Secret Complication After Bariatric Surgery

By Bari Life

If you have experienced cavities, tooth sensitivity or even tooth decay you need to read this article.

Since Bari Life was born in a busy bariatric surgery practice, we have great access to the entire process that patients go through. This includes complications that are associated with bariatric surgery.

Bariatric surgery complications include but are not limited to dumping syndrome, bowel obstructions, and general bowel function changes. There is, however, a hidden complication that you won’t find much information on or even research for that matter: Tooth decay. Tooth decay is basically damage that occurs when germs (bacteria) in your mouth make acids that eat away at a tooth.

Because so little is known about oral health concerns after bariatric surgery, we decided to do some investigating on our own to better understand this bariatric surgery complication. We have discussed this issue with other popular bariatric programs and found that many patients are experiencing this issue.

We realized through visits to support groups that patients are indeed experiencing oral health issues after surgery.

The New Life Center for Bariatric Surgery, Dr. Boyce’s practice, has had very few patients who have experienced tooth decay compared to other practices. This piqued our interest so we decided to research this problem for patients after surgery.

What we do know:

First, let’s discuss what the current literature on this topic has discovered. As with vitamin supplementation research on bariatric patients, the studies on oral health after bariatric surgery are quite limited. Dr. Boyce’s research on 309 gastric bypass patients is the largest study on the topic of vitamin deficiencies and the efficacy of recommended supplementation after bariatric surgery.

In reviewing the current literature concerning dental manifestations after weight loss surgery we found that all of the literature noted increased dental erosion, increased dental caries (is a breakdown of teeth due to activities of bacteria), and increased dental hypersensitivity after weight loss surgery.

Dental erosion is defined as a chemical dissolution of dental tissues by a chemical process (acid or chelating agents) without bacterial involvement. The acid in the food and drink and gastric acids from vomiting and reflux can lead to the softening of the tooth enamel.

As the dental hard tissues soften, the area is more susceptible to break down from abrasion. The acidic attack is irreversible.

Most articles blame the increase of exposure to gastric juices because of vomiting and reflux as a reason for the increased erosion after bariatric surgery.

You were probably told by your dietitian to eat several small meals throughout the day to fend off hunger – and it does! However, this may be attributed to increasing a bariatric patient’s risk of developing dental caries by allowing more bacterial growth compared to eating the usual three meals a day.

Dental Hypersensitivity is reported by a large number of patients after weight loss surgery. One study published in Obesity Surgery found that the most common variable associated with visits to the dentist after surgery was dental hypersensitivity. Hypersensitivity represents a condition of a presumable complex pathology.

Two processes are essential for its development:

1. Dentin must be exposed through genetic disturbance, enamel defect, loss of enamel (erosion, abrasion, attrition, abfraction), gingival recession with rapid loss of cementum and

2. The dentin tubules must be open to both the oral cavity and the pulp. One interesting study followed 54 patients and found that 25 % of the patients had more tooth decay, erosion, and hypersensitivity than before bariatric surgery.

Vitamin deficiencies can also play a part in tooth decay and erosion. Common deficiencies after bariatric surgery include protein, iron, calcium, vitamin D, vitamin B-12, vitamin A, vitamin K, zinc, magnesium, and vitamin C. These deficiencies can negatively impact the immune system and bone turnover rate as well as increase the risk of periodontal disease. Protein deficiency occurs in 13%-18% of patients after surgery.

The incidence of vitamin D deficiency may be as high as 63% in patients 1-4 years post-bariatric surgery. According to Dr. Boyce, 75-80% of his patients have vitamin D deficiencies PRIOR to surgery. Vitamin B-12 deficiency is associated with the risk of osteoporosis and anemia. Vitamin C is frequently deficient among this patient population and can lead to gingivitis and increased gingival inflammation.

So most of the research published about the link between increased tooth decay and bariatric surgery points to vomiting, gastric reflux, reduced saliva, more acidic saliva, vitamin deficiencies, and frequent meals.

How do we explain the increased tooth decay of those patients who insist they take their vitamins and have no deficiencies and also do not report excessive vomiting and reflux? There are many patients who fall into this category.

Check out the many patient comments found on Bariatric Surgery Source’s website: Dental Problems After Gastric Bypass Surgery

Our question is, “What kind/form of vitamins are these patients taking?” Most bariatric patients have been instructed to take chewable vitamins after surgery because many of the popular bariatric brands promote chewable vitamins.

At the New Life Center for Bariatric Surgery, patients are instructed to use Bari Life’s dissolvable complete bariatric vitamin powder after surgery, and many switch to the Bari Life complete bariatric vitamin tablet after 4-6 weeks. As you will recall, The New Life Center for Bariatric surgery reports very few cases of tooth decay in patients after surgery.

