Oral Hygiene Creates a Picture of Health

By: Michelle Stewart MPH, RDLD/N, CDEbg2

Sometimes we really don’t think of all the aspects WLS can have on our bodies including our dental health. Many patients who undergo Weight Loss Surgery have distinct gastrointestinal systems that may require unique care. Your dental team should be aware of your surgery as well as any medications you are taking.

Did you know that what your oral health provider sees as he peers into your mouth is often an indicator of your overall health? Many WLS patients have long-term nutritional deficiencies that often can be detected first during your office visits. Some of the most common vitamin deficiencies include Vitamin B, Iron, Vitamin C, Vitamin A, Vitamin D and Vitamin K. Good oral health is essential, it impacts the ability to speak, smile, smell, taste, touch, chew, swallow, and make facial expressions.

In maintaining a healthy mouth it is important to brush and floss daily to remove food and plaque from your teeth. Plaque is the sticky bacteria containing substance that coats the teeth. After finishing a meal or snack that contains sugar, the bacteria can produce acids that break down the tooth enamel. Continued attacks on the enamel can lead to cavities; plaque that remains on the teeth can also harden into tartar, which makes it harder to keep teeth clean.

The American Dental Hygienists Association (ADHA) recommends brushing your teeth at least twice a day for two minutes. Brushing the recommended two minutes is key to reducing plaque and preventing cavities, gingivitis and other plaque-related diseases. It is also important to floss daily as part of your dental hygiene. You should choose a soft-bristle toothbrush and replace it every three to four months or when the bristles become frayed and show wear.

Flossing will remove plaque and food particles that the toothbrush won’t reach that are under the gumline and between teeth. Failure to floss promotes plaque buildup which in turn can lead to tooth decay and gum disease. It is also important to include rinsing with an anti-microbial mouthwash after flossing and brushing to help prevent gum disease or gingivitis.

For Bariatric surgery patients the penalties could be caused from ill-fitting dentures due to significant weight loss or consequences from prescribed NSAIDS. Patients whom have had bariatric surgery should avoid NSAIDS because of higher incidence of ulcers.

In addition to developing a consistent oral hygiene plan, consider the foods that you eat. The best foods to include in your diet are:

–  Fiber-rich fruits and vegetables such as apples, broccoli, carrots, celery, cabbage, fresh cranberries, blackberries, and strawberries.
–  Dairy products such as hard cheese, milk, plain Greek yogurt.
–  Water aids in saliva production and can wash away acids that erode tooth enamel.
–  Lean red meat contains iron. Lack of enough iron in the body can lead to sores inside the mouth and an inflamed tongue. Some nuts   and cereals also contain iron.
–  Chicken and fish contain niacin; low niacin stores can lead to bad breath and mouth sores.

–  Avoid:
–  Acidic foods which can be found in citrus fruits and tomato products including pizza, soup, and pasta sauce.
–  High sugar choices such as dried fruits, hard candies, and caramels. Carbohydrates
such as cakes, cookies, pretzels, potato chips and crackers.

In addition to maintaining a good daily oral health plan, include regular visits to the dentist to ensure that your routine is keeping your mouth, teeth and gums healthy. It is recommended that you see the dentist twice a year.

As a bariatric surgery patient it is imperative you become your own advocate in health, not only at your dentist appointments but in every aspect of your wellness journey. It is easy to take the daily floss and brush tasks for granted— remember good oral health will give you plenty to smile about.

Take Away: Avoid high acid and high sugar foods, as well as NSAIDS and ill-fitting dentures. Floss, brush and rinse daily to maintain a healthy mouth. There are special needs for the Bariatric patient.