Antibiotics for Dental work

[Bushman]

So after my visit with the Cardiologist this week, he recommended for me to get proactive about some "house keeping" items before I have surgery. One of these items is any dental work should be done as soon as possible, So I talked to my dentist and his protocol for heart patients is 4 500mg pills of amoxicillin one hour before a major cleaning or dental work. I was under the impression that one would start taking antibiotics a few days before and continue for a few days after.

What are your experiences with antibiotics and dental work?

 

[Eva]

Your dentist is correct!

 

[harrietW]

I take antibiotics one hour prior to every appointment ! You have the right Pills and your dentist is right as Eva mentioned.

 

[skeptic49]

If you have a prosthetic valve you need to pre-medicate. The current guidelines do not call for pre-medication for patients with native valves.

 

[RobThatsMe]

I take 4 one hour before dental work. Have been for 14 years now, whenever I have any dental work, including cleanings.

 

[carolinemc]

Bushman, I have had to do that protocol for many years. It is important to premed before anything dental. You have infection in the gum that can go down to the heart and infect it. So be proactive and religious with the premed. You will be glad you did. Hugs for today.

 

[Bushman]

Thanks to all for the responses, it sounded a little off to me but hey...I'm new to this. Thanks again!

 

[jrandis04]

Same goes for if you get a tattoo!

 

[camgough]

My surgery is February 18, 2015 and my surgeon suggested a teeth cleaning prior. I had my cleaning on Tuesday , and was told by the dentist that I had a cavity in one of my wisdom teeth. His recommendation was for extraction. He said it was not a big cavity and it could be filled, or left alone for now. He said if they tried to fill and couldn't , then it would have to come out.
My decision was to leave it alone for now and re-assess after my AVR.
Has anyone had a wisdom tooth (or teeth ) pulled after AVR and if the antibiotics are the same, or if Coumadin is a major issue.
This was not news I was hoping for 2 weeks before !

 

[dick0236]

My surgery is February 18, 2015 and my surgeon suggested a teeth cleaning prior. I had my cleaning on Tuesday .......
.....Has anyone had a wisdom tooth (or teeth ) pulled after AVR and if the antibiotics are the same, or if Coumadin is a major issue.
This was not news I was hoping for 2 weeks before !

I have had a few teeth pulled and other significant dental work done over the years and the need for anti-biotics has always been the same....it used to be 2000mg amoxicillin before and 1000mg after the dental appointment. Several years ago it was changed to 2000 mg before only.

I have never had Coumadin(warfarin) be an issue and I have never withheld the drug for any of my dental procedures. Excessive bleeding has never been an issue.

 

[Paleowoman]

I saw an oral and maxillofacial specialist yesterday about my temporomandibular joint problem. He also confirmed that in the event of invasive dental treatment or extraction he, and the other doctors at the very large London hospital he works at, give any heart valve replacement patients, or others at high risk of infective endocarditis, 3g sachet of amoxicillin an hour before treatment - he and the other doctors ignore the UK's NICE guidance which says no to antibiotic phrphylaxis, and feel it's very important to have antibiotic phrophylaxis. He gave ma a prescription for a 3g sachet of amoxicillin, apparently it's a banana flavoured powder, in case I should need it for my wisdom tooth work or extraction.

 

[ottagal]

I saw an oral and maxillofacial specialist yesterday about my temporomandibular joint problem. He also confirmed that in the event of invasive dental treatment or extraction he, and the other doctors at the very large London hospital he works at, give any heart valve replacement patients, or others at high risk of infective endocarditis, 3g sachet of amoxicillin an hour before treatment - he and the other doctors ignore the UK's NICE guidance which says no to antibiotic phrphylaxis, and feel it's very important to have antibiotic phrophylaxis. He gave ma a prescription for a 3g sachet of amoxicillin, apparently it's a banana flavoured powder, in case I should need it for my wisdom tooth work or extraction.

