Antibiotics before dental work?

[CHDDoug]

In the past, my cardio has made me take antiobiotics before any dental work (to prevent endocarditis). In my last visit to the dentist, she mentioned that it wasn't necessary anymore...AHA has lifted that recommendation due to lack of evidence that it actually prevents it.

What's the word...are antibiotics still required before dental work?

Not sure if it matters, but I'm post surgery as well.

Just curious.

 

[Leah]

In my last visit to the dentist, she mentioned that it wasn't necessary anymore...AHA has lifted that recommendation due to lack of evidence that it actually prevents it.

Not sure if it matters, but I'm post surgery as well.

Hi, CHDDoug, I recommend reading the whole thing on the AHA website. My dentist told me about this too, and my cardiologist and internist both reiterated that the recos had changed. However, it's been a while since I read the guidelines but I believe that once you actually have had a valve replacement they still recommend antibiotics.

 

[Cooker]

YES IT MATTERS ....IMHO I would find a new dentist or at least have your cardio give her a call.....why take the chance....A couple of pills an hour before or a trip the the hospital....or the morgue.....

 

[dick0236]

I go to dentist normally every six month for cleaning and they have me premedicate before each visit, but the amount of Amoxicillin was reduced a few years ago. Currently I take 2000mg before visit. I used to take another 1000mg a few hours after the visit but that was discontinued sometime back. I'll be going for cleaning in about three weeks and I'll get the local dental guidelines.

 

[Bina]

I take 2 pills of Clindamycine (300mg) before my dental cleanings twice a year.
In my mind, this is not a big deal to ensure my safety and heart health.

 

[Superbob]

I still get the amoxicillin to take as a precaution for any dental work. Both my dentist and cardiologist insist on it. Been doing it for many years.

 

[Jkm7]

Tissue valve replacement here and my cardio, dentist and surgeon all insist I premedicate every time I go to the dentist for anything.

 

[kfay]

Before I had my surgery, my cardio told me it was up to me whether or not I took them anymore (I had done so my whole life). He is a funny, older guy and he calls this "the great 10 year experiment", and said whether I liked it or not, I was part of the experiment. However, once I had my valve replaced 3 weeks ago, the Mayo clinic gave me a card to give to my dentist saying I ALWAYS was to take antibiotics before any procedure.

Kim

 

[6 for Sarah]

I used to take 2000mg amoxicillin 1 hour before dental stuff then 1000mg 1 hour after. Now I just take 2000 mg 1 hour before. I have a tissue valve and both my dentist and cardio say YES to take it. In fact I had my cleaning 2 weeks ago and before they even started they made sure I took my meds. They would not have proceeded if I had not. I just don't think there is a reason to chance it. I had a cyst removed from my foot joint and they gave me IV meds abx before and after..also they gave me IV abx while in labor with my 2 post valve babies and another IV dose after they were born.

 

[Freddie]

DOUG

My dentist bluntly told me "its to save my butt in case you do get endocarditis. You might not get it at all - but if you do, I can prove that I prescribed amoxicillin if you decide to sue me".

Rather be safe than sorry there Mate.

 

[starrman]

A few pills is no big deal. I have been doing it for over 7 years. I would rather be proactive than be full of regret laying in the hospital or the morgue.

 

[marie]

I have a tissue valve and my cardio told me after my surgery three months ago to take them.
Earline

 

[ruthienc1]

I used to take clindamycin before any dental work and then, when then new recommendations came out from the American College of Cardiology, I was told by cardio hubby that I no longer needed to premedicate. I was so glad to stop because of the awful aftertaste ! He tells me that it's a totally different matter once you've had a valve replacement...........I'll be back on the pills the next dentist's visit!
Ruth

 

[tobagotwo]

He carries the wooden crate with the Ivory Soap label on its side slowly up from the basement. He places it on sidewalk and steps gingerly onto it. He's very aware that it's not as sturdy as it used to be, and he's not as light as he used to be. However, it doesn't wobble, and he gains more confidence as he begins to speak...

1) The use of prophylactic antibiotics was only a suggestion, and was never subjected to scrutiny about its efficacy. In short, nobody checked to see if it actually worked. It just sounded like a good idea, so they did it, and never stopped. The same is true of swiping the skin with alcohol before delivering an injection (courtesy of Marty and Betty). It has been shown to have no benefit whatsoever. Yet it's still done almost universally.

2) There is a very large and convincing study, incorporating 50 years of data, that shows no correlation between the use of prophylactic antibiotics and having a smaller chance of developing endocarditis. (*none*) Here are some study results: http://www.valvereplacement.com/forums/showthread.php?p=248361&highlight=association#post248361

3) The AMA advice is still in place to take antibiotics for people who have had their valves replaced, so that they may receive "...its benefits, if any."

