Oral health and kidney disease
Dental problems can cause other health problems you may not expect when you have kidney disease. Oral health includes your teeth, gums, tongue, saliva and the rest of your mouth. Protecting your teeth and taking care of your whole mouth can help lower the chance of developing infections and inflammation (swelling) in your body.
- Medically reviewed by
- Dr. Prakash Gudsoorkar and Dr. Priyanka Gudsoorkar
- Last updated
- May 12, 2026
Your mouth and kidneys are more connected than you may think
When germs in your mouth cause an infection, your body's immune system (your body's defense system) responds with inflammation. This long-term inflammation can adversely affect the heart and kidneys. If you have chronic kidney disease (CKD), are on dialysis, or have had a kidney transplant, taking care of your mouth is an important part of taking care of your whole body.
It's important to tell your dentist and dental team your medical history, and if you have kidney disease, are on dialysis, or have had a kidney transplant. Your dental team may include your dentist, dental hygienist, dental assistant, and other office staff involved in your care. They will work with your kidney team to prevent infections and protect your overall health.
Why does oral health matter?
When your kidneys aren't working well, your body may have a harder time fighting infections. This means a dental infection that might stay minor for someone else can become more serious for people with kidney disease. Keeping your mouth healthy can also support your heart and blood vessels, which are closely connected to kidney health.
Oral health by stage or treatment type
Your stage of kidney disease and treatment type can change your risk of bleeding or infection during dental care.
Early stages of chronic kidney disease (1-3)
During the early stages of CKD, you may be more likely to have dry mouth, gum disease, and infections than someone without kidney disease. The earlier you treat dental problems, the easier they are to manage. These mouth problems can raise inflammation in the body and may increase your risk of infection if they are not treated.
Later stages of chronic kidney disease (stages 4-5)
As kidney disease progresses, you may also have a higher risk of bleeding, mouth sores, dry mouth, a metallic taste, and infection. Healing may take longer, so it is important to treat dental problems early and keep your dentist and dental team informed about your kidney care.
Your treatment type can also affect your dental care. Depending on your treatment, you may have a higher risk of bleeding, infection, or slower healing after a dental procedure.
Hemodialysis
Hemodialysis is a type of dialysis where your blood is cleaned by a machine, usually at a dialysis center. Dialysis days can affect bleeding risk because blood-thinning medicine called heparin is often used during treatment. Heparin helps keep your blood from clotting in the machine. Because of this dental visits are usually easier to plan on non-dialysis days.
Peritoneal dialysis
Peritoneal dialysis is a type of dialysis that cleans your blood inside your body using the lining of your belly and a special fluid, often done at home. Strong infection prevention is especially important with peritoneal dialysis. Tell your dentist you're on peritoneal dialysis so they can coordinate with your kidney team if you need a procedure.
Transplant candidates on waitlist
A dental exam is often part of transplant evaluation because active dental infections can delay approval. Your transplant team may ask for "dental clearance" before you can move forward.
Transplant recipients
Anti-rejection medicines lower your immune defenses, which can make infections more serious. Staying on top of dental cleanings and treating mouth problems early can help reduce complications. Some transplant medicines can also cause mouth changes, These can include swollen gums, gum overgrowth(when gums grow over the teeth), gum inflammation, mouth sores, or a higher risk of infections like thrush (a yeast infection in the mouth that looks like white patches). Talk with your kidney team about how to plan dental visits based on your kidney condition and treatment plan.
When should you call your dentist?
Do not wait for a toothache to see the dentist. You should go for a cleaning every six months.
Call your dentist right away if you notice:
- Bleeding gums when you brush or floss
- Loose teeth or gums pulling away from teeth
- Tooth or jaw pain
- Swelling in the gums, face, or jaw
- Sores in your mouth that don't heal
- Bad breath that doesn't improve with brushing
- Trouble chewing
- Cracked or broken teeth
Habits to protect your mouth and kidneys:
Brush twice a day, in the morning and before bed, with a soft-bristle toothbrush.
- Floss daily (or use floss picks or interdental cleaners if floss is hard to use).
- Use fluoride toothpaste. Fluoride is a mineral that helps protect your teeth and prevent cavities.
- Ask your dentist if you need a fluoride rinse. If you do, choose one without alcohol, since alcohol can make dry mouth worse. Your dentist may also suggest a mouth rinse, such as chlorhexidine, for a short time if you have gum disease or are getting ready for a procedure.
