How to save your teeth after bariatric surgery

I hate dentists. I really do. There is no other doctor I would despise more. I have panic attacks when I am calling for an appointment. Imagine my going into the office. If they measured my heart rate, they must be convinced I am about to have a heart attack. That bad things are. Nevertheless, I still go there every six months. 

Why am I undergoing this level of self-torture? Because it is better to be safe than sorry. Since I had a bariatric surgery, I might get a pretty nasty surprise any time. Sometimes I have mild reflux, sometimes I feel like puking (this pesky feeling never went away completely), and I eat small portions of food all the time, so my mouth has no time to rest. Which means that I have ugly bacteria there all the time. It is not difficult math to figure out that I am likely to have caries. Sooner or later, they are likely to happen.

On the other hand, if you go to the dentist every six months, it is not likely that the potential caries would be very big, so it might not be so horrible to repair it. Also, the financial question would not be that high. Still, I am suffering like a dog every time. 

Before the surgery, I talked to my dentist and asked about potential problems. I saw the comments in every forum. The topic shows up quite frequently and it is never a nice reading. That is why I wanted to know where I was heading. I was investigating a lot. My panic about dentists is very real it it is not getting better with the years. What I found was not very encouraging. 

Well, half and half. If you brush your teeth regularly, you use fluoride toothpaste, you floss and you use your mouthwash, you should be ok. This is the ideal situation.

But if you are already after the surgery, you know firsthand that not every day is perfect and mishaps happen. You might have reflux, maybe you even vomited, so all the acids from your tiny stomach went up and are all over your teeth. You wouldn’t believe how strong the acid in your stomach is. It surprises me that it doesn’t eat itself.

The weeks after the surgery are a very bumpy road. I was with reflux for months and they prescribed me pills to keep it down. The success was questionable. Some days it was great and some days it was straightforward and nasty. Luckily, I never got to vomiting. But it doesn’t mean that I was not very close to that. Many times 😬 I was petrified that I messed up my teeth badly. 

The first dentist appointment went really good. He didn’t find anything wrong and apart from regular cleaning, it was all ok. I insisted and asked again about the protection. What can I do to prevent caries (and any other related problems)?

The answer was detailed and I keep following it to the last letter till today.

1. Brush your teeth regularly – twice a day minimum – ideally after every meal, but because we eat a little bit all the time, it is not doable. 

2. Floss – the space between your teeth is very important and usually, it is the first place where the caries show up. Neglecting this area is a recipe for disaster.

3. If you have space for interdental toothbrushes, use them. Yes, you are flossing but this is not a bad idea either.

4. Fluoride mouthwash is your great friend. Make sure you use it in the evening before bed, when you will not eat nor drink anything after, and extremely important!!! Don’t rinse the mouthwash. You would take away all the benefits. Obviously don’t swallow it.

5. Waterpick. This is what my dentist told me: if you want to invest some money into your oral hygiene, buy this thing. It works magic.

I did. I ordered the Waterpick about 6 months after the surgery and I use it every day in the evening. I fell in love with the combination of brushing and flossing. The accessory looks like a head for your electric toothbrush, but the difference is that it doesn’t vibrate, there is water coming out. It does not work with toothpaste, but if you add a little fluoride mouthwash into the water, you will be very pleasantly surprised. 

So first normal brush, then floss and interdental toothbrushes, then Waterpick and finish strong with the mouthwash.

The last thing that is extremely important are vitamins and supplements. I wrote a whole post about them a while ago. They are super important. If the endocrino prescribed them to you, take them. You won’t feel so weak and tired, but also your teeth will not suffer from demineralization. My dentist told me to take a pill of extra calcium daily. So I am taking it. Among all the other pills, who cares if there is one more.

The truth is that consistency is the key. Do it every day. No exceptions. Sometimes you think you don’t have time, you don’t feel like it, because – and this is pretty clear, your tooth brushing routine will take half an hour every evening. Not kidding. If you do it well and with precision, it will really take you this much time. 

I have been living like this for 2,5 years and I have to knock on the wood, so far so good. Not a single caries, very little material to clean (ehm, I drink quite a lot of tea, so the dental hygienist remembers me 😀). But definitely, this routine protected my teeth. Sometimes it is very tempting to say: meh, not today. But then I remember the smell of the dentist’s office and I am brushing like crazy 😀

On the other hand, if you had problems before and you are likely to have caries, you have bad teeth or you had issues before, they won’t miraculously go away. Most likely it will be the other way around.

This is a tough thing to assume. Have the surgery or not if your teeth are already bad? I don’t know if the decision is yours. What I would definitely do is, I would talk to the dentist and ask. Every and any question that pops on your mind, no question is stupid. They are there to answer.

As the very last resource, the same way as people count on plastic surgery to remove excess skin and they make a budget for that, maybe it wouldn’t be a bad idea to allocate another part of the budget for teeth. It is pretty annoying and costly, no matter what they to do you with teeth. But I think it is still much worth it if it is the only health complication that will be left. They can “easily” repair your teeth, but there is very little to do with diabetes, joint replacements, and premature death because of the silly weight. I would think about it this way.