Did you know that kidney failure also affects your oral health? We explain what it is, the differences between types of kidney failure and the oral signs that can present, as well as the relationship of oral health with the time of hemodialysis, the importance of having a good dental care and care recommendations for diagnosed patients.

What is kidney failure?

The kidneys regulate many physiological functions, including removing wastes from the body such as urea and creatinine, maintaining acid-base balance in the blood, producing hormones such as erythropoietin and active vitamin D, and controlling the volume of fluids in the body. We speak of renal failure when the nephrons of the kidneys, responsible for filtering the bloodThis means that toxins and waste substances accumulate in the blood, causing different symptoms, also in the oral cavity. There are two types:

Acute Renal Failure

Acute renal failure (ARF) occurs when the kidneys suddenly stop filtering blood well, within hours or days. suddenly, in a matter of hours or days.. It can be fatal if not treated in time, so immediate medical attention is necessary.

Chronic Renal Insufficiency

Chronic renal failure (CRF) is progressive, silent and irreversible. progressive, silent and irreversible. The kidneys gradually lose their function. Its deterioration takes months or years and is usually detected when the kidneys are severely damaged, requiring hemodialysis, peritoneal dialysis or kidney transplantation.

Oral signs in patients with renal insufficiency

Renal insufficiency can cause alterations with visible signs or symptoms in the mouth. visible signs or symptoms in the mouthMucosal pallor, petechiae, ecchymosis, uremic stomatitis, dry mouth or periodontal disease.

1. Paleness of mucous membranes

When kidney failure causes anemia, there are fewer red blood cells. fewer red blood cells in the blood. in the blood. This is due to a lack of erythropoietin, the hormone responsible for stimulating their production. The body tissues do not receive enough oxygen and cause lips, gums, palate and cheeks to look pale or a little brown.

2. Petechiae and ecchymosis

In people with CKD, the blood does not clot properly as a result of platelet dysfunction and may cause small red spots under the skin, called petechiae, or larger bruises (ecchymosis) in the mouth. They are often seen on the roof of the mouth and tongueand may be spontaneous or occur after minor trauma.

3. Uremic stomatitis

Uremic stomatitis causes pain or inflammation in the mouth due to the accumulation of urea in the saliva, a substance that is normally eliminated in the urine. This is converted to ammonia, irritating the tissues and causing sores, bad breath and a metallic taste. sores, bad breath and a metallic taste.. This happens mostly in people with very high levels of toxins in the blood due to kidney failure.

4. Xerostomia

Xerostomia, or dry mouth, is a common sign in patients with chronic renal failure. It may be due to drinking less fluids, the side effects of high blood pressure medications, or breathing through the mouth because of lung complications. Dry mouth makes it easier for tooth decay, gum problems cavities, gum problems and bad breath..

5. Periodontal disease

It is common that, in patients with renal insufficiency, the body is not able to activate vitamin D well, causing loss of calcium in the bones.. This is compounded by secondary hyperparathyroidism, aggravating bone loss. In this context, poor oral hygiene and plaque accumulation accelerate the development of serious gum problems.

6. Dental mobility

The loss of bone density mentioned in the previous point can also affect the alveolar bone that supports the teeth. If the periodontal disease is very advanced, the teeth begin to move. In the most severe cases, they can reach grade III mobility, moving in all directions and running the risk of losing them. risk of tooth loss..

Relationship between time on hemodialysis and oral health

Several studies have shown that the longer a person with renal failure has been on hemodialysis, the more oral problems he or she may have. These include increased paleness of the palate, loss of more teeth and more severe periodontitis. Such patients should receive frequent preventive dental care to both improve their quality of life and to prevent these problems from worsening.

CKD patients often have a weakened immune system weakened immune systemThis makes them more vulnerable to infections, including oral infections, which can complicate their condition. In addition, the mobility and loss of teeth affects patients' chewing and nutrition, triggering even more serious problems.

Recommendations for oral care in patients with renal insufficiency

1. Semiannual dental check-ups

Dentists recommend that patients with CKD have checkups every six months, although if they present with active periodontal disease disease or more serious oral complications, it is better to increase that frequency for good follow-up.

Adapted brushing techniques

Since cases of tooth mobility and tooth mobility and sensitivity are common are common, the brushing technique should be less aggressive to protect the gums and mobile teeth. Soft bristle brushes, flossing and oral irrigators are usually recommended.

3. Mouthwashes without alcohol and artificial saliva

For patients patients with dry mouthFor patients with dry mouth, using alcohol-free mouthwashes helps keep the mouth hydrated and reduces the sensation of dryness, while artificial saliva can relieve discomfort and improve chewing and swallowing.

4. Preventive therapies such as sealants and fluoride.

Both dental sealants and fluoride treatments are therapies that help strengthen tooth enamel. strengthen tooth enamel enamel and protect it against demineralization. This reduces the risk of tooth decay and periodontal disease.

5. Coordination between the nephrologist and the odontologist.

CKD patients need adapted treatments, so it isFor this reason, it is essential that nephrologists and dentists work together and assess possible side effects.

Frequently Asked Questions

Does kidney failure cause infections in the mouth?

Patients on hemodialysis or immunocompromised as a result of renal failure are prone to infections in the mouth, such as oral candidiasis, atrophic glossitis or uremic stomatitis.

Does the tongue change with chronic renal failure?

Yes, due to the accumulation of toxins, side effects of medications and changes in saliva production, the tongue may become pale, dry, cracked or swollen. A white coating called saburra may also appear due to oral candidiasis.

Does kidney failure also affect taste?

Yes, dysgeusia and cacogeusia are taste alterations that can be caused by chronic renal failure. Patients notice metallic, bitter or salty tastes due to intoxication of the receptors by toxins accumulated in the blood.