Could chewable vitamins be the culprit or compounding the problem?

Dentists will tell you to avoid gummy vitamins and suggest that chewable vitamins can cause problems for your teeth. One little known disadvantage of chewable supplements is that they may damage tooth enamel. There is some evidence that chewable vitamin C tablets can stain teeth.

The dosage for most bariatric chewable vitamins can be as many as 8-10 large chewable tablets per day. Patients will literally chew their vitamins all day long. Chewable vitamins get stuck in between the teeth and will remain there for long periods of time. According to one article, foods that contain the four fat-soluble vitamins, A, D, E, K as well as vitamin C is good for your teeth if you do not chew the supplements directly.

Malabsorption of calcium after bariatric surgery

Bariatric surgery affects absorption within the gastrointestinal tract. To get all the required vitamins and minerals after surgery, supplementation is essential. While you may not notice deficiencies in certain vitamins or minerals right away, long term consequences exist. If not addressed, negative health outcomes can occur.

Malabsorption occurs after bariatric surgery because of an alteration in the gastrointestinal tract. These alterations can be either restrictive or malabsorptive in nature. In restrictive bariatric procedures, gastric volume decreases due to a change in stomach size. With malabsorptive procedures, the stomach is bypassed. Because of the change in the anatomy of the GI tract in all bariatric surgery, absorption changes.

Bariatric procedures affect absorption through a reduction in stomach volume, a change in intestinal surface area, gastric pH changes, and an alteration in the speed of gastric emptying. These changes affect how the body is able to absorb nutrients from food.

One mineral that is essential to supplement after bariatric surgery is calcium. In a study completed on post-gastric bypass patients, calcium absorption decreased significantly after surgery, dropping from over 30% to less than 10% after surgery.

Along with a substantial drop in calcium absorption, malabsorption begins soon after surgery. Calcium malabsorption is documented as early as 3 months after bariatric surgery, providing significant evidence to begin supplementation early.

What happens if I don’t get enough calcium?

Calcium plays an important role in the body. It supports your skeletal structure and your teeth, providing structure, hardness, and support in maintaining and creating healthy bones and teeth. Calcium is so important that it even plays a further role in dental health, protecting your gums against irritation and gum disease.

It’s fair to say that if you aren’t getting enough calcium, there can be significant consequences, both short term and long term. If you aren’t getting enough calcium after surgery, your body starts taking it from various calcium deposits in your body. These deposits primarily exist in your bones and teeth. If enough calcium is taken from these deposits it can lead to weak bones, osteoporosis, and brittle teeth.

More specifically, when calcium is taken from your teeth, dental health issues occur. This creates a higher risk of tooth damage, tooth decay, and brittle teeth. If supplementation is not prioritized, these issues can become worse and create substantial problems.

The great news is, supplementing with calcium after surgery is an easy way to support your bones and teeth. By taking a calcium supplement, you protect your bones and teeth from complications that can occur because of low calcium.

Calcium requirements for bariatric patients

Getting enough calcium after bariatric surgery can be difficult. To be best absorbed, calcium needs the right gastric pH. This puts post-bariatric surgery patients at higher risk for deficiency because of a decrease in gastric pH after surgery. Because of this, calcium supplementation is required to meet daily nutrient requirements.

There are two different forms of calcium available for supplementation: calcium citrate and calcium carbonate. Because calcium carbonate is not as easily absorbed, calcium citrate is preferred. Here’s why.

After bariatric surgery, stomach acid is reduced. Less stomach acid is required for the absorption of calcium citrate, making it ideal for bariatric patients. It also causes less stomach upset and does not need to be taken with food.

While calcium is obtained from foods like dairy products, green leafy vegetables, and fish with bones, it is nearly impossible to get the recommended daily amount through food alone after bariatric surgery. With supplementation, calcium deficiencies are easy to prevent.

According to the ASMBS, 1,500 mg/day is ideal for post-bariatric surgery patients.

Bari Life has a great tasting Calcium chew to support calcium absorption after surgery. Three individual chews have 1,500mg of calcium citrate and 3,000 IUs of Vitamin D3 to support absorption. It is a complete calcium supplement to support your health after bariatric surgery.

Curiouser and curiouser…

The information provided by the medical community concerning the correlation of tooth decay and bariatric surgery does not mention chewable vitamins, only vitamin deficiencies as a possible cause. One article states that the medical literature has inadequately reported the potentially deleterious effects of such surgery on dental health.

The dental professional community makes it very clear that vitamin and mineral supplementation in the form of gummies, soft chews, or tablet chewable vitamins can cause problems that can lead to tooth decay and very poor dental health.

