Tips to prevent Endocarditis?

ncw3642 · Sep 16, 2024

Hi all!

I've been doing some research around the forums and online for tips to prevent endocarditis (to the best of your ability- sometimes things just happen), but I was wondering if anyone has any tips their doctor/surgeon suggested/they have picked up to do their best to lower the probabilitiy and risk of developing?

Specifically, as it relates to daily health/oral health. I go to the dentist 2x a year- and always (despite brushing twice a day and flossing) develop plaque buildup and bleed a lot when they clean my teeth-- my dentists just say that's genetic and recommend timely 6-month cleanings to avoid any cavity formation due to the buildup being (in their eyes) inevitable.

Just trying to see if anyone has any tips for at-home oral care/other ways in their day-to-day to reduce the risk of endocarditis. From my anecdotal perspective in the hospital, almost every patient who comes in with endocarditis has fairly poor outcomes-- so trying to get into good routines to lower the risk.

Jeff Lebowski · Sep 16, 2024

ncw3642 said:
Hi all!

I've been doing some research around the forums and online for tips to prevent endocarditis (to the best of your ability- sometimes things just happen), but I was wondering if anyone has any tips their doctor/surgeon suggested/they have picked up to do their best to lower the probabilitiy and risk of developing?

Specifically, as it relates to daily health/oral health. I go to the dentist 2x a year- and always (despite brushing twice a day and flossing) develop plaque buildup and bleed a lot when they clean my teeth-- my dentists just say that's genetic and recommend timely 6-month cleanings to avoid any cavity formation due to the buildup being (in their eyes) inevitable.

Just trying to see if anyone has any tips for at-home oral care/other ways in their day-to-day to reduce the risk of endocarditis. From my anecdotal perspective in the hospital, almost every patient who comes in with endocarditis has fairly poor outcomes-- so trying to get into good routines to lower the risk.

I do not believe that there is much to do about endocarditis, especially after taking the necessary precautions such as oral hygiene. I think you should not poison your life with this fear. Living with the constant fear that I will get endocarditis does nothing but upset the person.

tom in MO · Sep 16, 2024

To kill what's in my mouth, I use Listerine at home before the appointment rinsing for a few minutes. I also request a rinse with an antibaterial rinse before starting treatment at the dentist.

ATHENS1964 · Sep 16, 2024

Want attention if someone is cut deeply or injured, then an antibiotic is needed.
Also, if possible, do not store the toothbrush in the bathroom, the reason is that there are many bacteria and germs, always rinse the toothbrush before use.

pellicle · Sep 16, 2024

ATHENS1964 said:
Also, if possible, do not store the toothbrush in the bathroom

I store mine in alcohol after discovering this
https://cjeastwd.blogspot.com/2013/05/inside-reach.html

on the subject of the bathroom, I would ask what basis you have for that statement. I would think that sinks of any type (especially ones used a lot and where food is prepared) would be the main source. I can say that in microbiol we took swabs home and took samples then did growth from them. People were often disgusted with how filthy their kitchen was and how devoid of bacteria their toilet was.

So I'd say "don't let your brush fall into the sink" but in my case I douse it in vodka so its all good.

pellicle · Sep 16, 2024

Morning

ncw3642 said:
I've been doing some research around the forums and online for tips to prevent endocarditis

your diligence is excellent, so many just bury their heads in the sand of "ignore it"

(to the best of your ability- sometimes things just happen),

I guess, but based on what I know that would be a small percentage of the already small percentage of people who get endo. I've personally talked to people who have rank oral hygiene who have zero interest in cleaning their teeth. Its disgusting.

but I was wondering if anyone has any tips their doctor/surgeon suggested/they have picked up to do their best to lower the probabilitiy and risk of developing?

good oral hygiene
paying attention to throat infections (like Strep), do not let it go chronic and seek out a Dr and ask for antibiotics (and bloody stay the full course, don't just take them until you start to feel better).
single large dose of antibiotics prior to oral cleaning at the dentist

Specifically, as it relates to daily health/oral health. I go to the dentist 2x a year- and always (despite brushing twice a day and flossing) develop plaque buildup and bleed a lot when they clean my teeth-- my dentists just say that's genetic and recommend timely 6-month cleanings to avoid any cavity formation due to the buildup being (in their eyes) inevitable.

