." This is an excellent question which highlights the importance of dental health as well as how Dialysis patients should prepare for special oral treatments. 

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Most Chronic Kidney Disease patients know that staying away from the Dentist is no panacea (universal-remedy) because poor Dental Health is an immediate disqualifier for a Kidney Transplant and can lead to serious infections. Dialysis is already associated with many Dental Health Complications, including increased risk of Periodontal (Gum) Disease, tooth loss, inflammation of the salivary glands which produce saliva, and chronic bad breath because Dialysis patients' kidneys cannot remove urea from the blood and it breaks down to form ammonia which may create an unpleasant smell if left untreated. Hence it is important to maintain a consistent oral health routine, including regular visits to your Dentist; wouldn't you agree?

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Dental extraction (removal of teeth) in Dialysis patients receiving Heparin or Warfarin blood thinners is a controversial issue. Continuation of Anticoagulants (blood thinners) may expose those on Dialysis to serious mouth hemorrhages or bleeding out, whereas stopping their Heparin or Warfarin treatments increases the risk of blood clots and life threatening events such as heart attack or stroke. Hence, as usual, even removing a tooth (or teeth for that matter) is no simple process for those on Dialysis. In fact, traditionally, a high risk Dialysis patient who required oral surgery would have to be hospitalized during their otherwise typical procedure, or stop taking their blood thinner regimen. 

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Yet, a rather recent study published by the Journal of Oral and Maxillofacial Surgery, suggested that stopping or switching Anticoagulants was "associated with wasted time, consumed labor, and increased treatment expenses." Instead they suggested that with the aid of local Hemostatic Agents (along with tissue adhesives used to control bleeding and hemorrhages during surgery), dental extraction in patients receiving blood thinners such as Warfarin can be carried out without a significant risk of bleeding and without altering the anticoagulant regimen.

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While these new findings help improve the safety of Dialysis patients, in order to further improve your overall health outcomes from your Dental Procedure, be sure that your dentist has a list of all your medications. Also, according to Oral-B, " most Physicians recommend that Chronic Kidney Disease patients take antibiotics before receiving dental treatments because they are at an increased risk of infections."

Recommended Reading: High Rates of Gum Disease in Kidney Patients

Are you concerned about your dental health? Get it checked for FREE with the new oral health rating system! Just take a minute or two to answer a few simple questions. You'll get a summary of your estimated risks and an idea of how much care is needed to keep or correct your oral health. You can then take your scores to the dentist to discuss the results. Complete the below form to access your online Dental Score. Also, for the most current Daily News & Information about how Chronic Kidney Disease and Diabetics can better manage their lives, visit KidneyBuzz.com every day.

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References:

"Dental Extraction for Patients on Oral Anticoagulant Therapy."Http://www.sciencedirect.com. The National Hemophilia Center The Chaim Sheba Medical Center Tel Hashomer 52621, Israel.

"Management of the Dental Patient on Anticoagulant Medication."Http://www.dentistrytoday.com/. Dentistry Today.

"Comparison of the Effects of Warfarin and Heparin on Bleeding Caused by Dental Extraction: A Clinical Study." Http://www.joms.org/. Journal of Oral and Maxillofacial Surgery.

"On Dialysis? Tips for Your Dentist Visits." Http://www.oralb.com. Oral-B.