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Dental Health

Dialysis and Dental Care

Oral health is a vital part of the overall health of dialysis patients.
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Dialysis patients with Chronic Kidney Disease (CKD) may be at greater risk for oral infections. Infections may include:

  • Blood infections
  • Infection of the heart valve
  • Infection of the artery lining, which can lead to an infection of the dialysis access
  • Peritonitis, for patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) or cylcer dialysis

Before going to the dentist, it is important that you speak with your doctor to be sure that any necessary antibiotics are prescribed before a dental procedure.

Because of your kidney condition, you may have:

  • A higher amount of plaque formation
  • Erosion of tongue surface due to build up of toxins in the blood
  • Loosened teeth due to periodontal disease
  • Dry mouth from the effects of medications, which causes an increase in dental problems, such as gum disease and cavities

You may experience:

  • Dry mouth
  • Off taste (metallic or other)
  • Bad breath
  • Overgrowth of your gums, which may be caused by transplant rejection drugs
  • Red tongue and/or burning mouth due to effects of low red blood cells
  • Gingivitis and bleeding of the gums
  • Thrush or candida after kidney transplant

If you have CKD, be sure to review these important dos and don’ts.


  • Have regular dental checkups.
  • Go for a cleaning every six months.
  • Brush your teeth at least two times a day using fluoride toothpaste.
  • Floss once a day.
  • Get dental clearance before you go on a kidney transplant waiting list.
  • Let your dentist know if you have kidney disease, are on dialysis or have received a kidney transplant.
  • If you are on dialysis, check with your doctor to see if you need a prescription antibiotic before you have a dental procedure.


  • Smoke or chew tobacco.
  • Chew ice because it can crack your teeth.
  • Schedule dental procedures on a hemodialysis treatment day because of the blood thinners used during dialysis.
  • Ignore proper denture care and maintenance.
  • Neglect your dental health.

If you are taking any of the following blood-thinning medications or herbal remedies, speak with your physician before a dental extraction or any invasive dental treatment.

Oral medications: Aggrenox® (aspirin* with dypyridamole), Aleve® (naproxen), aspirin* (salicylic acid), Brilinta® (ticagrelor), Effient® (prasugrel), Eliquis® (apixaban), Motrin® (ibuprofen), Persantine® (dypyridamole), Plavix® (clopidogrel), Pradaxa® (dabigatran), Ticlid® (ticlopidine), Xarelto® (rivaroxaban), Zontivity® (vorapaxar)

Injectable medications: Arixtra® (fondaparinux sodium), Fragmin® (dalteparin sodium), Lovenox® (enoxaparin)

Herbal/alternative medications: gingko bilboa, omega 3 fish oil, vitamin E

Horizon Blue Cross Blue Shield of New Jersey gives you the tools to help you make smart health care decisions so you can better manage your health. If you have been diagnosed with CKD, the Chronic Care Program** may be able to help. For more information, call 1-888-334-9006, Monday through Friday, between 8 a.m. and 7 p.m., Eastern Time.

* It can take five to seven days for aspirin to clear from your system.

** Not all programs are available to all members. Please check with your benefits administrator to determine if you are eligible for this program. This document contains brand name drugs that are registered marks or trademarks of pharmaceutical manufacturers not affiliated with either Horizon BCBSNJ or the Blue Cross Blue Shield Association.