It makes sense that when all of these conditions come together, vomiting, reflux, acidic saliva along with food and vitamins sitting for hours in-between teeth and other bariatric surgery complications, there becomes an increased risk for tooth decay. There is no research available discussing the effects of chewable vitamins and tooth decay after weight loss surgery. If you are experiencing excessive tooth decay and have had bariatric surgery you should seek professional medical and dental consultations.

It is extremely important to have your lab work completed at least annually to look for vitamin and mineral deficiencies and have your dentist advise you on the special care for your teeth. You may need to eat less sticky, less acidic foods, and avoid chewable vitamins.

You may need to brush and floss more frequently and have regular fluoride treatments to counteract the acidic saliva. It’s actually been proven in studies that elderly people with better oral health are more resistant to all-cause mortality (death from all causes). What’s more – studies prove that people with chronic periodontal disease and exposure to oral bacteria are at greater risk of developing heart disease!

The Bottom Line:

Clearly, the dental health of patients after bariatric surgery is something that needs more research in order to determine and treat the cause of increased tooth decay after surgery.

It should be noted that proper dental hygiene is key in not only maintaining strong and healthy teeth after surgery but also lower your risk of all-cause mortality and heart disease.

Take care of your teeth, every day!

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56 comments

  1. Obesity surgery is surely the best method to get back the normal weight that helps in living a healthier life. Really beneficial post creating awareness about this problem.. Loved reading it. Complications are linked to every surgery. It depend on person how to deal with it.

    1. I do apologize in advance.. but I had my gastric bypass surgery in March of 2000 my teeth were gorgeous I was 21 years old I was 275 lb I never met my doctors who actually happened to be the ones who invented laparoscopic gastric bypass roux-en-y and I had the surgery done and got down to 98 pounds everyone thought I was anorexic bulimic I had to see a weight doctor I worked my tail off to gain weight as hard as I had worked to lose weight and now I sit here after my gallbladder being taken out a small obstruction surgery completed having my daughter and now finding out I had three nachos AKA tumors on my thyroid which have now miss sassa ties whatever that word is 244 so now I’m battling that big c word I only have about six teeth left on the top my teeth on the bottom or pretty much intact with regards and exception to my wisdom and I’ve never done a drug in my life it’s so quite embarrassing that hopefully I will not die with no teeth I just hope and pray for each and every one of you and the sad part is like I said I would do the surgery again I just hope they find a way to adjust store find some kind of supplement for teeth because a girl of my age that had it done and I’m now 41 going on 42 we have to have a life God bless you all

      1. I had the original ruex en y in 02 and my bottom teeth are ok for now. However I’m getting ready to have top dentures. Me too once had beautiful teeth. I’m 49. The stuff they never told me makes me sick

      2. Anyone who is reading this. I can tell you what is wrong with our teeth and gums. I see some commented as far back as 2017. I want to know how your teeth and gums are now? Anyone. Please. I had the Roux-en-Y in Nov of 2009. I did fine the first year. I went from 368 down to 200lbs. I was finally able to not have a cart to ride at the grocery store. Several things have happened to me since the surgery. In 2012, I found out that I have secondary progressive MS. The surgery had nothing to do with it. I have traced symptoms back to the first optic neuritis at age 20. I am now 66. On Oct 4, 2017, I had emergency surgery. My pouch rotted and ruptured. I had been having heart burn for years after the bariatric surgery. The drs kept giving me more and more antacid prescriptions. After the surgery in 2017, the surgeon put me on another one. I should never have lived to get to a hospital much less survive the surgery. But I did. The surgeon who was there to do the surgery said this,” I had to take a piece of rotted skin and try to repair a rotted hole. We washed you out 2 times for acid. I do not think it will hold. If you survive, you will never eat like a human being again.” I was in for 6 days and nights. Not one bite of anything. The fluids were from an IV and the pain meds they knocked me out with. I eat just fine.

        I spend everyday trying to keep the 150lbs on me. About 4 yrs ago I had a tooth to break in two. 2 yrs ago I found a small hole at the gum line of a front bottom tooth. I have been fighting a losing battle ever since. 4 dentists who told me I had periodontal disease. I knew it wasn’t that. I went to two different periodontists without them knowing about the other. They both, with no prompting, said that the good thing is I do not have predental disease. I was asking each one what could cause it but no one could tell me. I have done everything I could find to fix it but it happened too fast. I cant afford $100,000 for implants. I have the Multiple sclerosis and had to stop working in 2006. That was the price I was quoted over and over.

        I found a clinic last week with all five star reviews and made an appt. I am a grandmother. Never even smoked pot. Ever. Im reading everyone’s stories. It did explain why one dentist refused to see me when his assistant saw my teeth. I had no idea that meth users seem to have the same thing.