I've noted that chewing gum that has maltitol has changed my amount of plaque. I'm due for my 6 monthly scale and clean soon, so I'll report my outcomes (like is there an improvement)

HTH

3mm · Sep 16, 2024

ncw3642 said:
tips for at-home oral care

I use a small brush (GUM Proxabrush Go-Betweens) for large gaps between my teeth.
Then I use a waterpick.
Then I floss with string.
Then I brush my teeth.

carolinemc · Sep 17, 2024

ncw3642 said:
Hi all!

I've been doing some research around the forums and online for tips to prevent endocarditis (to the best of your ability- sometimes things just happen), but I was wondering if anyone has any tips their doctor/surgeon suggested/they have picked up to do their best to lower the probabilitiy and risk of developing?

Specifically, as it relates to daily health/oral health. I go to the dentist 2x a year- and always (despite brushing twice a day and flossing) develop plaque buildup and bleed a lot when they clean my teeth-- my dentists just say that's genetic and recommend timely 6-month cleanings to avoid any cavity formation due to the buildup being (in their eyes) inevitable.

Just trying to see if anyone has any tips for at-home oral care/other ways in their day-to-day to reduce the risk of endocarditis. From my anecdotal perspective in the hospital, almost every patient who comes in with endocarditis has fairly poor outcomes-- so trying to get into good routines to lower the risk.

Oral health is not the reason of Endocarditis. Even a virus can cause it like from a cold, or allergies that causes you to have a viral infection.

tom in MO · Sep 17, 2024

carolinemc said:
Oral health is not the reason of Endocarditis. Even a virus can cause it like from a cold, or allergies that causes you to have a viral infection.

Yes it's true that endocarditis can come from non-oral routes.

My old blind crotchety dog bit me good, proving the adage "let sleeping dogs lie." The vet at work said I should get some antibiotics immediately, that's what they do when bit by a dog. Me being stupid, said I've been bit many times before, so I didn't start antibiotics and soon my hand was swollen and inflamed. However the vet was right, and in two days I needed an antibiotic injection and a course of oral antibiotics followed up by another injection 5 days later. I didn't get endocarditis, but my doctor said the antibiotics were necessary not only for the infection in my hand but also to stave off the infection moving somewhere else.

mecretired · Sep 17, 2024

I have had endocarditis twice. Both times it was strep but different strains of strep. I was told that most strep comes from the mouth. But I had no obvious cause so—. I rinse with listerene before brushing and do not floss but use a waterpik. I’ve also been taking cephalexin 2x daily for the last 3 yrs with no big side effects prescribed by my infectious disease doc. I am allergic to penicillin and break out in hives from the cephalexin. Zyrtec takes care of the hives. Doc said no downside to taking the cephalexin long term. So I will be on it indefinitely.

ATHENS1964 · Sep 17, 2024

https://www.mayoclinic.org/diseases-conditions/endocarditis/symptoms-causes/syc-20352576

Chuck C · Sep 17, 2024

Oral bacteria, particularly staphylococcus, streptococcus, and enterococcus, are linked to 90% of cases of infectious endocarditis

https://pubmed.ncbi.nlm.nih.gov/29460534/

carolinemc · Sep 18, 2024

tom in MO said:
Yes it's true that endocarditis can come from non-oral routes.

My old blind crotchety dog bit me good, proving the adage "let sleeping dogs lie." The vet at work said I should get some antibiotics immediately, that's what they do when bit by a dog. Me being stupid, said I've been bit many times before, so I didn't start antibiotics and soon my hand was swollen and inflamed. However the vet was right, and in two days I needed an antibiotic injection and a course of oral antibiotics followed up by another injection 5 days later. I didn't get endocarditis, but my doctor said the antibiotics were necessary not only for the infection in my hand but also to stave off the infection moving somewhere else.

It is like for this RSV vaccine, they have it where you have to be 60 to get, despite all the health issues on their list. But I I call that age discrimination for the chronic people. I had the flu seriously bad in 1979, had to sleep sitting up in bed to sleep due to all the congestion. I was 13-year-old kid back then. Heard about the RSV, my colds nightmares crept back till student PC, and another clinic my hospital, and the CDC insists I be 60, I will be 60 in January, right in the middle of flu, and cold season. I will have one more shot with the diabetes and cardio in December. I hate chest colds, hard to shake off in the winter. And take the risk for endocarditis from the colds which can be high in the winter. {ray I make it to someone who will listen. And I am suffering allegeries right now, nose congestion and settle in my chest. Started during the weekend. Feeling a little better today. And you be okay too.

