antibiotics before dental work

[mac]

Hey All!!!

Well here we go, I lost a filling tonight while eating some great Christmas cookies, and now the hastle of getting and taking antibiotics before I can get it fixed. First question, can my Dentist supply me with the antibiotics or do I have to go through my doctor. Second question, do I have to take them for a few days before seeing my dentist or take them the same day and get it done. I guess not so easy anymore to get a quickie appointment and get work done.

Later,

Mac

 

[Philip B]

Dental Work

Dental Work

Practice among dentists may vary and there's some information out there that suggests antibiotics to address cardiac concerns prior to dental work doesn't do much good anyway.

Regardless, my dentist always gives me a prescription for antibiotics before working on me. I typically take the prescription a few hours before my appointment. While I'm not sure antibiotics do much good, I've never had any problems because of the antibiotics.

Some years ago, I had a dentist who required me to take antibiotics before and after procedures.

-Philip

 

[hall]

My dentist called my cardio and had them fax a presription for antibiotic. I take them 1 hour before the dentist appointment. They always ask before they touch my teeth if I took my antibiotic. Best of luck to you.

 

[Lionheart]

Mac,
The antibiotics are really simple. Your dentist can call the pharmacy with the prescription, you go pick it up, and take maybe 4 pills of Amoxicillin or something similar. You take them 1 hour before the appointment and that's it. Your dentist can take care of everything without your cardiologist.
Best of luck.
John

 

[dick0236]

Dentists can prescribe antibiotics. I take 2000 mgs Amoxicillin(spl?) one hour prior to appointment. They want me to take premed anytime they drill or otherwise disturb my mouth. I have my dentist prescribe 12 500mg pills at a time. This drug is very inexpensive and I always have them on hand, just in case problems like yours happen.

 

[river-wear]

Hi Mac,

My deal is the same as Dick and John (Lionheart) - 4 capsules one hour before the appointment, prescribed by my dentist. He can call it in for you. I get 20 or so capsules at a time and when I take the last ones I tell the dentist to give me a new prescription for the next time.

A few years ago they adjusted the guidelines for who has to pre-medicate but people with heart issues as severe as ours still need to take them just in case. For example, with the amount of regurgitation my valve has, the blood hangs around in my heart longer, increasing the risk of endocarditis. People with mild prolapse or something aren't given the meds anymore because it wasn't making a difference.

 

[ALCapshaw2]

The protocol for pre-Dental antibiotics was changed not too long ago. IF you already have an Artificial Heart Valve (I didn't check your profile), then it is generally recommended to take an appropriate antibiotic 1 hour Before your Dental Procedure.

Not All Dentists are willing to prescribe AntiBiotics for Dental Procedures. My dentist wants my Cardio to issue the prescription. I'm guessing it's a liability or responsibility issue.

'AL Capshaw'

 

[Maryka]

My dentist tried to get me to stop taking antibiotics because the American Heart Assoc. stopped recommending it. I just sneaked and took the antibiotic anyway. (IF YOU SEARCH FOR DENTAL ANITIBIOTICS YOU WILL FIND LOTS OF FORMER THREADS ABOUT IT, btw.)

 

[tobagotwo]

If the filling is above the gum line, current and previous ACC/AHA recommendations are that antibiotics are not recommended for the procedure. That has not changed.

Best wishes,

 

[Lynlw]

My dentist tried to get me to stop taking antibiotics because the American Heart Assoc. stopped recommending it. I just sneaked and took the antibiotic anyway. (IF YOU SEARCH FOR DENTAL ANITIBIOTICS YOU WILL FIND LOTS OF FORMER THREADS ABOUT IT, btw.)

I'm pretty sure the AHA STILL recomends the antibiotics for people WITH valve replacements, as long as it is a procedure that antibiotics are recomended for.
There aren't as many groups of people that they still recomend them for but, if was after your valve replacement you are on the list.

Antibiotic prophylaxis with dental procedures is recommended only for patients with cardiac conditions associated with the highest risk of adverse outcomes from endocarditis, including:

Prosthetic cardiac valve
Previous endocarditis
Congenital heart disease only in the following categories:
–Unrepaired cyanotic congenital heart disease, including those with palliative shunts and conduits

–Completely repaired congenital heart disease with prosthetic material or device, whether placed by surgery or catheter intervention, during the first six months after the procedure*

–Repaired congenital heart disease with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit endothelialization)

Cardiac transplantation recipients with cardiac valvular disease

*Prophylaxis is recommended because endothelialization of prosthetic material occurs within six months after the procedure



http://www.americanheart.org/presenter.jhtml?identifier=11086

 

[BlindFaith]

I had the same experience as Maryka did. I had always taken the antibiotic going to the dentist since my murmur was found many years ago. Just before my surgery, because I needed the dental clearance... I went in for multiple appointments and the dentist indicated that he would not prescribe the antibiotics anymore because the new AHA recommendation stated it was not necessary. This caused quite a big deal with my cardiologist who wanted the dentist to call him directly !! Basically, cardiologist says to continue doing the 4 pills 1 hour before and 4 hours after. I got the prescription from my regular doctor. Can't tell you how irritated the cardio was... "even if it only helps 1% of the time, why would you take the chance and not medicate"

 

[tobagotwo]

From a post from 2007 (I bolded the specifics):