        This is not what most people think. MS is caused by the Epstein Barr virus. There is no such thing as autoimmune diseases. Almost all diseases are caused by a virus and inflammation from the foods we eat. I was reading in a book about teeth and gum problems and there it was. Our pouches do not have enough stomach acid to start digesting our food before it moves into the intestine. The food sits and rots. That creates ammonia. Ammonia is cell permeable. At night as we sleep, the ammonia destroys our gums and rots the teeth at the gum level. My gums look like someone used a plastic knife and tried to tear them apart. Jabs and slices and a hole in the gum of one of mine right now. This specialist is pulling all of my teeth on Thursday and putting implants for the top and bottom. I asked him if the implant screws would be ok with the gums. He said it should all go away after he removes the teeth.

        I was on the phone with my sister this afternoon. I told her about my teeth and getting all of them out. Her mother in law’s sister had her gastric bypass about the same time I did. She said, “She just had all of her teeth removed also.” Bingo!! What do I need to do? Do I go with snaps on the bottom instead of implants and have an upper denture? I do not want dentures. I Have had so many horrible things happen to me medically, I know longer trusts any dr or dentist. This man was the first one that I didn’t leave crying.

        Please, I need help in this. I do not want to have this surgery and my body rejects the implants. I am going to speak to the specialist. Maybe between us we can find the answer. I research everything. All I have is time. I had ask God to give me a sign on whether I should have implants or not. After finding this, I think He just told me.

      3. I had my surgery in 2001 , weighed 309 . Lowest weight was 132 lbs . I did wonderful for the first 2 years until I got so sick I passed out from being anemic . Needless to say I give myself b12 shots now and have iron infusions . This has became my life . As I turned 45 this year and have battled weight gained for the past 7 years (even had a baby) , I realized my teeth issues are from my gastric bypass as well . It’s heartbreaking, and no I would not do this over . My mouth is sore , I have lost many teeth in the past year , and no I’m not a druggie . To add to insult I have gained weight because of having Novasure to stop such heavy periods which made the anemia impossible to control . So I have no idea what my next step is with fixing these dental issues , but am terrified of having no teeth at such a young age . Prayers to all that have had this horrible surgery .

  2. Had the operation a couple of years ago, now at 73 yrs old, having all kinds of dental probs teeth breaking off and having to have five pulled

  3. I have found this article very interesting. I had gastric sleeve surgery on 14 June. Since then I have been to my regular dentist 3 times, he has referred me to periodontist, and I have been to my regular doctor. My blood work shows no deficiencies. I am. In the category of having a vitamin deficiency prior to surgery. Despite various theories and treatments, nothing is showing improvement. After this shot while, my teeth and gums look like that of a meth addict for years. I am very interested in any successful treatments.

    1. Diana Boyd
      I can relate. Over the past 6-12 months every single one of my teeth have gotten him line cavities. I do not have dental insurance. Has anyone checked with their medical insurance to see if they will cover it since it’s a complication of surgery? My teeth also look like a meth addicts teeth. It was very fast. I have no idea what I’m going to do. Any advice would be great.

  4. I am a roux en y patient and I always have taken care of my teeth. My parents friends would ask if my teeth were fake because of their beauty. My surgery was 8 years ago and I have now lost everyone of them. In 2010 I had to have emergency surgery for a bowel blockage and was put on a feeding tube. I spent I month in the hospital and they thought I was going to have to live on a feeding tube. I wanted Sprite so bad and drank it behind the Dr and nurses back and it got my stomach to start moving again

  5. Had gastric sleeve 2012 my teeth having gotten really bad. Cavities, very dry mouth, bleeding ,hurting etc…….

    1. I had the gastric sleeve almost 3 years ago. I have lost a few teeth since then. Recently, I went to my dentist and he said I had gum disease and had to have all of my teeth pulled. A few visits before this I told him that my teeth were very sensitive, so he gave me a small tube of Sensodyne and a soft-bristled toothbrush He told me to start using them. Which I did. My mouth was always very dry, so I had to constantly drink water. I was waking up with a think, white film all over my teeth in the morning. My gums were bleeding also. I had always been proud of my teeth, now I worry every day about getting them pulled. What can I do so that others know about this side-effect?

    2. Iam having the same problems. Lots of blisters cracks inside lips. Cannot drink cool water hurts so bad. On soft diet due to mout pain.

  6. I was brought to this website due to the fact that my teeth are crumbling like fine china a year out of surgery. Make no mistake, my bypass was the best decision I did for my overall health and I have absolutely no regrets, but I am having to replace lost teeth at an alarming rate. I’ve always taken good care of my teeth so I suspect this surgery has had some negative effect.

