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The Nutritional Status of the Bariatric Patient and Its Effect on Periodontal Disease
Many bariatric post ops already experience the misery of long term hair loss and that we must now be concerned with losing teeth is cause for even greater alarm.
Calcium and vitamin D have been routinely noted as being deficient in bariatric patients. These micronutrient deficiencies can result in osteoporosis or metabolic bone disease that affects the maxilla and mandible bones of the jaw. When these bones are influenced by nutrient deficiencies, loss of teeth may be inevitable.
Early last year I was forced to have a back molar extracted because ‘tremendous’ bone loss in my jaw would not support saving the tooth. I thought I was the only one experiencing this as a long term post op. I now realize that bone loss and losing teeth is something many of us will face in our life after bariatric surgery. I am still upset that I lost a tooth as I have always taken care of my smile – the empty space I can feel with my tongue is a painful reminder to not miss a supplement dose as they make up for what I am unable to eat or absorb.
After extensive bone grafts I now face having a titanium post implanted into my grafted bone and a new tooth carved and placed. These procedures cost upwards of five thousand dollars, which is why I have a space instead of a replacement tooth.
A recent study The Nutritional Status of the Bariatric Patient and Its Effect on Periodontal Disease” by Terry Weideman, BS, DTR and Roschelle Heuberger, PhD, RD explained the link between my 2001 RNY surgery and the bone loss responsible for my tooth not being sufficiently anchored.
While even my bariatric friends preferred to think my losing a tooth was a coincidence of aging, it was probably not. I am approaching twenty years post op and it just hasn’t hit the fan yet for enough long term post ops to be speaking out. This report focuses on how nutrient deficiencies caused by bariatric surgery are linked to periodontal disease.
With a gastric bypass, a substantial portion of the small intestine is by passed creating nutrient deficiencies that are a result of malabsorption. Whereas improving the quality of life in individuals, bariatric surgery can have undesirable effects that lead to anemia, skin disorders, neurological complications, edema, visual disorders and periodontal disease.
Protein, vitamin, and mineral deficiencies are common in gastric bypass patients even though recommendations to use vitamin and mineral supplements are addressed before the surgery. High percentages choose to ignore warnings and do not take any vitamin or mineral supplements. Medical practitioners and researchers are discovering major nutrient deficiencies in individuals 20 years after their surgery.
To prevent these diseases, the bariatric patient must be schooled in the importance of proper dietary intake. Changes to saliva flow, our altered carbohydrate metabolism, how we chew, the foods we choose, stress created by bariatric surgery, and alveolar bone loss due to deficiency are ways that bariatric surgery can create problems with oral health. The synergistic relationship between bariatric surgery and proper dietary patterns is necessary to prevent periodontal disease.
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