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Kidney Disease and Your Mouth

Chronic kidney disease, dialysis and transplant medicines can all affect the mouth, from a dry mouth and a metallic taste to swollen gums. Here is what to watch for and what to tell your dentist.

Updated September 2026·By the OHA editorial team·8 min read·How we write
Key takeaways
  • As kidney disease progresses, it can cause bad breath and a metallic taste. Kidney Care UK says around one in three people with kidney disease have changes in taste.
  • A fluid restriction and some medicines can leave your mouth dry, which raises the risk of tooth decay. Ease it within your fluid allowance.
  • Ciclosporin (a transplant medicine) and some blood pressure medicines can make the gums swell or overgrow. Careful cleaning and regular dental care help.
  • Tell your dentist about your kidney disease, dialysis or transplant, and bring a full list of your medicines. On haemodialysis, the US National Kidney Foundation advises dental visits on non-dialysis days.
  • Transplant teams usually ask for a dental check before you go on the waiting list, with any dental work finished first.

healthdirect Australia describes chronic kidney disease (CKD) as kidney damage, or kidneys not working as they should, for more than 3 months. The NHS and healthdirect say it often causes no symptoms in the early stages. Later on, and with treatments such as dialysis (which filters the blood when the kidneys cannot) or a kidney transplant, the mouth can be affected in several ways. The US National Kidney Foundation (NKF) says good dental health is essential for people living with kidney disease.

How can kidney disease affect your mouth?

Bad breath and a metallic taste

healthdirect and the Better Health Channel (Victoria) list bad breath and a metallic taste among the symptoms that can develop as kidney disease gets worse. The US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says that as kidney function goes down, you may lose your sense of taste.

Kidney Care UK, a patient charity, says taste changes (called dysgeusia) are common in CKD: food may taste bland, salty or bitter, there may be a metallic taste, or you may go off meat. It quotes its chair as saying around one in three people with kidney disease are affected, more so in later stages and on dialysis. It says the main cause is likely a build-up of waste products such as urea, and that a dry mouth and some medicines (including some blood pressure medicines and statins) can add to it. Because taste changes can put you off food, it says they are always worth mentioning to your kidney team. See bad taste in the mouth and bad breath.

A dry mouth

Kidney Care UK says a dry mouth is likely if you have been asked to limit how much you drink or take certain medicines, and the NKF says a dry mouth from some kidney medicines raises the risk of tooth decay. A dry mouth can also be a sign of dehydration, which a peritoneal dialysis booklet from Hull University Teaching Hospitals NHS Trust says occasionally happens in CKD. If your mouth is suddenly drier than usual, tell your kidney team. See dry mouth.

Infections and gum problems

The NKF says infections in the mouth are more dangerous for people whose immune systems are weakened by CKD, dialysis or transplant medicines, and that oral infections and gum disease can cause inflammation that may make kidney problems worse. It lists signs to watch for, shown in the box below. See gum disease.

Swollen or overgrown gums from medicines

Some medicines can make the gums swell or grow over the teeth (called gingival hyperplasia).

  • Ciclosporin (cyclosporine in the US) is used with other medicines to prevent rejection of a transplanted kidney. US MedlinePlus lists growth of extra tissue on the gums among its side effects. The Better Health Channel says immunosuppressive medicines such as ciclosporin can raise the risk of gum inflammation and mouth infections.
  • Some blood pressure medicines can cause gum swelling or overgrowth, according to the Better Health Channel.

The Better Health Channel says swollen gums are harder to clean, that a dentist can carefully trim overgrown gum tissue, and that your dentist may suggest talking to your doctor about adjusting a medicine. Never stop or change a transplant or blood pressure medicine on your own. See medicines that affect your mouth.

Looking after your mouth day to day

The NKF suggests brushing twice a day with a soft-bristled brush and fluoride toothpaste, cleaning between your teeth once a day, asking your dentist whether you need a fluoride or antimicrobial mouthwash, cleaning dentures daily and taking them out at night, limiting sugary foods and drinks within your kidney diet, and seeing your dentist twice a year. See cleaning between your teeth.

Easing a dry mouth when you have a fluid allowance

The usual advice for a dry mouth is to drink plenty of water, but that may not be safe for you. The NKF says to drink fluids as advised by your kidney care team. Kidney Care UK suggests:

  • regular sips of water within your fluid allowance, and rinsing your mouth with water, especially before eating
  • sugar-free gum, sugar-free hard sweets or frozen fruit segments to get saliva flowing
  • artificial saliva products
  • a no-added-salt diet, which it says is usually the first advice

For taste changes, Kidney Care UK also suggests brushing your tongue and seeing the dentist regularly, and describes a sodium bicarbonate mouthwash: one level teaspoon in 500 ml of water, 10 to 20 ml gargled and spat out four times a day, made fresh daily.

Dialysis and dental treatment

The NKF says people on dialysis may have a higher risk of bleeding, infection and slow healing, and that blood-thinning medicines used during dialysis can increase bleeding during dental treatment. It advises booking dental visits on non-dialysis days, telling your dentist your dialysis schedule, giving them a full list of your medicines including blood thinners, and asking them to plan treatment with your kidney team. See blood thinners and dental treatment.