    1. I had surgery 8 yrs ago had many complications 5 yrs after surgery ulcer bursting. My teeth were falling out after 8 months they are almost all gone . not only are dentist expensive Medicare does not help with teeth it leaves me without teeth. Its terrible this surgery I did lose 150 lbs am not sure it was a good decision for me. 8 yrs later today I have another ulcer. Best of luck to all

  7. I have not seen a lot of difference in my teeth, but my nails were terrible until I got the once a year drip for my bones. They still break some, but for the most part they have gotten harder and also have almost stopped pealing. I am over 8 yrs post-op. They are also very dry and so is my mouth. I don’t go anywhere without my drinks!

  8. My teeth are breaking off at the gum line it’s been about 4 years since my first barbaric surgery the like 2 years since my 2nd one was having complications with a ulcer that caused my 2nd surgery , I did not have perfect teeth I did have a couple fillings in the back teeth but I can show you pictures of my teeth and they was pretty nice for my age , now I only have 4 teeth on the top 2 in the back , one on each side and my two front teeth and one of those is ready to go at any time, I went to a dentist they insisted I go to oral surgery and have all the top ones pulled and then treat the bottom ones , but now the bottom line to the tune of $5,000 dollars of which I could not afford , so now I don’t think I have to worry about dieing from being fat but now from sepsis from bad teeth, I pray that some day that the doctors will advise their patients that this can happen and also to,push the research as to find out the exact reason why this happens and how to,prevent it Thanks for listening
    Mrs Robert Blatz

  9. I am a 51 year old white male who had RNY Bypass in 2005. Since my surgery I have experienced alcoholism and have since stopped drinking for 6years. I have spent thousands of dollars on dental work. Many crowns and cavities fixed. I am now going through another round of dental work. I have low B12 and anemia. I talk liquid vitamins to aid in absorption. I have lost 165 pounds after surgery but have recently gained around 30 due to not smoking and getting enough exercise. While I was aware of the issue with alcohol I had not idea about the dental issues but since experiencing the last two bouts of mouth sores and teeth issue due to vitamin deficiency, I will be seeking out more specialized health care than my family doc. Hope this is helpful.
    Steve

  10. I haven 8 years with the surgery I have ostopenia. But recently y had two broken tooth. My surgeon didn’t say it had nothing to do with vomiting or anything else. It worries me this could be a very important degeneration of the tooth and surgeons should worn us about what to do! Because obviously all of us vomit a lot. Thank you.

  11. I am going on my tenth year as a gastric bypass…??? Im not going to say survivor because I’m 34 and I weigh almost 65 lbs!!! Yes ladies and gentlemen for your information I’m not embellishing the truth one bit! My teeth have completely rotted out my hair has feel out u throw up every time i eat a single bite but yes I lost weight and I’m not fat anymore!! Yay!! Not. Look I have 2 kids who really need me I’m denied treatment because I can’t afford that high fancy insurance others have I’m begging if there is a dr willing to take me as a patient please feel free to use me v as your guinny pig I’m desperate email me or call 864-251-0593 please help me

    1. Hi Ashley. I’m so sorry to read what you are going through. Have you found someone who will help you? I am having the surgery in January. I’m not concerned about losing to much weight because I’m 5’10 @ 280 lbs. My teeth and hair though are two of my best features so I your story has stopped me in my track’s. Have you attempted sending letter’s about your situation to the head of the Bariatric Center? The head of the hospital maybe where you had it done. I would try because from the sounds of it you are slowly fading away. How much did you weigh prior to surgery?? I would like to try to help you find someone to help you.

      1. Please take these dental issues very seriously! Not one person ever Mentioned a single word about this! I’ve always had beautiful white teeth, but in the past 3 years since the surgery- I did follow the instructions and went from 248 to 105, which was my weight all my life.(had an adrenal breakdown causing the weight gain). I had no idea what was causing my teeth to break off get cavities, have needed root canals and had to have some pulled. I’m really afraid that this can’t be fixed. Please, please consult a dentist familiar with the bypass dental issues and develop some type of plan before moving forward. Good luck with your surgery !

    2. Hey sorry to hear about your teeth. I was 27 when I lost mine. I was also the youngest gastric bypass surgery at the time. That was 2008 and here we are…. 12 yearsm I regret nothing but I wish I knew what to expect for the rest of my life. Email me sometime. Gmuratore317@gmail.com

    3. Yes I had Bypass surgery about 5years ago. I had my gallbladder removed about 2014 after about 1 month after I started with these painful blisters in my mouth around the lips,tongue it is so painful it hurts to talk burn to drink water. They say it’s stress I have it any advice to help me. Really need help bad.