- Limit sugary drinks and snacks, which feed cavity-causing bacteria.
- Avoid any form of tobacco, which raises the risk of gum disease and slows healing.
- Manage dry mouth: sip water if your kidney team allows it, chew sugar-free gum, or ask about saliva substitutes.
- Check with your dentist or kidney doctor before using nonsteroidal anti-inflammatory drugs (NSAIDs) for dental pain (like ibuprofen or naproxen), since they can be unsafe for many people with kidney disease.
- Ask your nephrologist (kidney doctor) if you need antibiotics before dental procedures, especially if you're on dialysis or have had a transplant.
- Antibiotics are medicines used to prevent or treat bacterial infections. Your care team can help decide if you need them and which type is safest for you. Since kidney disease can affect how your body handles some medicines, your care team may need to choose a safer antibiotic or adjust the dose.
- If you're on hemodialysis, schedule dental visits on non-dialysis days when possible.
- If you take any medicine for your bone helath, tell your dentist at every oral health exam. Some bone health medicines can cause problems with healing in the jaw after tooth removal or other dental surgery. Your dentist and kidney team can help you plan safely.
- If you wear dentures, clean them daily and remove them at night to help prevent sores and infections.
- Ask your dentist to check for signs of mouth cancer at your regular visits. This is extra important if you have had a kidney transplant, because anti-rejection medicines can raise your risk of some cancers over time.
How do dentists and kidney doctors work together?
Your dental team and kidney team will work together to prevent infections and protect your overall health. Your nephrologist (kidney doctor) helps manage kidney-related medicines and can give advice on procedure timing, pain medicines and whether you need antibiotics. Your dentist checks for cavities, gum disease and mouth infections, and treats problems early to lower your risk of complications. Working together can reduce avoidable infections, support safer procedures, and help you stay healthy.
Diagnosis
Most mouth and gum problems are found during a regular dental visit. Routine checkups help catch issues early, before they turn into infections or create bigger problems for your overall health.
Tests
To check your teeth and gums, your dentist may look closely inside your mouth, take X-rays, which are pictures of your teeth, jaw and surrounding bone, to spot cavities or bone changes and measure the space between your gums and teeth to screen for gum disease.
Treatment
Your treatment plan depends on what's going on in your mouth and how well your kidneys are working. Taking care of problems early can lower infection risk and reduce inflammation in the body. Treatment may include a dental cleaning, a filling, gum treatment, or care for an active infection.
Medicines
Sometimes you may need antibiotics, pain relief or a medicated mouth rinse. With kidney disease, some medicines are not a good fit or may need a different dose. Tell your dentist and kidney team about everything you take, including prescriptions, over-the-counter medicines, vitamins, supplements, and any dialysis or transplant medicines, so they can choose options that are safer for your kidneys.
Nutrition
Eating well supports healing and helps your body fight infection. Cut back on sugary foods and drinks that raise your risk for cavities. If your mouth hurts or you've had dental work, softer foods may be easier to manage. Keep following a kidney-health eating plan as recommended by your kidney care team. If dental pain makes it hard to eat enough food, ask your doctor or dietitian for guidance.
Additional resources
- Medicare: Medicare may cover dental services that are necessary to protect your health for another covered medical procedure, such as an oral exam prior to a kidney transplant. Visit the Medicare website and select your state to obtain contact information and to see if you are eligible and/or can apply.
- Medicaid: In some cases, Medicaid provides dental coverage for eligible individuals and families. Visit the Medicaid website and select your state to obtain contact information for your state Medicaid agency and to see if you are eligible and/or can apply.
- Private insurance: Many insurance companies offer coverage for services like dental cleanings and other preventative treatments. Look on the back side of your insurance card and call the member services or customer hotline to learn more about your dental coverage and benefits.
Local & national dental assistance programs
- Dental Lifeline Network: Dental Lifeline Network provides information on state-based comprehensive dental care for adults across the United States.
- National Association of Free & Charitable Clinics (NAFC): Find free or low-cost community clinics in your area that offer dental services.
- Dental schools: Often have clinics that allow dental students to gain experience treating patients while providing care at a reduced cost.
- HRSA Find a Health Center: Federally funded health centers offering medical and dental care on a sliding-fee scale based on income. Available nationwide, including rural areas.
- Give Kids A Smile: ADA program providing free dental care to children from families with limited income.