Is your dental health in jeopardy after Bariatric Surgery?

Dental Health after WLS

Dental health wasn’t something I gave a lot of consideration to when I made the decision to have bariatric surgery.

They warned me about the possibility of my hair falling out. I combated that with biotin shampoo. I took biotin and horsetail supplements. In case you don’t know this the main ingredient in horsetail supplements (silica, or silicon) helps strengthen hair strands, as well as nails and bones. Selenium helps your body process iodine, which regulates hair growth.

Losing my hair was something I was afraid of after bariatric surgery. So I did my research. I took steps to try and help insure I didn’t end up with thinning hair as a result of rapid weight loss.

They warned me about the loose skin. As a result, I was aware there was a high likely-hood that I would need reconstructive surgery after losing 250 lb.

Heck, they warned my about the high chance of cross-over addictions. They prepared me for the fact that I had to be cautious that I didn’t develop a transfer addiction that replaced my addiction to food.

But, they never told me that there was a possibility that having bariatric surgery could effect my dental health. That it could cause issues with my teeth, my gums or, that I would need to pay better attention to my overall to the party happening in my mouth.

9 years ago I weighed 420 lb. and suffered from several co-morbid conditions.

I had a diagnosis of high blood pressure, high cholesterol. My type 2 diabetes was controlled with drugs like Glucophage and Avandia. Until that that didn’t work anymore. As a result, I began taking insulin shots 3 times a day.

Because I had sleep apnea, I used a c-pap machine when I slept. When that stopped working and my sleep apnea got more severe, they moved me to a bi-pap machine.

I was taking diuretics, water pills, not to help me lose weight but to combat the issues I was having with severe edema and swelling of my hands, lower legs and feet.

I had a plethora of medical conditions that were related to the fact that I suffered from obesity.

But for the most part, I had pretty good dental health. My parents spent a lot of money on my teeth when I was a teenager.  My mother was always telling me, “your teeth are so important.” My father’s hard earned money got spent on orthodontics. I wore braces, I wore a retainer.

As a kid, my mother was constantly reminding me to brush my teeth. But as a young adult, I didn’t take those dental health lessons very seriously. I was nearly 18 years old before I ever even had a cavity in my mouth. Blessed with good teeth, I took them for granted. I brushed my teeth morning and night, just like they tell us too. But, I ignored regular dental visits and regular cleanings.

My twenties came and went and my dental health was never a big concern.

By never a big concern, I mean to me. I didn’t have any signs or symptoms that there were problems with my teeth or gums. I was always broke. Living paycheck to paycheck, bouncing from boyfriend to boyfriend and from bad situation to another. Most of my my early twenties I was on disability due to obesity and “mental illness”. I never had the kind of health coverage or dental health insurance that made regular dental visits a priority in my life.

In my mid twenties, after getting married, things began changing. I was working in field that made really good money. My husband was a union employee. We had money and we had great benefits. As a result, I started going the dentist. Surprisingly, my lack of attention to dental health had not caused me much problems.

Dental Health after Weight Loss Surgery

Life kept me away from the dentist chair for almost six years. I was a smoker. I had been smoking since I was about fourteen years old. So nearly 10 years. As a result of ignoring my dental health and smoking, I had developed periodontal disease. The dentist recommended deep scalings to clean all of the built  up tarter off my teeth. The dentist expressed shock that there were no cavities in my mouth.

Around the time my diabetes started getting out of control I had my first big dental health issue.

I was about thirty-two now. I had some pain in my front tooth when I bit into things and I noticed that it had begun to move a little bit. The tooth felt loose to me. I rushed off to the dentist. His prognosis was that a lifetime of thumb-sucking had damaged the front tooth from constant pressure. He preformed a root canal on my front tooth. The root canal didn’t heal. As a result, I lost my front tooth.

Since I was diabetic and my blood sugars were out of control, I wasn’t a candidate for an implant. Since there wasn’t any foreseeable chance of me losing 250 lb. and reversing my diabetes, the oral surgeon suggested I save the money and not invest in a bone graph. As long as I was diabetic they wouldn’t do an implant. The hole in the middle of my smile was replaced with a flipper,  a retainer that has a fake tooth attached to it to fill the space of the missing tooth.

Regular dental cleanings became a habit. Paying attention to my overall dental health paid off.  For the next five years everything was fine and I didn’t develop any cavities.

Shortly after losing that front tooth I started looking bariatric surgery.

Dental Health after Gastric Bypass

I underwent gastric bypass surgery in 2010 and was still seeing a dentist regularly. In 2012 after losing 250 lb. and no longer diabetic. (Yes, bariatric surgery cured my diabetes.) I consulted with a dentist about the possibility of getting an implant. But, I was in the middle of paying for reconstructive plastic surgery and the $4,700 price tag on a dental implant wasn’t something I could invest in at the time.

As I became more involved in the WLS ( Weight Loss Surgery ) community, it started to bother me. When my social circle started expanding and I started gaining notoriety as a blogger, attending conventions and what not, I was uncomfortable with my smile. It was something I really wanted to get fixed.

