Answer: Dental and oral health matters are an important topic for all patients, but particularly for patients who have received an organ transplant. None of us should neglect oral health and hygiene. However, patients who take immunosuppressive medicines may be at higher risk for infections from germs that normally reside in the mouth. Transplant patients can be affected by tooth loss and breakage. It is likely that the best answer to your particular problem of tooth loss and breakage would come from your local dentist. Ordinarily, these problems relate to longstanding gum disease or problems affecting the roots of your teeth. Immunosuppressive medications can affect the gums and the teeth as well. However, loss of a tooth occurs because of longstanding periodontal or other dental disorder. Tooth breakage, also a problem you note, can occur in older patients, or those who have had disorders of bone or mineral (calcium) metabolism. You should not stop taking your transplant related drugs simply because you are having problems with your mouth or teeth. Those problems should be addressed by a dentist, and you should continue to maintain your medication schedule in order to preserve your transplant organ function. In addition, it is important to bring these questions to your personal transplant professional whenever you visit the clinic. That way, you will have the best chance at maintaining sound oral health and hygiene while enjoying the ongoing function of your transplanted organ. Answer provided by Thomas Peters, MD, a transplant surgeon at the Jacksonville Transplant Center at Shands Jacksonville Medical Center, Jacksonville, Florida. Dr. Peters also serves on the AAKP Board of Directors and AAKP Medical Advisory Board. The Dear Doctor column provides readers with an opportunity to submit renal related health questions to healthcare professionals who specialize in the area of concern. The answers are not to be construed as a diagnosis and therefore, altercations in current healthcare should not occur until the patient's physician is consulted. This article originally appeared in aakpRENALIFE, March 2004 Volume 19 Number 5.
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