    4. Ashley Sanders, check with your nearest dental college or medical university to see if they can help you! I’ve heard that one of the Universities here near Sacramento will help people that have no insurance because it gives them someone to learn from and practice on – all done with excellent supervision! I hope you find the help that you need not only for your teeth but for the eating problems that you’re having. ((hugs))

  12. It’s been 3yrs since my gastric sleeve,I’m 56 and imy dentist insinuated I was a drug user. As if being extremely depressed from the state of my teeth and being in constant pain wasnt enough I’m also looked at as though I’m a drug user.Most days I wish I would just die already. I dont know how much more I can take.

  13. I am 14 years post-op with Roux-en-Y Gastric Bypass and my teeth are a total nightmare. They are decaying, breaking off, and are extremely sensitive. I have several vitamin deficiencies although I take my supplements every day. My biggest concern is the unethical way my dentist and endodontist treat me. They treat my as if I am a meth head or drug addict and insinuate my dental problems are in my head; however, they always seem to find something wrong enough to bill my insurance! These “so called” professionals need to do their research or believe their patients!

  14. I had bypass on 5/7/18. I had perfect teeth prior and now my gums are bleeding after the surgery. I have a dentist apt in a few days will discuss with the dentist. I was never told about dental issues i am freaking out about the tooth loss issue people here have had

  15. Four years post roux en y and am devastated at the condition my teeth are in now. I have lost 11 teeth. have had four root canals, four crowns, and am about to get partial dentures, upper and lower. I knew nothing about this possible complication, and I think if I had, it may have affected my decision to have the surgery. My dentist has been baffled as to the cause of my problems, now we have the answer. Thanks for posting this article. I will copy it and take it to my next appointment.

  16. Exactly what vitamins should we take to prevent this. I am having surgery in January and I know they have told me to take a multi vitamin with minerals. Is this enough or do I need something more? I thought about taking prenatal vitamins since they help with all that stuff when you’re pregnant. I don’t want to lose teeth or my long thick blonde hair. ????????

  17. My mouth has been very very dry since surgery and no teeth problems yet but I have worried about this as this is the reason for meth mouth per say I work with methamphetamine addicts daily and it has been discovered that the problem is not caused by the drug or chemicals themselves but rather the fact that it causes the person to stop producing saliva which helps keep teeth healthy

  18. I had gastric bypass 5 years ago. I lost 100 lbs, I have gained some back. I have Lupus & RA. I have had two knee replacements and breezed through them.
    I had some problems with being anemic and very low D for sometime. I went off the bariatric vitamins thinking I could take my own. I learned I had to take the bariatric vitamins.My hair came back in and my skin looks better. Absolutely no dental problems. I have not had a cavity since I had the surgery. Neither have I had any trouble with vomiting because I learned pretty quick not to over eat. No problems

  19. I had a BPD with DS 8 years ago, Dr Boyce, I have had my labs checked by his office every year and take my supplements religiously. All my levels have been normal. I too have lost quite a few teeth, had an increase in cavities and breaking of teeth. I have horrible gastric reflux, to the point I am taking Omeprazole twice a day and Zantac 300 mg daily as well. It barely controls the heartburn. I do not take any type of gummy vitamins or chewable vitamins and never have. The vitamins I take are a capsule. That leaves the gastric reflux as the only one of the causes listed for my dental issues. The gastric reflux has worsened since my surgery.

  20. I have had no dental problems at all, but I have always taken good dental hygiene which I learned early in life.

  21. I had gastric by-pass surgery 6 years ago. I lost 150 lbs and have been able to keep it off. The only problem I had early on was the dumping syndrome but I caused it myself. Now in the past few months I have had 3 front teeth on the top crumble on the back side. Before they crumble they get a white spot on the front of the teeth. After the first one crumbled I went to the dentist and he said 2 or 3 root canals were needed. They were going to submit estimate to insurance carrier but have never heard back from them. Now with more teeth crumbling there is no way I can afford that kind of dental work. The front of the teeth feel really strong. Guess I will have to wait and see if more crumble and if the front of the teeth will get bad.

  22. I ad my gastric bypass in jan of this year. My teeth are feeling awful. My fillings are falling out & I now have a chipped tooth. It’s causing me loads of pain. I hadn’t had any trouble until my op. I wish the dentist would just take them all out. This needs to be told to patients as it might change their minds.

  23. Just found out about the relationship of my periodontal problems to my sleeve surgery! I may be low on vit B and C. I brush all day long and floss. No acid reflux no vomiting. 2 years post sleeve. No decay just sensitive swollen gums?

