hello, my doctor told me to take two multivitamins and two caluim with d becase people that had gastric bypass needs more vitamins than a person that didn't have the surgury. i am losing bone and tissue in my teeth and i need a crown to fix it my gastric bypass doctor told me i might not getting enough caluim with d. has anyone else have this problem let me know you can also look at my profile too.

Dawn, Yes you have to take your calcium and vits every day, plus I take Iron and B-12. We have to make sure we stay on top of this with the regular blood tests. Calcium absorbs better with D and Magnesium.  I hope that helps some... 

Sorry to hear this.  I haven't had an issue, yet.  I'm taking 2 FLINTSTONE vitamins and 2 VIACTIV Calcium chews (yummi)

I am only a month post op but my surgeon has me taking Optisource vitimans.   I know many people believe they are a waste of money, but I had faith in my surgeon to do the surgery so I try to have faith in him for the follow up.   I will obtain copies of my labs (have not had any done yet) and follow them closely along with my PCP.   My daughter had her first of labs done 2 weeks ago and they were wonderful.   The vitimans seem to be working for her so far.   I will get an order for my first set of blood work next week.   I almost look forward to it.   Hope you find what works for you.    Sally

You must take straight calcium citrate to help prevent bone loss My surgeon has me take 1500 mg a day

Optisource vitamins are great. They are specially formulated for bariatric surgery patients. You get them at walgreen's or walgreens.com As for calcium citrate, it has to be straight calcium citrate. Viactive chews aren't acceptable.

Howdy Guess where I just came from??????????? The dentist. Yup, I have bone loss too............ Just discovered that today.  But he told me it's got nothing to do with the gastric bypass surgery which I don't buy. I have been lacking in calcium citrate, so I believe its got a lot to do with it. I have been very poor with going to the dentist all my life. If I never had bone loss before, you better believe it coming from the bypass surgery. Thats what I believe. But we'll see. I start treatments on Tuesday. BLAH!!

Hello, did you dentist tell you that you might have to have a crown put in by dentist told me this so my denitist is going to bat with the insurance to pay for it i was only taking 2 caluim citrate that is 300mg and caluim with d 600 mg and i militvitamin and my doctor told me to keep taking two caliom citrate and now take two caluim d and two militiviatimns i don't know if it will hel*****t keep me informed.

FYI http://obgyn.health.ivillage.com/newsstories/dentistsmaybefi rstspotoste oporosis.cfm?general=nl_obgyn March 14 (iVillage Total Health) -- Women concerned about the onset of osteoporosis -- a bone disease that primarily affects menopausal women -- should probably keep regular dental appointments as they age. According to the Academy of General Dentistry (AGD), your dentist may be the first to spot signs of bone loss from osteoporosis, a disorder in which the bones lose mass and density. Though it may affect either gender, it typically impacts women during and after menopause. These women have lower estrogen levels and the hormone is essential for bone mass and retention. Low levels of calcium, phosphorus and other minerals also contribute to weakening of the bones. Dental x-rays taken over time can show the gradual erosion of the bones supporting the teeth and in the jaw. The bone loss can lead to periodontal (gum) disease, dentures that no longer fit properly and other mouth disorders. According to the AGD, recent studies have shown a connection between osteoporosis and periodontal disease and are testing various drugs to prevent tooth loss. These include topical solutions, anti-inflammatory drugs and mouth rinses. "This is a significant finding for women, since osteoporosis affects many more women than men," AGD spokesperson Dr. Susan Sup-Barnes, said in a press release. "Hopefully, this study will influence more women to visit their dentist on a regular basis for the health of both their teeth and bones." She said the new drug treatments will help dentists detect osteoporosis and provide early treatment. Copyright 2007 iVillage Total Health. Publish Date: March 14, 2007 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Sent: Wednesday, April 26, 2006 11:22 AM To: [email protected] "Lori Brogna" wrote:

Dental health is closely related to your nutritional status. Periodontal disease (gum disease) is a leading cause of tooth loss.  It is normally caused by bacteria, but if you are calcium deficient then you can develop periodontal disease.  The sad thing is that about 75% of Americans suffer from this disease normally, if you add a calcium deficiency into the mix you can end up with tooth loss.  Make sure your dentist or dental hygienist has done a complete periodontal charting of your mouth and ask them to explain the pocketing numbers to you.  Pocketing develops between the tooth and gums and as it gets deeper that tells us there is bone loss.

