As a kidney disease patient, it’s likely that you have or will experience related medical issues or conditions as a result. You may have a compromised immune system, which can lead to increased vulnerability to infections, including dental infections. You may also experience halitosis, or bad breath, from your kidneys’ inability to remove urea from the blood. Regular brushing, flossing, and dentist appointments are key preventive measures for people with chronic kidney disease to protect dental and kidney health.*

Oral health is also looked at in patients undergoing certain kidney treatment methods. Dialysis and kidney transplant procedures come with an inherent risk of infection. Regular dental check-ups may prevent the occurrence of severe infections exacerbated by dental problems. In transplant patients, the risk of infection could dictate the length of survival of the transplanted organ. That is why patients seeking transplants are screened via a panoramic X-ray of the mouth to become eligible for candidacy. 

Guidance for dialysis patients

Dialysis removes protein waste from your blood, so you may need to increase your protein intake to replace the protein lost during treatment. Healthy teeth are important to be able to chew high-quality protein foods, such as meat, fish, and poultry. It’s always best to check with your care team, specifically your renal dietitian, to monitor your particular dietary needs, including vitamin and nutrient levels.

People on dialysis may also receive a blood thinner medication during their dialysis treatments to prevent clotting. Because some dental procedures can cause bleeding, it’s important to schedule dental appointments on non-dialysis days.

Guidance for transplant candidates and recipients 

After receiving a kidney transplant, anti-rejection medications (immunosuppressants) can further weaken the body’s defenses against infection. Before a transplant, patients are generally screened and treated for all infections, including dental infections, to prevent post-transplant complications.

Medicare will cover the dental screening exam, but if dental procedures are needed to remedy any issues, it will not cover the cost. Lean on your transplant team for possible resources to help with these costs if necessary. 

Managing dental costs

Dental insurance plans can run as low as $400 a year. If you’re experiencing financial issues, look for free or low-cost dental care, such as care at a dental school. Dental Lifeline Network’s Donated Dental Services (DDS) is one such program that could help. If you already have an established dentist, don’t shy away from asking your doctor to lower your bill by basing the fees on your income. 

Tips for good dental health

To remove bacteria that could lead to infection and ineligibility for a kidney transplant, make optimal oral health an important part of your daily regimen. 

Some such tips include:

• Brush twice daily, and aim to floss once a day. 
• Use a fluoridated toothpaste to help strengthen teeth against cavities. Your dentist may also suggest using fluoride or antimicrobial rinses.
• You may have a “dry mouth” as a side effect of some drugs used to treat kidney diseases. This makes it easier for cavities and gum diseases to develop. To increase saliva, try chewing sugarless gum or sucking on sugarless candy. You can also try a saliva substitute, such as Biotene.
• Regular dental exams and cleanings, at least twice a year, can detect and treat cavities and gum disease before they become serious. 
• Carefully clean—and at night, remove—full or partial dentures to prevent the development of sore spots or ulcers.

Additional information can be found on the National Kidney Foundation’s page about “The Dental/Kidney Disease Connection.”

*Schmidt, L. (2020, May). Kidney Disease and Your Teeth. aakpRENALIFE, 53(3). https://aakp.org/magazine-id-16755