  24. I had open gastric bypass surgery July of 2004 six months later I had to have a second surgery because I could not eat or drink anything. Y threw up everything. I was too there was snow opdtruction of scare tissue. After all that I continued to have problemd eating and keeping it in me. I have been vitamin dificent, andmic several times
    Over the past 14 years I have had very sensitive teeth, rotten teeth and many have either broken off and fallen out or I would be flossing and I would pull a tooth out. I am on disability and have health care thri my previous employer along wy very limited dental care. I currently owe my dentist over $5000. I am begging for help. I need at least 3 more crowns and I do know where to turn. I have been thinking about my situation and if dental disease is a result of gastric bypass shouldn’t my health insurance cover my teeth as a complication of my last surgery? Please contact me if you have any answers or can help in anyway. I I willing to take part in a related research project if I could get new teeth. My contact info is emmeruru@yahoo.com thanks Terri Sullivan

  25. I am two years post gastric sleeve surgery. I always prided myself with good teeth. I now have recently had three teeth pulled,many teeth have decay, and two days ago one tooth on the bottom front just cracked off clear down to the gum. My savings are gone due to dental work, as I have no dental insurance. I am 70 years old, retired and on limited income. My teeth falling apart has really got me down.

  26. I had ruin-why? (that misspelling is intentional) in 2010 & my teeth are breaking off like they are glass. Fillings have survived better than my teeth! I’ve lost my smile which is a very bad thing for someone suffering from depression! I didn’t have any vitamin deficiencies prior to surgery. Not much vomiting & no chewables. I knew my hair could change & did getting very thin & now curly. I have terrible muscle weakness that no amount of exercise & protein pushing has helped. I was prepared for these problems but if someone had told me I could lose my absolutely beautiful teeth as well I don’t think I would have had the surgery! I only lost about 80 lbs but instead of improving my health as much as I hoped I look & move like someone who’s 90 not 51! It didn’t cost me one penny to get the surgery but it did cost me my strength, my hair & now my smile! NOT WORTH IT!

  27. It has been 3 years since I had a sleeve surgery done. My lab work is great. I had my first tooth break two years ago did not think about it much be cause the dentist told me at 58 years old this is the most common tooth to break. had it repaired three times. My second tooth broke today while eating a calcium chew its a molar. I am now worried. My teeth are crumbling for no reason.

  28. Suffering; blisters and cracks in mouth, cannot taste food. Perodontitis!! 2 years post op. Lab work ok, take lots of vitamins, never vomit very little acid reflux. Please do not want to lose teeth!!

  29. I had Roux N Y in 2004 and my teeth are still healthy , it is the bone under then wearing away and my beautiful, healthy teeth are literally just falling out. I also have problems with mouth sores. There are a lot of things they are learning that were unexpected in the long term.

  30. I thought I was alone in experiencing these problems! I’ve been so embarrassed for so long. I’ve eventually convinced myself that all my issues are my fault because mental disorders, or that I’m just a trashy imbecile at least. I had my surgery back in 2004. My teeth have been getting increasingly worse and increasingly fewer for years now. They’ve been cracking, crumbling and eroding from every angle. I’ve lost so many in the front as well the back of my mouth that chewing is difficult and biting anything is impossible. I look like a meth addict. I especially do more recently, for I’ve been rapidly losing more weight and muscle to the point I look like bones with saggy skin. I’ve had tooth infections constantly, and I don’t know how far infection might be…..into bones and sinuses maybe. I can’t afford to fix anything or even get the vitamins and supplements I need at this point. I lost my job for health issues and teeth, and nobody wants to hire this toothless mess. Just about given up. Though unfortunate, it is nice to know I’m not alone in some of these problems. I could go on about all my health declines, but don’t want this to be a book.
    If someone out there happens to read this, and has any advice or resources that could help me in any way, I would be eternally grateful for it.

  31. I feel incredibly lucky with my teeth! I had RNY 3 yrs ago today and my dentist said that my teeth and gums are better than before, despite being 65 yrs old. He thinks it’s because I’m eating healthier, getting 80-100 gms of protein per day, taking tons of vitamins, calcium and other minerals, and drinking more fluids. The RNY got rid of the horrible acid reflux I’d had for nearly 40 yrs and my diabetes is gone, so I’m overall healthier. I take my vitamins daily without fail and brush my teeth at least twice a day (but rarely floss, which he always knows). Good luck to all of you that are struggling. My heart goes out to you! <3

  32. I am a gastric sleeve patient. I had the sleeve on 8/13/208. Before my surgery I got my teeth cleaned and at that appointment my dentist said my teeth were excellent. I went to the dentist 6 months after my other appointment which was after my surgery and he told me I had a bad case of gum disease starting. I feel that the vitamin deficiency has played a huge part on this tooth issue. I have not had any vomiting so it’s not the stomach acids. I asked my dentist about it and he told me it wasn’t from my surgery. I beg to differ.
    Thank you,
    Lynn
    La Crosse, WI

  33. Had Gastric Bypass 3yrs ago. Prior to the surgery, I hadn’t had a cavity in 37yrs. In the 3yrs since surgery, I have had over 25 cavities and two chipped teeth and one that broke off. I have had many tests to and we are unable to find why this is happening. I take my supplements, brush, and floss regularly and eat almost zero added sugars.