Timmay · Sep 18, 2024

At night I …

Brush my teeth
Floss
Waterpik (distilled water)
Rinse with Listerine for 60s

I also rinse my toothbrush with a little bit of Listerine twice a week

The above routine I only do once a day

. There are days that I brush my teeth twice a day … but honestly, that mainly happens on the weekends or days that I go into the office. Yes, I work from home

. If I went into the office my teeth would be brushed every morning without fail.

I go to the dentist twice a year, every year, without fail.

Even with my mainly once a day routine, I still have never had a cavity … and I’m 53yo. My gums don’t bleed. Things are good (for now).

Timmay · Sep 18, 2024

Oh!! And in response to my above post, I only started with the Waterpik about 1-1/2 years ago. I put it off forever saying to myself “Meh! It can’t help that much”. I was wrong. Not only do I actually SEE the extra crumbs being forced out, but my dentist saw the difference immediately on the next cleaning. There was significantly less to clean … especially behind my back teeth and on my back teeth.

I know this post is about endocarditis and not dentistry and oral hygiene … but as Chuck pointed out, a lot of endocarditis can be tracked to oral “stuff”

pellicle · Sep 18, 2024

Timmay said:
I know this post is about endocarditis and not dentistry and oral hygiene … because as Chuck pointed out, a lot of endocarditis can be tracked to oral “stuff"

I changed one word to effect my point

Eva · Sep 18, 2024

ncw3642 said:
… (despite brushing twice a day and flossing) develop plaque buildup and bleed a lot when they clean my teeth-- my dentists just say that's genetic and recommend timely 6-month cleanings to avoid any cavity formation due to the buildup being (in their eyes) inevitable.

Healthy gums should not always bleed. If you’re using a hard toothbrush, try switching to a soft one. Also, stay hydrated, as a dry mouth can lead to plaque buildup.

From Mayo Clinic:
“Not having enough saliva and experiencing dry mouth can lead to increased plaque, tooth decay, and gum disease.”
You can read the full article here:

https://www.mayoclinic.org/diseases...enough saliva and,mouth, also known as thrush.

ATHENS1964 · Sep 19, 2024

Infective endocarditis and oral health—a Narrative Review

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8748486/

pellicle · Sep 19, 2024

ATHENS1964 said:
Infective endocarditis and oral health—a Narrative Review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8748486/

some pretty "persuasive" photographic examples in there to promote oral hygiene ...

Eventually, it has to be emphasized that besides antibiotic prophylaxis prior to certain dental procedures the maintenance of good oral health in patients at risk seems to play an even more important role in preventing IE (1,12,41,42,61,62), since persisting odontogenic infections may remain undetected (61) causing bacteremia with high frequency and intensity during every-day activities (38). Therefore, the prevention of oro-dental infections and the consistent adherence to oral maintenance care including regular dental and periodontal examinations as well as prophylaxis are crucial in the prevention of infective endocarditis, especially in patients at increased risk for IE and those at high risk of severe disease outcome (4,9,12).

Ultimately I'm going to do both:

good oral hygiene as part of daily life
antibiotic cover during a clean

People can make an argument that seatbelts aren't needed most of the time, but I still wear mine.

Best Wishes

pellicle · Sep 20, 2024

pellicle said:
I've noted that chewing gum that has maltitol has changed my amount of plaque. I'm due for my 6 monthly scale and clean soon, so I'll report my outcomes (like is there an improvement)

Appointment was today and the results are a resounding yes!

The appointment required far less scraping than before as well as the observation by my dentist that something has definitely changed.

Turns out he too has recently become a convert of Maltitol and is now selling a chewing gum with Maltitol.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8791908/

Conclusions

Habitual xylitol gum chewing appears to show plaque-reducing effects that differ from those of sorbitol gum. This suggests specific effects for xylitol on plaque accumulation. Xylitol candies appear not to decrease plaque. The heterogeneity of the studies warrants further research.

Further he mentioned this aspect

The relationships between mastication and cognitive function: A systematic review and meta-analysis

So, something to chew on

Tips to prevent Endocarditis?

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Oral bacteria, particularly staphylococcus, streptococcus, and enterococcus, are linked to 90% of cases of infectious endocarditis

Infective endocarditis and oral health—a Narrative Review

Infective endocarditis and oral health—a Narrative Review

The relationships between mastication and cognitive function: A systematic review and meta-analysis