Perhaps, you already posted this and/or are aware of the following:, the NICE guidelines on antibiotic prophylaxis are going to be reviewed and possibly revised:
http://www.nice.org.uk/news/press-a...antibiotics-to-prevent-infective-endocarditis

 

[Paleowoman]

Hi Ottagal - yes, I'm fully aware that NICE guidance is being urgently reviewed due to the increase in cases of infective endocarditis since their 2008 guidance. I printed off the NICE statement about reviewing their guidance last November for my dentist and cardiologist but it made absolutely no difference ! And when I wrote to NICE to ask what should someone like me do they said to stick to the current guidance until they have produced new guidance. I just DON'T go along with that crazy advice. All of Europe and North America advices antibiotic prpphylaxis, it's just the UK being 'cost effective'. One of my previous GP's, who did not like NICE, said that the letters stood for National Institue for Cost Effectivenss, not National Institue for Clinical Guidelines. BESIDES NICE guidance is GUIDANCE ONLY, no doctor or dentist has to ever obey it, it is not law - I have that from my member of Parliament who wrote to the Department of Health on my behalf some years ago with regard to a medication I'm on. So I was really PLEASED to find a top specialist telling me on Friday that one of the biggest London hospitals IGNORES and has ALWAYS ignored NICE guidance with regard to antibiotic prphylaxis prior to invasive dental procedures.

 

[scott.eitman]

1 hour before only

 

[tjay]

A question for you guys who know so much about dental. I'm BAV with native valve (i.e. no AVR yet). I totally started skipping going to dentist about 10 yrs back because of BAV. My logic was why take a chance at all, i..e. even if there is a minor chance (I know it's statistically significantly small if at all) of antibiotics not fully working, and it passes along dirt to the valve during dental cleanup, I don't need that. I will rather have my valve than the teeth, I probably thought in my head .... In other words, I thought not going to dentist won't hurt my valve but going MAY.
I know I was irrational in my thinking but curious what you have to say.

 

[pellicle]

Hi

I know I was irrational in my thinking but curious what you have to say.

I think you are exactly right about your thinking.

If you need to go to the dentist, get the antibiotic cover and go. You can have your teeth and your valve.

FWIW I went to the dentist for over twenty years with no antibiotic cover, even after having an OHS to do a valvotomy. Never had a problem. Infection is a risk not a certainty.

 

[epstns]

tjay - I would still advise to go to the dentist on a regular basis. The risk of infection travelling from your mouth to your heart is greatest when there is, in fact, infection in your mouth. Regular dental check-ups and care when needed will reduce the likelihood of having any dangerous infection in your mouth.

I agree with what I think pellicle is saying -- that your thinking is irrational. The antibiotics aren't any sort of a big deal, and they help to reduce the chances that you will contract endocarditis while needed dental work is underway. Get 'em and go. . .

 

[dornole]

My insurance will actually pay for more frequent professional cleanings for heart patients (like 4 times a year) just because having healthy, infection-free gums is so important. Not going to the dentist could definitely hurt your valve if your gums are in bad shape.

 

[Paleowoman]

Hi tjay - definitely your thinking is wrong ! Go to your dentist and have regular check ups and cleans, that's the BEST thing you can do for your heart valve ! Not going is the worst thing you can do. Along your lines of thinking you might as well say that it's not worth risking brushing or flossing your teeth as you may introduce bacteria doing so ! I managed to keep my teeth fine for the past ten years - now one of them cracked and I got an infection under the filling. I get, will get now, antibiotic cover for invasive dental work now that I've had my aortic valve replaced. You don't need antibiotic cover for a check up and clean, either before or after AVR, you only need it after AVR for invasive work. Maybe some people take it for descaling, I don't think any dentist would normally give it for descaling even after AVR. Make an appointment to see a good dentist !

 

[tom in MO]

A good friend did not take care of his teeth. He aspirated the bacteria from a gum/tooth infection into his lungs. The mouth was easy to fix, but he could not get the infection out of his lungs w/o removing a good part of the lung. There are non-heart related reasons to have good dental care.