  34. I am a female and had Gastric Bypass about 10 months ago. I have developed an extremely dry mouth. My tongue is so dry it cracks and get little red bumps on it and I can barely swallow my food unless its wet or if I drink something to get it to go down. The inside of my mouth and tongue peel. There are little pieces of skin that stick to my teeth and tongue. This is the most uncomfortable, irritating and sometimes extremely painful thing I’ve ever experienced. My surgeon, dentist and ENT drs have no idea what it is or what to do for it. Do you have any suggestions that could help me? I am miserable. Thank you!

  35. I have beautiful teeth. I had sleeve surgery December 2015. About 2 years ago (2018) I started have an acidic taste and dry mouth at night time. I went to the dentist and not have lots of visible erosion at the base of many of my teeth. I asked my dentist and she just gave me a very short answered to dismiss it. I just read this article. I take gummy and disolvable vitamins every day. I take a multivitamin, magnesium, vitamin C, vitamin D3, biotin (10,000 mg). Blood work is all within normal range. Maybe the chewables are causing more acid. I have increased my water consumption which I think is another problem.

    How do you find a dentist that understands bariatric issues and is knowledgeable on this? My dentist just blew me off when I told her about the acid at night.

  36. I wish I had known I’m embarrassed to even smile. It’s so heart breaking for me and now years later I can’t afford to fix them

  37. I had bariatric surgery on 6-3-15. About a year later I started experiencing tooth sensitivity and a few lip and mouth blisters. I was told by my dentist to start using toothpaste for the sensitivity and mouth wash for blisters. I have always had beautiful, strong teeth my whole life. I was 49 when I had the surgery and had only 2 cavities my whole life. The things he asked me to use did not help. Eventually I noticed a black spot on a tooth and thought it may be plaque so i went in to Aspen Dental where they scanned my mouth and i about fell on the floor when they showed me the results. Every tooth in my mouth except bottom six were decaying from the inside out. I cried, and asked why? He asked me if i take vitamins and i had mentioned i had to because of the surgery. There you go he said, that is why. Bariatric surgery does not tell you these things. When I was 16 I was asked to model for a cosmetic company, always had a beautiful smile. Today my teeth are shells breaking, sores every day, elcers are unbearable. I have Medicare, so no dental insurance. I was quoted 12,500 to fix the problem. I dont have that kind of money. I also have 3 cavities in the 6 bottom teeth I mentioned. They took my teeth from me. I want them back, and I do not mean dentures. Implants, I am taking this to court and my chances are good. I should be able to get the teeth I want, after all they took my best ones.

    1. Please keep us informed. I do not have dental either and I was thinking the same thing. This is a complication from surgery, it should pay for it.
      I think my teeth are going to be worse than your teeth. My teeth look like a meth mouth, cavities at the gum line.

  38. Hello my name is Jodi Moss, I had my Rouen Y done in 2003 and within 2 yrs of my procedure, my teeth were crumbling. prior to my surgery I had beautiful teeth. I never had 1 cavity as an adult. the only filling I had was from a chipped tooth. so needless to say when this started happening to me I was shocked. I didnt understand. and I certainly wasnt warned of this. I had gastric bypass to regain my health, and here i am 18yrs post op and have yet to achieve that goal. I have had to resort to dentures however due to my bone loss I cannot wear a bottom denture. Without teeth its really hard to eat properly eating with dentures for me is impossible, when I saw my dentist when this isssue first came up he immediatly recommended I consider getting dentures. He said to fix my teeth would be very expensive and there was no guarantee I wouldnt end up loosing them any way. towards the end of my teeth crumblimg and following out I no longer had dental insurance and had to resort to one of those clinics where they see hundreds of patients at a time to have my teeth pulled (what was left of them.) a lot of them were broken at the gum line. The dentist thought it was due to meth abuse. I have been in recovery since 1989. Needless to say was offended. just as others have suggested it did appear that way, he had no way of knowing. Anyway life today without bottom teeth is a struggle I lack confidence, I am always covering my face, I am very limited in what I can eat. I at least thought dentures would be a solution to my problem. I was wrong. It looks like implants are the only possible soulution. the last quote I got was like 30,000 I just laughed until I cried.

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