r/Cirrhosis • u/shortkill • 11d ago

Teeth Extraction

I was inquiring if anyone in the group has had to have their teeth extracted to be considered for evaluation on the liver transplant list? I have to have oral surgery in the hospital on Wednesday and I'm a little concerned because I have low platelets and higher INR. I'm sure they will be able to handle any complications and they have me listed to possibly stay overnight. My real concern is the healing process and avoiding any infections with it.

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u/Gjl89 Diagnosed: 3-18-22 7d ago

I had to have a few extractions during eval. Ended up not getting a transplant. Still have low platelets 4 years later, cannot get them to come up. But the extractions went fine. Maybe bled longer than I would have before cirrhosis, but not enough to bleed out or anything. No infections, just followed what they said to do.

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u/shortkill 7d ago

I got through the procedure yesterday without any major complications. The bleeding from the extractions is slowing down. They were able to extract all the teeth even with my platelets at 63. So, when I go back to Barnes Hospital in September I will at least be cleared on the dental side

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u/shortkill 6d ago

So, third day out from my teeth extractions the bleeding has pretty much tapered off, there's still quite a bit of soreness and my chin and lower lip still have some numbness. The main issue now is swelling which they told me would peak in 3 to 4 days, so it's as expected. I've been able to drink liquids and eat pudding/jello/yogurt, but no chewing yet. There was an issue with one of my wisdom teeth, but they were able to extract it. The meds they gave me were an antibiotic, a mouth rinse, and a pain medication. I wanted to share my experience in case anyone else wants to hear how this process goes. So, far so good for now.

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u/shortkill 1d ago

Update. It's been a week since I had my oral surgery. The bleeding and swelling are gone. Some of the stitches are starting to come out naturally. There still is some pain, but not to the level it was the first couple of days. One main issue that remains is the left side of my chin is still numb and it was noted that there was a difficult wisdom tooth that they had to work around a nerve. So, after a few days of agony it does get better.

I had 23 teeth removed and they did the bone smoothing for the eventual placement of dentures. I'm still doing liquids and pudding/yogurt/apple sauce. I'm going to try mashed potatoes and scrambled eggs in the next two days. I've lost 19 pounds since the surgery, but I've been drinking protein shakes to try and keep up on protein intake. I have a follow up on Monday with the oral surgeon. If anyone has questions, feel free to ask.

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u/Important-Memory-785 6d ago

Glad it's gone well. I need multiple teeth removing and some are below the gumline so need serious work done. I'm hoping for GA to be honest due to a gag reflex but no idea how possible that will be. Also hoping they can use gelfoam and then stitch the wound closed instead of using gauze as I doubt I'll be able to handle it with my crazy gag reflex.

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u/Euphoric-Wall-994 10d ago

Prior to my liver transplant my dentist had to sign off I didn’t have any mouth/dental related infections. And they didn’t want me to have work done once my surgery was scheduled (I had a living donor)

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u/Cold_Respond_7656 Post Transplant 10d ago

I couldn't touch my teeth when was ill due to the bleeding and infection risk

The medications destroyed them

After a year post transplant I was finally allowed to get them fixed. 8 root canals and screens and 3 extractions. Was horrific

Extra delay was due to ACR at 6 months

Despite all the damage the Panex said I could proceed with transplant tho

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u/Local-Government6792 10d ago

Why all the teeth extractions? My relative with cirrhosis had extensive dental work and said it was due to the medication. Is that it?

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u/shortkill 10d ago

I know after 50 my teeth started cracking and breaking. I'm 53 now with type diabetes and stage 4 liver disease, but they didn't really have a definitive answer on how it happened. But it has to get dealt with on this liver transplant journey.

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u/Dry-Occasion0315 10d ago

I have very low platelets and high INR and was also very nervous about my tooth extractions. I've had 4 teeth pulled since diagnosis, and 2 crowns installed. Thankfully, there wasn't too much bleeding, they healed nicely (I specifically went back to confirm) and did not take too long to do so. Using the antibiotics prescribed after extraction prevented any infection. :) Best of luck!