4) It is not, and was never intended for valve patients to take prophylactic antibiotics for all dental procedures. Only those that involved heavy bleeding or work below the gumline. Example: if you're just going for a filling, you are NOT recommended to take antibiotics first.

Here is a fairly readable list from before the study, from the American Dental Association site, also found on the American College of Cardiologists and American Heart Association sites:

All patients in these high-risk categories may need antibiotics for all high-risk dental procedures. High-risk dental procedures are those involving bleeding or producing high levels of bacteria in your blood. They include:

all dental extractions
all periodontal procedures
dental implant placement or insertion of teeth that were knocked out
some root canal procedures
initial placement of orthodontic bands (not brackets)
certain specialized local anesthetic injections
regular dental cleanings (if bleeding is anticipated)

Here is a list of times when it is NOT recommended:

Endocarditis prophylaxis not recommended

Restorative dentistry? (operative and prosthodontic) with or without retraction cord?
Local anesthetic injections (nonintraligamentary)
Intracanal endodontic treatment; post placement and buildup
Placement of rubber dams
Postoperative suture removal
Placement of removable prosthodontic or orthodontic appliances
Taking of oral impressions
Fluoride treatments
Taking of oral radiographs
Orthodontic appliance adjustment
Shedding of primary teeth

*Prophylaxis is recommended for patients with high- and moderate-risk cardiac conditions.

? This includes restoration of decayed teeth (filling cavities) and replacement of missing teeth.

There are many threads on this. Use the Search feature and search for Dental.

Best wishes,

 

[Bonzo Dog]

Having suffered endocarditis, any dental work likely to cause bleeding, that includes a good de-scale and clean, had to be preceded by an IV antibiotic and followed by an oral antibiotic. On the last visit, I had contentious discussions with dentists as they said the IV wasn't now necessary and two oral doses would do.

 

[DeWayne]

How things have changed over the years. As a child I was required to take antiboitics for 10 days prior to any dental procedure, today 4 pills an hour before. I figure it can't hurt.

 

[Trinityheart8891]

hey guys,
not sure what to say on this one, I am 21 and have been told to take antibiotics before dental visits all my life, this just changed for me in february when I asked my cardio's office, they say now I am borderline on the list, and dont need to take them my GP said she would write me the script if I still wanted to take the antibiotics,

my point of view is that they make me really sick to my stomach for a couple days (excuse me for bringing this up, but I also get female issues too) so I will go with my cardio's office on this, and not take them, unless something else comes up, part of the reason they are cutting back these reccommendations is because of the threat of super bugs, if we keep taking the same antibiotics pre dental, our own bacteria in our mouths are gonna get used to them, and these antibiotics will eventually be non effective for their intended purpose, also if we have a bug lurking internally, and we kill some of it, but not all of it because we only took one dose of antibiotics, this bug can become resistant, and come back with a vengeance, and cause some serious issues. I totally understand the being careful point of view, because part of me wants to continue taking antibiotics prior to dental visits, I was once told to always take them by a cardiologist who has seen me from 2 months of age, and I have a very complex case, but being in the medical field I know that superbugs are a very real risk, and they shouldnt be taken lightly. one thing that my GP and I agreed on is that I am very in tune to my body, and know the signs and symptoms of endocarditis well, so this is in my favor if I do have issues. finally, if I have an ok from my cardiologists office to not take the antibiotics, and doing so will prevent me from various GI and female issues, I'll follow.

that said, the guidelines say that anyone with an atrificial valve, or artificial material used to repair a valve is still eligible to recieve antibiotics, that covers most of the members here. I say, if your doc is reputable, listen to him, I really think that we need to take into consideration the threat of superbugs though, we could cause huge issues on another front by trying to do something proactively that we cant even prove is effective.

hope this helps
Morgan, 21

 

[pamela]

http://www.americanheart.org/presenter.jhtml?identifier=4436

... for patients with the highest risk of adverse outcome resulting from endocarditis.

Those people at highest risk include those with:


Prosthetic cardiac valve or prosthetic material used for cardiac valve repair

If it's not yours, it's prosthetic, at least in part. Quite often they use a teflon ring to strengthen the native tissues so you've got something that isn't tissue even with an allograft ... take the antibiotics.

 

[ponygirlmom]

I've just had some experience with this. My cardiologist gave me a card to keep in my purse that talks about the current antibiotic guidelines in general, and then says that this particular patient requires this dosage of thus-and-so antibiotics before dental work.

I think the idea is to discourage dentists from routinely prescribing antibiotics for all patients who have all types of heart conditions, as well as to reassure dentists who are rethinking universal antibiotics that the card-carrying patient really does need them.

 

[Petros]

Deantal Work.

Deantal Work.

My Surgeon said that 2000mg of amoxicillin one hour prior to dental work is necessary.
Petros