Another issue is B12 and nitrous oxide use during dental treatment. Because nitrous interferes with B12 you can develop serious nerve damage if you are B12 deficient.  Because B12 deficiency in gastric bypass patients is high, we are at higher risk for nerve damage if nitrous is used during dental treatment.  If it has to be used then you want to keep the use under 30 minutes.

Another issue is overall dental hygiene issues when you are dehydrated.  We can tend to get dehydrated rather easily so that means our mouths will be dryer as well.  This can lead to more cavities and sensitivity. Getting your teeth cleaned on a regular basis and brushing and flossing at least twice a day will keep plaque from building up.

Another thing I talk about in my class is for denture wearers.  They need to be aware that as they lose weight after surgery that their dentures will not fit as well and will need to be relined.  Soft relines are probably the place to start until the weight loss slows down or stops then a hard reline can be done.  People lose weight in the face also so this effects the dentures.  If the dentures are loose then the person won't be able to chew food as well.

Another issue to think about before surgery is going in for a complete dental check up to make sure all your dental work is in good working order. The reason for this is that afterward you will be chewing a lot more to make sure the food goes down well.  If there is broken fillings, or other dental work that is loose or broken, then chewing will be more difficult and the increased chewing could lead to further breakage that may effect the structure of the tooth even more.

I also talk about the medications that we prescribe in the dental office and why or why not a gastric bypass patient would not want to take them..Motrin, is one that is prescribed a lot.not good for us!  So I talk about all the medications and give them better choices.

I talk about how to recognize symptoms of vitamin deficiencies that can show up in the mouth.  I talk about the importance of updating medical history. I talk about talking to the patients about their vitamin intake and if they see certain symptoms, like a smooth tongue or sores in the corner of the lips to ask about protein intake and other vitamin intake and remind the patient about the importance of vitamins for overall health, but how it effects the mouth and teeth as well.

The other thing to think about is if you were to swallow dental work while in the chair.  It is rare but there have been patients who have swallowed a three-unit bridge, and for us that would mean a trip to the hospital because it would not pass through the stoma opening.  Too large!  So I cover those issues as well.

I really try to educate the dental professionals that I speak to about the overall surgery and how all of it can effect the work we do in the dental office and how we can better serve our

Lori Brogna

RDH

Some Important Points About Calcium

 

 

 

Some Important Points About Calcium   By Jacqueline Jacques, ND   Calcium is the single most plentiful mineral in the human body, and is very important to many aspects of human health. 99% 0f the calcium in your body is stored in your bones and teeth. The remaining 1% circulates in your blood stream and helps to regulate functions like the contractions of your heart, the ability to move your muscles, and the signaling of your nerves. There are two ways your body can keep adequate calcium circulating to maintain these vital functions in proper working order: from the food you eat or by removing it from your bones. The ideal is that we get adequate calcium from our food sources so that we never have to take calcium out of storage, but few Americans actually accomplish this. Survey data from the United States Department of Agriculture (USDA) suggests that the average American only gets about 700 milligrams of dietary calcium per day. The National Academy of Sciences tells us to maintain bone health, we need between 1000 and 1300 milligrams daily, far above what most of us can accomplish with diet alone. Under some specific cir****tances such as osteoporosis or malabsorption (such as after weight loss surgery), higher doses of calcium may be recommended. The safe upper limit has been set at 2500 milligrams daily for all ages, and should not be exceeded without physician supervision.   Patients who have undergone weight loss surgery need to think carefully about calcium supplementation. Most forms of calcium require contact with stomach acid for proper absorption. With a small stomach pouch, this essential contact is greatly diminished or does not happen at all. Additional concerns with gastric bypass and other forms of weight loss surgery such as duodenal switch, can include higher risk for the formation of kidney stones and malabsorption of fat soluble nutrients such as vitamin D that are critical for bone health and calcium metabolism. For this reason, it is important to give careful consideration not only to the amount of calcium supplemented, but also to the form, and to assure adequate intake of the other nutrients important to bone health. Generally calcium citrate has been shown to be the best-absorbed form in human studies. It may be of special preference following gastric bypass because it requires little or no stomach acid for absorption. Additionally, recent studies on both diet and supplements suggest that calcium citrate may protect against kidney stone formation, which may be an added benefit for this form.