Kidney Disease

Some people whose kidneys do not function properly need help from a machine to "clean" the blood. This process is called dialysis.

The machine is usually connected to a tube called a shunt. The shunt is attached by surgery to a blood vessel in the arm or leg. Many dentists may feel that they lack the knowledge and experience to treat dialysis patients. That's because kidney disease can cause many further health problems.

People with renal (kidney) problems may have a bad taste in their mouths. They often have 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. People with kidney problems can lose bone from their jaws. 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

Dry mouth (xerostomia)

Periodontal (gum) disease

Loose teeth and loss of teeth

Inflammation of the mouth and salivary glands

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

If you are on dialysis, you should plan to receive any dental treatments on the day after you have dialysis. If you have a shunt, you may take a blood thinner. This can increase the risk of bleeding and hemorrhage. Because of the shunt, you may be at higher risk for certain infections. Therefore, you should take antibiotics before receiving invasive dental treatment.

Make sure that anyone on the dental staff who may take blood pressure readings is aware of the location of your shunt. The blood pressure cuff can damage the shunt. Your blood pressure should be taken on a different arm or leg.

Before you receive treatment, give your dentist a detailed list of your medicines and their doses. The dentist will consider the medicines you take before deciding to prescribe any 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.