Organ Transplant and Your Oral Health

80% of transplant patients get at least 1 oral infection

Oral Complications from Post-Surgery Drugs

During transplant surgery, a failing or damaged organ is removed and replaced with a healthy one. The most common transplants are kidney, liver, heart and lung.1

After a transplant, you’ll take medications that lower your immune system’s response to prevent your body from rejecting the new organ. But these drugs weaken your immune system, making it harder to fight off infections everywhere in your body, including your mouth.2 In fact, more than 80 percent of transplant patients get at least one oral infection.3

You may also take additional medicine to prevent blood clots, or to help you cope with the side effects of anti-rejection drugs. Most medications, including antibiotics, anti-ulcer medications and diuretics can also cause oral complications.


Possible Mouth Problems3

Transplant patients are most prone to oral health complications in the first six months after surgery. So it’s especially important to take care of your mouth to help prevent these problems:

  • Infections - With a weakened immune system, you’re at greater risk of developing gum disease. If not treated properly, gum disease can progress to a serious infection called periodontitis. Other oral infections include yeast (thrush) and herpes (cold sores or fever blisters).
  • Enlarged Gums - Your gums may swell up and cover part of your teeth, making it hard to brush and floss. Food and bacteria can get trapped underneath, causing cavities and gingivitis.
  • Ulcers and Canker Sores - Mouth ulcers are red, yellow or pale sores on the soft tissues in your mouth. Ulcers typically appear inside your lips or cheeks, or on your tongue. Without treatment, these open sores can get infected.
  • Oral Cancers - Long-term use of anti-rejection drugs increases your risk of cancer of the tongue, salivary glands, lips and throat.4 Make sure to have your dentist perform an oral cancer screening at every appointment.
  • Dry Mouth - Many medications cause dry mouth. And when your salivary glands aren’t working well, they don’t produce enough saliva to keep your mouth moist. Without saliva to help wash away plaque and bacteria, you can develop cavities and gum disease.


Transplant Patients Need Special Dental Care

When you’re not feeling good before the transplant, it can be difficult to get to the dentist for regular checkups and cleanings. So you may have developed cavities or gum disease while you were waiting. Even if your mouth is healthy now, you’re still at risk for oral problems.

Minimizing any infections, including in your mouth, is an important part of your care both before and after your transplant. So remember, your dentist and hygienist are part of your transplant care team.

Make sure to schedule an exam and cleaning and take care of any dental work before your operation. Talk with your physician and dentist about when to get follow-up dental care after your transplant. Most transplant centers advise waiting at least three months before getting dental treatment after the transplant unless it’s an emergency.


Tips for at the Dentist’s Office

  • When you make the appointment, let the office know you’ve had a transplant. Your dentist and physician may need to consult and create a care plan before you go. If you’re having a cleaning or procedure that can injure your gums, your dentist may prescribe antibiotics to take before your dental appointment to prevent infection.
  • Pre-appointment jitters or “dental anxiety” is common. Make sure to tell your dentist and hygienist about your worries. Many dentists use relaxation techniques such as soothing music to calm patients’ fears.
  • Bring a list of the current medications you’re taking.
  • Tell your dentist about any symptoms, sore spots or bleeding you’ve noticed in your mouth.
  • If your dentures or partials don’t fit anymore, make sure to get them corrected. Loose dentures can rub your gums, causing sores and infection.
  • Your dentist and hygienist will recommend the best ways to care for your teeth and gums – and how often you should see the dentist. You may need to visit the dentist more often than before your transplant.


Keep Your Mouth Healthy at Home

  • Brush at least twice a day, especially after eating and before bedtime.
  • Floss at least once a day to clean the hidden pockets between teeth.
  • Brush gently using a toothbrush with ultra-soft bristles. If you’re taking anti-coagulants, you may be prone to bleeding.
  • Ask your dentist to recommend the right mouthwash for your home care routine.
  • Check your mouth on a regular basis. Look for swollen and red gums, bleeding, or spots on your tongue or cheeks. Contact your dentist if you notice anything unusual.
  • Limit sugary foods and drinks. And make sure to swish your mouth with water after eating or drinking to reduce harmful bacteria and plaque.
  • If you have dry mouth, drink more water, chew sugar-free gum or use artificial saliva, available over-the-counter at the pharmacy. You can also suck on sugar-free candy to stimulate saliva.



1. News Bureau; United Network for Organ Sharing; January 2018

2. Oral Manifestations in Transplant Patients; National Center for Biotechnology Information; May-June 2015

3. Organ or Stem Cell Transplant and Your Mouth; National Institute of Dental and Craniofacial Research, April 2015

4. Dental Management of the Organ or Stem Cell Patient; National Institute of Dental and Craniofacial Research; July 2016

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