Antibiotics for Dental work

[pellicle]

.. 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

that's exactly what I was saying ... :-D

 

[tjay]

Thanks everyone. Yes, I'll be going to a dentist soon

 

[Agian]

Thanks everyone. Yes, I'll be going to a dentist soon

You've been schooled.

 

[epstns]

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 !

Both my cardio and my dentist agree that even for my normal (4-times/year) cleaning, pre-meds are appropriate. I'd rather be safe than sorry.

 

[Bina]

I've been going to the dentist for cleanings every 6 months, for 52 years. Yes, 52 years. My family is big on nice teeth and oral hygiene.

Anyway,when I was around age 20 and my heart murmur was discovered it was recommended that I take the pre-visit dose of antibiotics and I have done that for the past 36 years.
Lots of numbers I'm throwing around, but my whole life I have only had 2 different dentists and both of them agreed that the single mega dose of antibs was well advised for my heart safety.

 

[Paleowoman]

Bina and Steve - yes I understand what you are saying, but in the UK and Europe you would never get antibiotic cover for a clean. Even the doctors and dentists who agree one needs antibiotic cover for invasive dental work and do not agree with NICE guidance in the UK would not give antibiotics for a clean.

 

[epstns]

Bina and Steve - yes I understand what you are saying, but in the UK and Europe you would never get antibiotic cover for a clean. Even the doctors and dentists who agree one needs antibiotic cover for invasive dental work and do not agree with NICE guidance in the UK would not give antibiotics for a clean.

I could come back with a smart-aleck remark about health care in different countries, but I will just say that I'm glad I have the options that I do - especially in cases like this.

 

[pellicle]

Hi

g, but in the UK and Europe you would never get antibiotic cover for a clean.

I can't speak for the UK but this is not my personal experience of Europe.

Perhaps you have not surveyed enough dentists in Europe

 

[Paleowoman]

Hi

I can't speak for the UK but this is not my personal experience of Europe.

Perhaps you have not surveyed enough dentists in Europe

I'm going on the European Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009) http://www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments/guidelines-IE-FT.pdf page 2376 (about 8 pages into the guidelines). It's those that Europe goes by. The UK goes by NICE guidance which curently says no to any antibiotic prphylaxis. No doctor or dentist has to obey either guidance as both are guidance only, but certainly, even though the European guidance covers invasive dental work, while the UK guidance does not at all, the European one does not cover cleaning.

 

[pellicle]

I'm going on the European Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009)

and I was going on what I quoted you as saying (which Steve picked up on and was having a giggle about) not what you didn't say, and not what you didn't refer to. I was also going on my own personal experience in Europe where I've just said to the dentist "can I have antibiotics because I've had a valve op" to which they just said "sure" and wrote a script. Nobody in the dentist office huffed and puffed about European Guidelines, they just wrote out a script and off I toddled to the chemist to get it.

Which is a contrast to:

but in the UK and Europe you would never get antibiotic cover for a clean

I simply reacted to what seemed to be a blanket statement of certainty which I from personal experience knew was wrong. If you had said "the guidelines" well I wouldn't have know.

None the less I have never once had any dentist anywhere (never lived in UK) even blink when I requested antibiotic cover

 

[tom in MO]

I just saw my cardio and asked about this. He said that the current literature indicates that antibiotics are indicated for teeth cleaning but not for cavity filling. He knows about the European guidelines, but indicates there is evidence that there are higher rates of endocarditis in populations w/o antibiotics than with. He agreed there is no hard science of a direct causal link between dental procedures and endocarditis, just a statistical link.

In my saga with BAV, I've gone from antibiotics with every cold (~1980) to the current state. Now antibiotics are not prescribed for just a BAV. My cardio says antibiotics are only for owners of an artificial valve. For dental procedures, antiobitics are suggested for cleaning but not for cavity filling, unless the soft tissue of the gums will be disturbed and broken.

If you are like me and don't tolerate 2g of penicillin very well (I have an irritable bowel ever since they removed 6" of it) there are options. I used to tolerate the penicillin, but not so much. Last bout I almost went to my GI doctor and I haven't been to them in years. I am going to try Kefalex (?) for my next cleaning. He said there are more than one option for penicillin, they all work, but don't go w/o it.