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donor, he can choose the time of his operation. Therefore, people who receive a donated kidney
have a greater chance of living a longer life than those who stay on dialysis.
For the disadvantages of kidney transplantation, patient will go through extensive
medical testing at the transplant clinic, he may need to wait years for a deceased donor kidney,
body may reject the new kidney, so one transplant may not last a lifetime and will need to take
immunosuppressants, which may cause other health problems, for as long as the transplanted
kidney functions.
Before performing any transplant we must consider general dental management such as
consultation with the physician to discuss overall condition of the patient, we must educate,
inform and motivate the patient to maintain a proper oral hygiene and to be aware of the risk
and problems that may arise in the oral cavity after transplant. We must give oral hygiene
instructions and recommend the use of fluorinated compounds and antiseptic mouthwashes
such as chlorhexidine. Dental status should be evaluated. For dental treatment planning, we
must carry out a radiographic study and we must be careful with the use of certain drugs
including general anesthesia, nonsteroidal anti-inflammatory drugs, antibiotics, co-trimoxazole,
tetracyclines, aminoglycosides and quinolones.
The general dental management after transplant for the first three months after surgery
is that it is recommended that emergency dental treatment be carried out in a hospital, and that
specialist be consulted and treated with antibiotic prophylaxis. The dental treatment will be
essentially palliative and local, the aim is to prevent hyposalivation and xerostoma, educate the
patient about oral hygiene, eliminate risk factors and improve the diet, remove dentures and
orthodontic appliances, dental examination by the risk of developing malignant lesions and
prevention of infections.
Special dental management for kidney transplant patients: Before kidney transplant, we
must be careful with the use of some drugs in patients with end-stage renal disease because as
renal function is reduced, the plasma levels of some drugs may be high or prolonged.
Acetaminophen and codeine can be given for postoperative pain management. Local
anesthetics are metabolized in the liver and hence are safe to use for dental procedures.