If you look back at pictures of me before then, the flipper that filled the missing front tooth wasn’t nearly as aesthetically pleasing. You could easily tell that my left front tooth wasn’t real in photos.

In late 2013, right before I moved to North Carolina my flipper was replaced.

I was extremely happy with the replacement. It allowed me to eat without having to remove the flipper from my mouth. Making it so that it was much easier to fit in to social situations. The tooth on the flipper looked so real that if you were looking right at me, you’d never know I was missing a front tooth.

The only real down fall was when it came to photos and videos. Light doesn’t travel through that tooth, so if you take a photo of me with my teeth showing it is easy to tell that the tooth is fake. As a result, you are unlikely to find a photo of me with an open mouth smile. I try to make sure to always smile with my lips closed when taking photos.

Then my life changed drastically. I moved to North Carolina, my husband’s dental insurance didn’t have out-of-state coverage. For the first year, every time I went back to visit, I went to the dentist and got a cleaning. Then we officially separated. I stopped visiting both him and the dentist. That was in late 2014.

Now, five years later things are very different.

I started experiencing the vitamin deficiencies after bariatric surgery in about 2016. First my Calcium and Vitamin-B were low. Then my Iron levels were too high. As time went on, my Vitamin-B got lower and lower, until finally I began taking Vitamin-B injections. My Calcium and Vitamin-D would stabilize and then suddenly I was low in Iron and Anemic all the time. No matter what I do, something is always low now.

Even though I have a constant struggle with vitamin deficiencies, I’ve never really experienced really noticeable symptoms of it. Other than constantly feeling tired, which I attribute more to my “constant on the gas pedal” life. I don’t know when to stop and take a deep breath. I tend to be on go until I run out of gasoline and then pass out and do it all over again. That’s just who I am.

Dental Health and Bariatric Surgery

Last month, when I noticeably chipped the one filling I’ve had in my whole life, I went to the dentist. This time, after skipping the dentist for 5 years I’ve got a mouth full of problems.

I could make excuses for not going sooner. It could easily point at finances or lack of insurance. But, one thing I can tell you for sure is that if anyone had told me that I needed to pay closer attention to my dental health after bariatric surgery, I probably would have.

5 years of not paying attention to my dental health now has a price tag of over $7,000

The flipper that I’ve had in my mouth for the last 5 years has caused significant damage to the teeth it touches. I’m now looking at having to have my two upper back molars extracted. I need fillings to cavities in six – eight other teeth. Consequently, since the flipper has caused so much damage, they want me to remove it and replace it with an implant to avoid any further damage.

While 5 years might not seem sudden to others, it seems sudden to me. It puzzled me how I could go from having such good teeth and only ever having one cavity in my mouth to suddenly having so much decay happening. I’d skipped the dentist for similar amounts of time several times in my life and the repercussions were never so grave.

I started asking myself, “What made this time so different?” Was lack of attention to my dental health just catching up on me or is there another reason that everything in my mouth went south this time? I started doing some research.

Does Bariatric Surgery effect your dental health?

Dental Health and RNY

This was the question I was trying to answer. Not that I don’t want to take responsibility for the fact that I neglected going to the dentist for five years, but I wanted to know why this time the results were so abundantly different. I didn’t just need deep scaling again this time, my mouth was a mess.

What I found was evidence that there might indeed be some connections between bariatric surgery and dental erosion. Some of it is attributed to the higher levels of acidity and lower pH levels. Many of the articles I read mentioned the issues with vitamin deficiencies. Several of the articles talked about the increase in meals versus how often we are ( or are not ) brushing.

Others pointed out the increase in acidic drinks. One study even pointed to the fact that our absorption levels cause us to produce less saliva. Resulting in a change in the pH levels in our mouths.

There is no arguing that I have to attribute much of my dental health issues on my own neglect. But would I have given my overall dental health a higher priority if someone had told me that I needed to because I was a bariatric surgery patient? I probably would have.

Dental Health just might be an issue to consider as post-op Bariatric Patient.

I feel like there are too many things that we are not talking about when it comes to life after weight loss surgery. Too many things we are not receiving education about. And too many things we are not being advised that we need to be paying attention to.

As a result, I feel compelled to share my experience with you. Additionally, I am providing links at the bottom of this article to the limited studies and articles I found in a simple internet search on the topic of Dental Health and Bariatric Surgery.

As always, my goal is that you are able to avoid a pitfall that I fell in and learn from my mistakes. Don’t ignore your dental health care after bariatric surgery. Not only can it bite you in the ass, if you start losing teeth it could effect your ability to bite back.

Pandora Williams author of Desperately Seeking Slender is an ISSA Certified Personal Trainer and Cooper Institute Approved Wellness Coach Trained in Weight Management Strategies. Her training and coaching services are offered exclusively through GoGirl Fitness Studio.

Articles I read regarding Dental Health after Bariatric Surgery: