It is not uncommon for patients to come to us with extensive dental disease. This is a sad story that may help others contemplating this surgery: a patient has gastric bypass surgery performed approximately 5 years ago. The surgery was successful in helping the patient reduce his/her weight from 394 pounds to 110 pounds. Although the patient was warned about subsequent dental problems, they often do not follow through with regular dental care.
As you can see in the photographs, this is what is termed rampant decay. This occurs when the environment in the mouth is acidic. There are numerous factors at play following gastric bypass surgery. Patients are advised to eat more frequently with smaller portions. Due to the bypassing of the majority of the small intestine these patients are unable to absorb many of vitamins and minerals, which are necessary for bone, teeth and general health. Another common finding is ‘xerostomia’, the condition of dry mouth. Inadequate saliva results in the inability to neutralize the acid which leads to dental carries and the dissolving of the tooth structure.
With special attention to diet, oral hygiene, oral pH and ancillary treatments such as fluoride trays and other mineralization products these problems can be prevented. The use of Xylitol needs to be closely monitored due to potential gas production, which could result in GERD and more acid in the mouth