Organ Transplants and Dentistry

Organ Transplants and Dentistry

The transplant of an organ from one human to another is a miraculous accomplishment, yet it only marks the beginning of lifetime efforts to address the side effects of anti-rejection drugs and efforts to minimize infection. More than 33,600 organ transplants occurred in the United States in 2016. Among those procedures, kidneys were the most commonly transplanted organ.

Care Considerations

Dr. Angart explains the role of dentistry for patients with organ transplants, because the medical complexities of organ transplantation represent only one aspect of patient care.  Dr. Angart emphasizes the human aspect of treating the patient as a person.  Making the patient feel understood and comfortable, even when you do not have a shared experience, can mean the world to this population.

Dental treatment should begin prior to transplant surgery. Dr. Angart will

• Collaborate with the patient’s health care team to fully support them
• Determine if an antibiotic is necessary prior to dental treatment
• Assess a patient’s bleeding potential
• Perform a comprehensive oral exam, which may or may not include radiographs
• Review your Medical and Dental History
• Address active oral disease

Any active oral disease must be eliminated prior to transplant surgery because patients’ immune systems will be suppressed post-surgery.  If a tooth is not able to be saved, it will likely need removed prior to the organ transplant. In some cases, temporary restorations may be indicated until a patient’s health improves.

Jeffrey L. Angart, DDS consults with patients’ physicians about medications that can affect dental procedures, such as antibiotics to prevent infection and antifibrinolytic drugs to prevent or stop bleeding.

Dental Hygiene Care

Effective dental hygiene care can make a significant contribution to the health of patients who have received organ transplants.

• A personalized plan for efficient and diligent oral-care.
• Toothbrushing, flossing and mouthrinses customized to fit the needs of the patient.
• Establishing a routine schedule for cleanings based on the patient’s oral care.
• Examine signs of infection such as bacterial, viral or fungal.
• Determine if non- alcholic antimicrobial rinses may be prescribed if oral ulcers are present.
• Saliva substitutes or plain saline rinse may be prescribed if the mouth is dry.

These visits will help arrest areas of possible infection that begin in the mouth and travel systemically throughout the body.

Immunosuppressant Drugs

The side effects of immunosuppressant drugs may cause oral problems after surgery. For example, excess gum tissue gingival hypertrophy may occur due to the use of medications, including cyclosporine, immunosuppressive agent typically given with a steroid to prevent the transplanted organ from being rejected by the patient’s body.  The risk of candidiasis can also increase when the immune system is suppressed. Likewise, dry mouth can occur as a side effect of certain immunosuppressive medications.

Orthodontic patients who use cyclosporine after transplant may develop excess gum tissue.  Jeffrey L. Angart, DDS works with the orthodontist to discuss whether to adjust prostheses or remove orthodontic bands prior to transplantation.

Collaborating With the Medical Team

Working with the patient’s transplant team may seem daunting, yet this interprofessional collaboration is vital to maintaining patient health. This relationships helps to

• share medication lists that could have an oral impact and review prescriptions
• Share radiographs and photographs
• Sharing narratives with medical and dental insurance.

Jeffrey L. Angart, DDS is here to support the patient, just like the transplant team.  Please call us if you have questions for yourself or a loved one.  614.775.0840