Is this random?

[taar]

I have early bridging fibrosis, just short of cirrhosis, so I understand, but I wanted to ask others on the site about issues with teeth. My teeth have been, quite literally, falling apart over the last few years. Chunks just break off. I see my dentist regularly, but I am now left with two holes on either side of my mouth where molars have come away. Is this related to my liver condition? I don't drink at all, never have done.

I think I have read that teeth problems can be an issue if and when the time comes when I need a transplant. My first visit to the hepatology clinic involved being told, "You probably have a liver transplant in your future..."

Losing the teeth is making eating difficult. I hate the idea of dentures, but might have to come around to that. I was thinking of dental implants, but they are, I understand hideously expensive, and might need to be removed if I have to have a liver transplant.

3 Questions:

1) Could my teeth problems be liver related?

2) Are dental implants a no-no for a (possible) liver transplant patient

3) What is the connection/problem between dentistry and liver transplant.

Grateful for thoughts and comments.

Thanks and good luck to all.

[AyrshireK]

Hello Taar, Reading back your previous posts it doesn't look like you are receiving any treatment for your liver condition.

If you were taking the steroid Prednisolone which is the main and normally first drug given to reduce liver inflammation - especially in the case of auto-immune hepatitis that could have been the cause of your tooth loss issues. Pred causes a reduction in calcium in the body and can cause bone loss issues and weakness in teeth. My hubby has certainly lost several teeth and got a few more wobbly ones since going onto Pred and starting to go to the dentist.

I haven't heard anything about dental implants being a no-go for possible liver transplant patients other than perhaps they could become damaged I suppose with all the intubation pipes and things that would be in the mouth during the surgery etc. Obviously the ones which require screws and such like into the jaw might prove and issue with it being almost a surgical procedure.

Your dentist should take real care in treating you due to potential blood clotting difficulties (dependent on your blood result - platelet and INR levels). I know that ours has asked for hubby's levels before carrying out extractions.

Regarding transplant and dentistry, when my hubby was due to go in for his transplant assessment we were asked for a clean bill of oral health. The issue here is the mouth is a real gathering point for germs and the potential for serious infection is high. Post transplant when you are given lots of immuno suppressant drugs to prevent rejection then your body is stripped of its defences against infection and a normally simple mouth infection, abscess or such like could very quickly spread around the rest of the body and be a serious health issue.

I know that when hubby had his dentist appointment at the time of his transplant assessment, dentist found wobbly teeth that had gaps below them and these could have become the seat of infection so sadly all the wobbly teeth have had to go & he's left with a gap at the top and all four front bottom teeth gone - all perfectly healthy teeth but the gums and bone had receded so much there was nothing much holding them in. Dentist made him some dentures but he never bothers with them. Due to all the messing about with hospitals and tests he just can't be bothered with the extra hassle of the dentures.

We've said that post transplant when all the endoscopy's and other invasive tests are out of the way we'll perhaps invest in a nice set of bridges or something for him,

Sorry I can't give a definitive answer to all your queries but sharing our experiences.

Katie

[taar in reply to AyrshireK]

thank you Katie for your response. I always find your postings interesting and helpful.

All the best.

[jules45]

Im sorry I can't give you any medical advice about teeth issues but just wanted to sympathise and say that I have cirhossis and last year I had to have 6 molars removed all at once. Im not sure why my teeth suffered so badly either. Managed to hang on to the front ones which were in poor condition but had 6 veneers which keep coming off because I choose to drink flavoured water which is apparently bad for teeth.

Hope you get the information you want

Best Wishes

jules