Dental question

[judy13]

Had a root canal yesterday, all dental work completed except permanent crown. Do I need to pre medicate to have temporary switched out for permanent?

 

[Greg a]

DDS should know but ask him/her and your cardio.....they will want your full meds picture ,,,,,,my 2cents is YES

 

[judy13]

Thats what i was thinking. I will pre medicated just to be sure. I have been to the dentist 4 times in seven days and had to pre medicate for deep cleaning and root canal, so whats one more time gonna hurt. Glad to be done with the teeth. One less thing to worry about.

 

[Greg a]

Judy , I lost my sternum to MRSA and so infections scare the #$$^^ outta me

 

[carolinemc]

I have always premed before even a cleaning. You need to get in touch with either your pc doctor or cardio to get a script. Most dentists won't a cardio patient unless he or she is premed. Just had to put in my two cents. Most dentists I have gone to wont's touch me without premed first, even for a cleaning. It is to prevent infection to the heart. Take care.

 

[deano89]

i had antibiotics for the prem work but when it came to temp being removed and the crown being cemented on the dentist said it wasnt neccessary as she wouldnt be doing anything that could enter the blood stream

 

[tobagotwo]

Hah! This is where that post was supposed to go... I accidentally reanimated an old dental thread from 2009 trying to respond to this a few days ago. This would fall into the same response as Deano89...

From a post from 2007, here are the more specific (and restrictive) older guidelines from the AHA/ACC, endorsed by the ADA. The newer guidelines actually call for less use of prophylactic antibiotics, but are so vague and generalized that they lack substance in my view.

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:

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 (bolding mine)...

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 even these more restrictive older guidelines describe "significant" bleeding as being the criterion, they are not referring to the occasional, accidental poke of a pointy probe.

Best wishes,

 

[Jkm7]

If I don't premedicate, I don't go to the dentist for anything.
My surgeon, PCP, cardio and dentist all agree I should not appear in the dental office without my pre med dose.