Teeth Issues

Diagnosed in 2015, having dental issues over last couple years with teeth cracking, crowns failing too quickly and other. Read something recently that a study showed a correlation in oral care issues in cirrhosis. Has anyone experienced this? Anyone have any resources? Dentists and oral surgeons don’t mention anything specific. My oral care is average above average over last 10 years. Any suggestions/comments would be great.

Back in 2014-2015 when I feel my PSC started, I too had crown failures (2), root canals (3 of them) plus cavities happen in a very short window of a couple of years. My only bout of IBS was 2015, thank god, plus I was slammed into menopause in 2014 - essentially I stopped making any hormones.
I blame PSC and by January 2018 stricture damage was complete and LFT’s quite high.

For me personally - If start having bodily failure, I know my disease is on the march. Right now I’m in remission and as I say the creeping evil is sleeping. Oral health is very important I know with PSC but in my experience the random failing of oral health can be due to PSC.

I take excellent care of my teeth and those were the first cavities I’d had since a child. I’m now 58 and so far, things have stayed quiet. since 2020.

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Thanks for sharing, its good to know Im not completely crazy.

I had healthy teeth before PSC. Not sure if it was medicines or the disease that caused my teeth to discolor and decay. I was faced with dentures or implants. I went with implants. It took a full 2 1/2 years to complete the project (and $50,000). To this day, I had no definitive answers from my dentist and oral surgeon. They knew what was wrong and how to fix it, but no knowledge or experience with what caused it. My conclusion was PSC was the cause.

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I was diagnosed in 2014, and about 3 years ago started having bleeding gums…I try my best with my oral care…:at this moment I am heading to become another in the waiting list of transplant…in Fort Worth!!! Does anybody know of this hospital?

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I’ve wondered the same thing as I’ve experienced multiple teeth problems since my diagnosis as well. I had the occasional cavity/filling pre diagnosis, but since being diagnosed I’ve gone through what others have already stated. I felt it was more related to Urso as it’s an acid. I try to take it with dinner as many hours as possible before going to bed. Not sure if it helps, but makes sense and doesn’t hurt. Great question! I’m glad you brought it up. Thanks!

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GlassHalfFull,
During my years with PSC leading up to the transplant, I also experienced numerous issues with my dental health. I’ve had a number of root canals, teeth pulled, implants, etc. It is very critical leading up to a transplant that you see your dentist on a regular basis to maintain all your dental health needs. Your dentist must sign off before you can be listed for a transplant. Now that I’m post-transplant things have greatly improved although immune suppression does cause some dental issues at times. I think it’s important for those of us even post-transplant to see our dentist at least every six months. I wish you the very best and hope your situation improves soon.

Mark
PSC 2011 / Liver Transplant 2015

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I had 4 implants while battling PSC (transplant in 2021), and have two broken molars I’ve been living with that are basically just the roots now. Until reading this post I did not associate the loss of teeth to PSC! Makes perfect sense though as I had good teeth prior to my diagnosis.

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I am a dental assistant with AIH/PSC overlap. I have been taking great care of my teeth for over 40 years - I can’t just teach oral hygiene-have to practice what I preach. Having said that , I too suffer from periodontal disease and have had to have gum surgery. I also have many fillings on the sides on my teeth. So not fair. I have been told by the dentist and Hygienist that it’s not caused by poor hygiene. It is a combination of genetics and clenching and grinding that causes stress on the teeth which in turn causes cavities and bone loss. Dry mouth and acid also play a role. And there is also the autoimmune component that they cannot explain but tell me is part of the problem. So I brush, floss, wear a night guard, drink lots of water and try to eat healthy food. So in conclusion, I do think that autoimmune liver diseases do play a role in our oral health. I think that’s a study paper for someone write one day so we can find out why this happens. Wish I could explain it …

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I’m glad that GlassHalfFull started this topic of conversation. I have an appointment with my transplant hepatologist tomorrow afternoon. I’m going to inquire whether he knows of any studies have been done on this dental health for PSC patients and/or patients with any form of autoimmune disease. If there is further information I’ll surely share the findings in this post. Thanks for everyone’s contribution to this topic thus far.

Mark

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Hi All,
I just wanted to follow up on my post a few days ago. I had an appointment with my hepatologist/liver transplant doctor at Duke yesterday and I asked him about the connection between PSC and dental issues with PSC patients. He said the problems are coming due to cirrhosis and these are big issues for PSC patients when they are facing a transplant. That’s why your dentist has to sign off on your dental health during the pretransplant evaluation. He didn’t think it was so much the autoimmune condition itself but the cirrhosis. I assume the dental issues would be more serious the worse your liver condition gets so this is another reason why it’s critical that we make sure we are seeing our dentist on a regular basis. I hope this is helpful.

Mark

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Within the last 8 months, I have had the same crown fall off twice. One was due to Jelly Bellies, so I don’t really blame anything but that.
Jeff

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Thanks, Mark, for asking that. I wonder though, what is the connection between dental issues and cirrhosis? Would it be that poor health associated with cirrhosis affects your teeth and/or your ability to care for them? It is so important to see your dentist regularly! Many issues such as heart disease are also related to dental health. Plaque, the bacteria that causes cavities and gum disease also can affect the heart. I forgot to mention plaque in my previous reply

I wanted to say thank you to Mark and Jeff for moderating this very special community. I have been following but was too shy to say anything before. I think everyone in this group is amazing and brave and kind.

Hahaha!

Thank you, Heathermarie. Very kind of you to say that.
Jeff

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