Dental Work and Artificial Tissue Aortic Valve

[rich01]

I'm having a difficult time finding current information on what precautions, if any, are required for different dental procedures. One paper I read showed a relatively small difference in the rate of infection whether an antibiotic was taken or not. Time seemed to be a much bigger factor. I'm also wondering if dental requirements are the same for a valve replacement by TAVR and SAVR.

I'm considering getting some at-home invisible aligners (braces), which is what prompted my concern. I have an appointment tomorrow with my cardiologist, so will ask him, but would like to know what others have been told.

 

[caro]

Hi! I have Invisalign with a mechanical valve. Haven’t been told to take antibiotics unless I’m at a 6 month dental cleaning.

 

[ATHENS1964]

https://www.aae.org/specialty/wp-co.../06/aae_antibiotic-prophylaxis-2017update.pdf

 

[pellicle]

my understanding was that it was related to getting a pulse of infections in the blood which were so significantly high that before the phagocytes could destroy them that some could take refuge in the heart where there is scar tissue and in particular a valve (bio or mech) which was stitched in and vulernable.

Some places consider individual human health lower in priority than some (misunderstood) goal of reducing antibiotic usage in humans (but its fine in pigs and dairy cattle) in order to prevent there being an increase in antibiotic resistant bacteria.

To me this is quite laughable.

The risk is small but not insignificant. Accordingly if I'm having any dental work done (such as scale and clean, which is highly gum invasive and by nature stirs up everything sessile in the mouth) I take antibiotic cover.

Fillings are not invasive in contrast.
Discuss this point with your cardio.

 

[pellicle]

https://www.aae.org/specialty/wp-co.../06/aae_antibiotic-prophylaxis-2017update.pdf

exactly

 

[rich01]

https://www.aae.org/specialty/wp-co.../06/aae_antibiotic-prophylaxis-2017update.pdf

I had to look up manipulation of gingival tissue and manipulation of the periapical region of teeth. Even after looking them up, I don't know if braces are a problem or not. They are manipulation of the periapical region and gingival tissue, but over a long period of time.

One problem with the aligners is if they are not kept clean and if you don't brush after eating, the chance of gum disease greatly increases.

 

[rich01]

My cardiologist didn't think invisible aligners were a problem and no need for antibiotics.

Also said after 1 1/2 years, the valve is performing well. A slight leak, but he didn't find that as problematic.

 

[pellicle]

Glad the valve is performing well.

My cardiologist didn't think invisible aligners were a problem and no need for antibiotics.

Years ago doing my biochemistry microbiology degree I found the biggest idiots in the class were the doctors.
"What do we need to know about this stuff for anyway"

 

[dwhist]

I just finished up with invisaligners. The only time it was decided I should take antibiotics was when they were running a file device between some of the teeth to gain small amount of extra space. They said there was a chance they may go below gum line and wanted the extra protection.

 

[kevanndo]

My daughter has had traditional metal braces twice with a mechanical mitral valve and wears a nightly retainer. It was never suggested that she take any antibiotics during any of her orthodontic treatment.