Not all dental procedures call for the use of prophylactic antibiotics. Some descriptions of when they would be used, if needed:

From the ADA website:

Quote:
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)

Another view of the guidelines of the American College of Cardiology, the American Heart Association, and the American Dental Association, in regard to when people using prophylactic antibiotics would use them for dental work...
Quote:
Table 2. Dental Procedures and Endocarditis Prophylaxis

Endocarditis prophylaxis recommended*

Dental extractions
Periodontal procedures including surgery, scaling and root planing, probing, and recall maintenance
Dental implant placement and reimplantation of avulsed teeth
Endodontic (root canal) instrumentation or surgery only beyond the apex
Subgingival placement of antibiotic fibers or strips
Initial placement of orthodontic bands but not brackets
Intraligamentary local anesthetic injections
Prophylactic cleaning of teeth or implants where bleeding is anticipated


Endocarditis prophylaxis not recommended

Restorative dentistry 1 (operative and prosthodontic) with or without retraction cord 2
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.

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

2 Clinical judgment may indicate antibiotic use in selected circumstances that may create significant bleeding.

As you can see, filling cavities is in the Endocarditis Prophylaxis NOT Recommended column. Remember, the word "significant" is placed alongside bleeding in these recommendations.

Best wishes,

 

[Ross]

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

People who have damaged, repaired or replaced heart valves are at increased risk for developing an infection of the valve (endocarditis). Until recently, the American Heart Association recommended giving antibiotics to prevent endocarditis to these patients before they had dental work. However, those guidelines have changed — the American Heart Association no longer recommends antibiotics before dental procedures, except for patients at the highest risk for bad outcomes from endocarditis, including:

those with prosthetic heart valves
patients who have had endocarditis in the past
patients with certain types of congenital heart defects, and
heart-transplant patients who develop a problem with a heart valve.
For all people with prosthetic heart valves, it’s very important to receive antibiotics before certain types of dental work involving the gum tissues, teeth or other soft tissues inside the mouth. This includes routine professional cleaning.

If a person has had heart valve surgery, but has not had a heart valve replaced, their cardiologist or surgeon will tell them if they need antibiotics.

The American Heart Association no longer recommends antibiotics to prevent IE in patients who have gastrointestinal tract or genitourinary tract procedures..

People who have had heart valve surgery will probably be placed on an anticoagulant to prevent blood clots from forming.

The American Heart Association does not conduct technical review of mechanical heart valves. The U.S. Food and Drug Administration is the agency empowered to make determinations when such products come under question.

Related AHA publications:

Your Heart Valve Surgery


See also:

Anticoagulants
Artificial Heart
Dental Care and Heart Disease
Heart Valves
Infective Endocarditis (previously referred to as bacterial endocarditis)
Open-Heart Surgery Statistics

 

[neil]

interesting point,here in the uk the heart council have recommended the antibiotics can be more harmful than not? there have now instructed dentists not to give them,it seems there might be more problems and danger taking them than the risks of not taking them,it does seem that not all countries are agreeing about this ,

 

[Jeanie]

When I was a child with a murmur (basically all that was 'known' about my condition at that ancient long ago time), it was common for me to be premedicated. In the past 15 - 20 years or so, I noticed Dentists no longer routinely recommended it and it made sense to me not to bother with it for cleanings or fillings. The only time in recent past that I had antibiotics was at my insistence, for a surgical extraction of an abscessed tooth that had so little of its original structure remaining that extraction was better than trying to repair it. The oral surgeon did not want to prescribe abx, however with my by then updated dx of AS, I insisted, and got it.
Jeanie

 

[Jkm7]

My surgeon, PCP, Cardiologist and dentist all agree they want me taking prophelactic antibiotic for dental work. My cardio prescribes for me but my dentsit has told me anytime I can't reach him or whatever, he will provide. I would not take the chance and not pre-medicate. If I came upon a dentist who denied a patient with prosthetic valve the ability to take antibiotic pre-dental, I would find a new dentist.

I have no delay in getting appointment. As long as I take it one hour prior to treatment, all is good.

 

[mac]

Thanks for all the feed back,

later,

mac

 

[sue943]

interesting point,here in the uk the heart council have recommended the antibiotics can be more harmful than not? there have now instructed dentists not to give them,it seems there might be more problems and danger taking them than the risks of not taking them,it does seem that not all countries are agreeing about this ,

I think that you will find that it was PACE who decided to stop recommending antibiotics. There isn't a heart council, perhaps you are thinking of the British Heart Foundation.

My cardiologist is of the opinion that if a high risk patient such as myself makes an informed decision to take antibiotics prior to dental treatment which could involve blood, such as extraction, cleaning etc., then they should be given it. I receive my dental treatment at the hospital due to being such a high risk patient and am given a prescription by the hospital dental surgeon which I take to the hospital pharmacy, then on the day of treatment have to report to the dental department an hour prior to my appointment so they can witness me taking my 3 grams of Amoxillin and put it in my hospital notes.

 

[neil]

sue you are correct it is the british heart foundation,, having spoken to my doc and cardio there are in agreement with there findings, so no antibiotics for me,

 

[Danny]

Im glad i read this post.... i also just lost a filling, and dentist said i would need antibiotics prior to my appointment since i just had OHS. Cardio agreed and called one in.