Interesting article regarding dental care and liver disease

[LAJ123]

Found this interesting article which might be of use here.

Jim

medicalnewstoday.com/releas...

[Hidden]

Thanks for sharing Jim, really interesting. I have sent it on to Andrew,

Best wishes,

Rebecca

[smc555]

Interesting article. It doesn't surprise me. I don't have cirrhosis of my liver but I do have AIH from unknown causes. I live in the United States and have never been able to afford dental insurance. Normal health insurance does not include dental. I try to keep my teeth in good shape by eating healthy, oil pulling, etc. but I figure if anything is going to negatively affect my liver it will be my teeth. I'm in my mid-60s now. I had gotten a severe gum infection about a year ago. The glands in my neck were enlarged and swollen. I changed my diet (trying a diet supposed to help with tooth repair) and started doing daily drainage exercises to get rid of the toxins in my glands. It seemed to work. After two weeks my glands had gone down to normal size. But then my antibodies started attacking my liver. My skin turned yellow, my enzymes went up to almost 2000, I developed ascites, and ended up in the hospital E.R. My theory was the sudden onslaght of toxins overwhelmed my liver and my antibodies went bonkers. Doctors weren't interested in theories, just in prescribing the common medicines that are normally prescribed. Now I just try to keep my teeth as healthy as possible...

[Millie09]

Interesting read but also a worry . I have had to have a few extractions over the last 2 years. Mainly extractions due to crumbling teeth .it was in Jan this year I was found to have very low vitamin D .I was on an intense course for 6 weeks in tablets and now on them for life .I linked this lack to the tooth problems. Now I am very worried as to regards to this

So anyone with gum disease will basically die early due to this ? If they have cirrohsis like myself now end stage. Also is it saying this could have an impact on transplant, well if that's the case I have been medically written off 😐. Feeling very negative all of a sudden. 🤔

[LAJ123]

Millie,

I'm sure that the message I think we should get from the article is how important it is to make sure we take good care of our oral hygiene/ health.

Sorry if it worried you. That certainly wasn't my intention when I posted the article. But the more we know about keeping healthy, especially if we have liver problems, the better.

For example, now that I'm post transplant and on medication that makes my immune system less able to deal with infection, I know to keep on top of my dental care. In fact I'm definitely dental phobic and it takes a huge effort to go to a dentist. So I'm asking for a referral to a dental hospital.

Pre transplant or in end stage liver disease, dental care is extremely important, but I cant really see it as being a barrier to being listed or having a transplant. Perhaps somebody here knows a bit more about this.

As for your vitamin D deficiency - get out there as much as you can when we are enjoying some sunny weather.

Take care,

Jim

[Millie09 in reply to LAJ123]

Hi jim and thank you for the post which I did have mixed feelings about .I have to have any work done at the hospital due to possible bleed. My only concern is I already have this disese and I do as much as I can to help but my dentist over ever looks at the teeth and I have only ever heard him say extraction. I personally think I should be seen by a hygienist. I also have flings that could do with replacing and a cap is needed on one of the teeth but my dentist won't do the work .I think he is personally worried to take on a liver patient so I may have to go elsewhere for proper treatment so that is what worried me .your post was good as it has bought things to the surface of what I need to do next. Much appreciated Linda 😊

[jojokarak in reply to Millie09]

Millie please don't worry my teeth and mouth were in a shocking state and when I got on transplant list that was first thing they requested that I had teeth extracted, told me it's impossible to save them as would take years and I figure being alive more important than teeth xxx I also had to have all work done in hospital and Leeds just wrote to my dentist to get them to arrange it

I still have receding gums but not much can be done apart from look after my mouth as much as I can.

It certainly won't effect anything I think he should of thought about effect this will have on people waiting, I have known a link between liver and teeth for years but who wants to know ins and outs of everything, please don't let this get you down and really don't worry about it x

[Millie09 in reply to jojokarak]

Hi jojo , thank you so much for your reply. I have been worried about this all week , I do make the effort to look after what I have left but I think the disease has taken a hold now .I am going to seek out a different dentist as I require new fillings and I want to see a hygienist which my dentist at present is useless. Your an angel as usual. Thank you for putting things in to perspective. As you say what's more important? 👍💜xx love Linda

[catrinamakes]

It is a worrying article,have cirrhosis always went to the dentist regularly, post illness my top teeth were fallingout went back to dentist , went to a specialist privately as I was so worried then went on to see a professor and there was nothing they could do had to a the remainder of top removed as my jaw bone was crumbling had new set done privately . I was in shock and it took me 7 months to come to terms with having done and a lot of couselling. I don't want to frighten anybody but they found out i had severe osteoporosis , low vitiman D and B 12 and I am now tube fed as i carnt consume enough calories (never had this problem when i was drinking 😊 so going to the gym and looking after myself iis a waste of time if im going to have an even shorter life. (Only kidding ha ha ). Now if I have any dental problems it is done at the hospital, so im feeling looked after . Try and not let it get you down millie, its just another hurdle that we can define the odds.