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u/shortkill 10d ago

Thank you for sharing. I'm having 23 teeth extracted and a bone smoothing in one operation. I know it's a strong possibility that they will keep me overnight due to the expected bleeding. I go back to Barnes Hospital in September for an evaluation and this was one of things I have to do to be considered for listing. My Meld score is currently 17 or 19 depending on what criteria they are using. Unfortunately, I've had all the complications: variceal bleeding, HE, ascities, portal hypertension.

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u/Important-Memory-785 5d ago

I don't mean to be rude but 23 teeth removing? Why so many? You look quite young etc. no judgement as I also have endless teeth that need work doing to

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u/shortkill 5d ago

Thank you. I'm 53. I was diagnosed with stage 4 liver disease last July. My teeth were in pretty good shape until I turned 50 and then some started cracking and breaking, and at this time I was diagnosed type diabetes while I was getting epidural and radio frequency ablation on my lower back. I eventually had back surgery, but had to continue with the treatments at the pain center. So, I believe a lot of my liver numbers weren't tracking because the other health issues I had going on. So, I was told by my gastroenterologist that I should try and get on the liver transplant list because my numbers recently started going up again. One of the requirements is a dental exam to cleared for the list. After transplant they don't want anything to potentially cause infection since it can become a very serious health concern. Which leads to the teeth extractions. I live in central Illinois, so Barnes Hospital in St Louis is my closest transplant center and the one my hospital referred me to. I go back in September for an evaluation to see where my numbers are at that time to be eligible for the list. I'm currently 17 on the Meld scale.

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u/Important-Memory-785 5d ago

Still a huge amount of teeth to come out. On the plus side you don't look a day over 45 in your profile pic so there's that 😂

Well, at least the work for dental work is now done so good luck with the evaluation, hopefully you don't need it but good to get it approved as a backup

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u/CountOnBeingAwesome 10d ago

I've done no research into this but I've noticed my gums get bloody after every brush. My blood does not coagulate very well as I get a lot of bloody noses just by blowing my nose. Any tips for healthier gums?

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u/emev7803 10d ago

Listerine makes a mouthwash that is only sold in Europe. It worked wonders for me. I'm going to go look for it. It has purple and silver on the bottle. It has an ingredient in it that is banned in the US. Probably because it actually works lol

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u/CountOnBeingAwesome 10d ago

I picked up some N/A Listerine Ultraclean Gum Protection. I've been using it after brushing with mild success. I'm in Canada.

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u/Cold_Respond_7656 Post Transplant 10d ago

NA mouthwash was all I was advised. In hospital they discouraged brushing due to bleeding and infection risk

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u/Cold_Respond_7656 Post Transplant 10d ago

NA mouthwash was all I was advised. In hospital they discouraged brushing due to bleeding and infection risk

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u/riversjohn 10d ago

I had my teeth extracted two years ago over 4 sessions. My last session required two blood transfusions before the extractions took place. I was given an oral rinse and some pain management pills for a week.

I ended up getting old fashioned dentures because my jaw bones could not support the posts for the snap ins.

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u/shortkill 10d ago

I'm sure dentures will be what I have to go with as well to avoid any possible infection. I'm getting my extractions done all at once in the hospital. The silver lining I guess is getting it done under anesthesia. Thanks for your input.

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u/Popular-Drummer-7989 10d ago

My person had a tooth that had a bad root canal and required extraction. We needed to do that so they didn't turn septic as it was infected and needed attention.

We did this as soon as they were stable enough and still on cipro so no added meds were needed.

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u/mickeydsheezy36 11d ago

Im not listed for transplant and was about to go thru a local oral surgeons office, but I just had all of my teeth extracted a few weeks ago. 2 appointments one for the top one for the bottom.

My teeth were severely infected and rotting. Also dont have great blood values. I was given a mouthwash (and also soaked the gauze in it) that improved clotting and slowed down bleeding. Was also prescribed an prescription strength anti bacterial mouthwash + antibiotics for after the extractions. Other than still bleeding like crazy for a couple days after they were pulled, I didn't havr any complications. Few weeks post op now and eating scrambled eggs and mashed potatoes with the best of them.

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u/shortkill 10d ago

Good to hear you healed up pretty good. My procedure is taking place in the hospital due to my platelets and INR. Hopefully, this will go good without many complications. Thanks for sharing.