Taking care of our teeth is crucial with liver disease

For as long as I can remember, I’ve dreaded visiting the dentist. It started in childhood with a mean dentist who’d once had his thumb bitten off. An antsy little girl got scared, chomped down, and that was that: He was short a thumb.

Like every kid, I wasn’t a perfect patient, but the experience left me with a lifelong fear of dentists — which isn’t fair to them or to me.

Last week, though, I had to swallow that fear. Three broken teeth needed to come out before I could move forward with a knee replacement. It made sense: A knee replacement is no small surgery, and loose or damaged teeth could complicate things.

But since this column is about metabolic dysfunction-associated steatohepatitis (MASH), a type of liver disease, you may be wondering why I’m talking about teeth. Here’s why: So many of our body systems depend on one another, and the liver plays the role of cleanup crew. Poor dental health can wreak more havoc on the liver than most people realize.

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The liver is our pathogen-processing center. So it makes sense that the mouth — the entry point for eating, breathing, and kissing — can also invite bacteria and disease into the body. Those invaders don’t always stop at the gums; they can travel to the liver. Hepatitis, one of the most notorious liver diseases, can take root this way.

For those of us already living with liver disease, keeping the mouth — especially the teeth — clean isn’t just vanity. It’s survival.

The connection between MASH and dental health

After examining me, my dentist said she could remove the three broken teeth on the upper right side of my mouth. They hadn’t bothered me much, so I’d put it off.

“We cannot risk you getting an infection that could affect your knee replacement,” she told me. “And with your liver situation, this is all for the best.”

The dental assistant numbed me completely, and the doctor pulled the teeth. Relief hit me immediately. I’d learned the hard way how dangerous infection can be. Two years ago, after breaking my hip and undergoing a partial replacement, I developed an infected skin graft while trying to manage recovery alone. I ended up back in the hospital with sepsis, a life-threatening infection, complicated by a newly discovered penicillin allergy. Aggressive treatment saved me, but the experience left scars I’ll never forget.

Foreign invaders to the body don’t just stop at causing discomfort. They can lead to insulin resistance, systemic inflammation, and oxidative stress — conditions that can strain an already taxed liver. Something as simple as brushing your teeth twice a day and flossing can keep bacteria from traveling where they don’t belong.

The connection between MASH and dental health runs both ways. MASH itself can worsen oral health. Dry mouth, a common side effect of many prescribed medications, deprives you of the protective barrier saliva provides. That gives bacteria free rein and increases your risk of cavities.

Lipid metabolism — the process of breaking down fats in the body — also plays a role. Impairments here increase the risk of periodontal disease, often signaled by blood in the sink after brushing. Dentists can address this and may even prescribe a mouthwash to help lubricate and protect the mouth.

My face is still bruised and swollen from the extractions, and a nagging headache has followed me around for the past few days. But I feel a little lighter, too — more prepared for my knee surgery, and more aware of how closely connected dental health and liver health really are.

I’m paying closer attention to my mouth now. Not just because I swear like a salty old sailor, but because my health depends on it. A smile isn’t only about looking good; it’s about survival. Now, if I can only find one of the many boxes of dental floss I’ve misplaced.

Note: Liver Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Liver Disease News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to liver disease.

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