[RodeoJoe]

Interesting article Jim. But is it suggesting that gum disease predicts early mortality or that it increases the chance of early mortality, that bit wasn't clear to me. By that I mean is it suggesting that gum disease is merely an indicator or that treating it will improve your chances?

Funnily enough I've just got back from the dentist this morning. As is usually the case I was warned that my gums were receding and this was likely caused by too much hard brushing. However I don't think I've ever done too much or too hard brushing, but I know when I had cirrhosis and as it progressed my gums would bleed after every brush. To the point that the months before transplant I would bleed for hours after brushing and relatively large amounts of bleeding. I always put this down to low platelets, not sure if this is the case. So I'm starting to think that cirrhosis can also actually cause the gum disease to, and that is why I now have receding gums.

[LAJ123]

Joe,

To quote from the article;

" "Our study shows that SEVERE periodontitis strongly predicted higher mortality in cirrhosis" said Lea Ladeg PhD, RN, Aarhus University hospital Denmark and lead author of the study. "Periodontitis may act as a persistent oral bacterial translocation, causing inflammation and increasing cirrhosis complications. AS IT CAN BE TREATED however, we hope our findings motivate more trials on this subject. "

I've highlighted the key words.

Its common sense really. Persistent infection may lead to complications in liver disease.

The important message here is that it is treatable and avoidable.

Jim

[Esmerelda62]

Hi LAJ123 I read an article siimilar to the one you referenced which I found very interesting and I can relate to having had a great deal of pain and problems with my gums culminating me having to have a lot of teeth removed !

I discussed this with my Consultant who acknowledged a possible link between long standing, recurring infections and Liver problems

It is such a huge area to find root causes and I think we still have a long way to go - have you read any other interesting Liver related articles that you would care to share ? 🤔

[newangel2016]

Im glad you put this up. Im currently waiting for fibroscan after some blood tests showed i may have NAFLD. In the last 7 months my teeth have really got bad n i need 12 fillings and a root canal. I was wondering if this is due to my liver problems as didnt really have any problems before then. I hope they do some more research on this.

[jojokarak]

Hiya Jim I didn't read the article but got the jist of it from replies.

As much as I am up for interesting and relevant information I think posting and scaring the shit out of people waiting for transplants is a shame. seriously when I was waiting I was told I needed to get teeth out due to risk of infections which would then take me off waiting list but not once did any consultant or dentist tell me anything about mortality due to my mouth being in poor condition, reason our teeth end up in a state is who knows how long before we get diagnosed have we had cirrhosis and our liver struggles as we know and one of things is absorbing vitamins and minerals hence what we need for healthy teeth and bones.

Anyway like I say all up for info but just think how you would feel or put yourself in someone else's shoes pre transplant reading the article.

[AyrshireK]

It's a scientific paper really which just outlines that the mouth is a root source of many major infections which in someone post transplant who is on immunosuppressant medication might struggle to fight off (the mortality word is always a scary one to hear when you are poorly already).

Good oral hygiene is key and regular dental check ups to make sure there is no infection of the mouth.

When my hubbies paper work came through for his transplant assessment it stated that they wanted him to have an upto date clean bill of oral health from a dentist due to the infection risk post transplant. We panicked because hubby hadn't attended a dentist since childhood (white coat phobia & previous bad experience with gas & air for sedation put him right off).

We only got this information days before his assessment so there was no time for him to see a dentist prior to assessment though we did immediately register him with a dentist and the week after being accepted on T/P list we went to dentist the result being one small filling and four teeth extracted (none of these teeth were in anyway decayed but just very loose and wobbly thereby creating a gap within the gum which would have been a capture point/breeding point for infection). Following that we have attended dentist every 3 months for a good scale and polish and check ups. Dentist credits himself with hubbies improvement in blood results as dentists learn about all manner of things other than just teeth. Good oral hygiene is definitely good for the rest of your body.

[LAJ123]

Goodness !

Quite a response to this post.

Another tooth issue for those who are listed is the intubation for the anaesthetic and the assisted breathing during the transplant.

The teeth have to be in good condition, no wobbly teeth as they can be dislodged and cause problems if they then go where they shouldn't.

Jim

[Ash322 in reply to LAJ123]

I wonder if they could put a mouth guard over your teeth, before intubating you? That would stop the tube dislodging any wobbly teeth.