Advice on antibiotics differs. A haemodialysis guide from Cambridge University Hospitals NHS Foundation Trust says any dental treatment must be carried out with antibiotic cover. The NKF says only that your dentist may prescribe antibiotics to treat an infection. Ask your own kidney unit what it advises.

The NKF also says some dental medicines may need a different dose, or should be avoided, in kidney disease, and the NHS says ibuprofen may not be suitable if you have a kidney condition. Check with your dentist, pharmacist or kidney team before taking a painkiller.

Before and after a kidney transplant

  • Australia: Kidney Health Australia lists a dental examination among the tests before a transplant, and suggests regular health and dental checks while you prepare.
  • UK: Leeds Teaching Hospitals NHS Trust says the mouth and teeth are often a source of infection and strongly advises a dental check-up before you are registered. Any dental work should be finished before you are listed as active. If you cannot register with a dentist, the transplant coordinators may be able to refer you to a dental hospital.
  • US: the NKF says transplant teams often require a dental exam, and active infections such as untreated decay or gum disease can delay or prevent approval. It says Medicare covers the exam required for transplant clearance but not follow-up treatment such as fillings, so raise costs with your transplant team early.

After a transplant, the NKF says anti-rejection medicines weaken the immune system and make it harder to fight dental infections, so keep up daily care and regular check-ups.

Where to get support

  • UK: Kidney Care UK Support Line, 0808 801 00 00 (free).
  • Australia: Kidney Health Australia Kidney Helpline, 1800 454 363 (free call, 9am to 5pm AEST, Monday to Friday).
  • US: NKF Cares patient help line, 855.653.2273 (Monday to Friday, 9am to 7pm ET).

For finding or paying for a dentist, see finding a dentist and dental costs and help.

When to see a dentist

Contact your dentist soon if you notice (NKF):

  • red, swollen or bleeding gums
  • bad breath that does not go away
  • loose teeth, or changes in how your teeth fit together
  • mouth sores that do not heal
  • tooth pain or sensitivity, or a dry mouth

Also see your dentist if your gums seem to be growing over your teeth.

Get help urgently
  • The NHS says to ask for an urgent dental appointment, or contact NHS 111, if you think you have a dental abscess, for example intense toothache, a swollen face or jaw, or a high temperature. Mention your kidney disease or transplant.
  • Call 999 or go to A&E (or your local emergency number) if you find it hard to breathe, speak or swallow, have a lot of swelling in your mouth, or cannot open your mouth (NHS advice).

Frequently asked questions

Why does my mouth taste of metal?

healthdirect and the Better Health Channel list a metallic taste among the symptoms of worsening kidney disease. Kidney Care UK says a build-up of waste products such as urea is the likely main cause. Tell your kidney team.

Can I have dental treatment on a dialysis day?

The NKF advises booking dental visits on non-dialysis days, because blood thinners used during dialysis can increase bleeding.

Do I need to see a dentist before a kidney transplant?

Usually, yes. Kidney Health Australia, Leeds Teaching Hospitals NHS Trust and the NKF all describe a dental check as part of transplant assessment.

Can I drink more water to help my dry mouth?

Only within the fluid allowance your kidney team has given you. Kidney Care UK suggests sips, rinsing, sugar-free gum and artificial saliva.

Sources

  1. Kidney disease, healthdirect Australia, accessed September 2026
  2. Kidney disease, Better Health Channel (Victoria), accessed September 2026
  3. Teeth and medication, Better Health Channel (Victoria), accessed September 2026
  4. Chronic kidney disease: symptoms, NHS, accessed September 2026
  5. Ibuprofen for adults, NHS, accessed September 2026
  6. Dental abscess, NHS, accessed September 2026
  7. What is kidney failure?, NIH National Institute of Diabetes and Digestive and Kidney Diseases, accessed September 2026
  8. Cyclosporine, MedlinePlus (US National Library of Medicine), accessed September 2026
  9. Loss of taste and kidney disease, Kidney Care UK, accessed September 2026
  10. Help and support, Kidney Care UK, accessed September 2026
  11. Kidney transplants, Kidney Health Australia, accessed September 2026
  12. Kidney Helpline, Kidney Health Australia, accessed September 2026
  13. Dental health and kidney disease connection, National Kidney Foundation (US), accessed September 2026
  14. NKF Cares: patient information help line, National Kidney Foundation (US), accessed September 2026
  15. Is kidney transplantation for you?, Leeds Teaching Hospitals NHS Trust, accessed September 2026
  16. A patient's guide to haemodialysis, Cambridge University Hospitals NHS Foundation Trust, accessed September 2026
  17. Peritoneal dialysis information booklet, Hull University Teaching Hospitals NHS Trust, accessed September 2026

This article is general information about oral health. It is not a diagnosis or a substitute for advice from a dentist or doctor who knows your situation. If you have pain, swelling, bleeding that does not settle, or a problem that is getting worse, see a dental professional. In an emergency, contact your local emergency service.

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