Endocarditis and bicuspid valve

[jadams]

Hi All,

Went to see my dentist who recommended to take all 4 wisdom teeth out. I have a bicuspid aortic valve and I am planning to have my aortic valve surgery in April. Based on your experience (if any) is it better to do the extractions now or do it after the surgery? Also, would you suggest maintaining the wisdom teeth using fillings or get them extracted? Read a lot about IE (endo) and just want to make a right decision.

Also, does Bicuspid valve expose you to higher risk for Endocarditis after invasive dental work even with antibiotics cover? Anyone has any experience or know of anyone that had Endocarditis with a bicuspid valve and was it due to any dental work after taking the prophylactic antibiotics?

Thanks very much

 

[pellicle]

Hi

extractions are regarded as less of a problem than dental cleans. Imagine that your teeth are covered in a film of bacteria (but your gums not so much, then look at that as scraping the old paint off a bunch of chairs in your living room vs just picking them up and taking them outside.

does Bicuspid valve expose you to higher risk for Endocarditis after invasive dental work

to the best of my understanding the most important aspect is if you've had your valve operated on or not. There's nothing in your bio (except a rather useless point of your birthday being the same as racehorses, a year would help, the date of the month is irrelevant). However what's there implies you've had AVR (so clearing that up would help).

If you have not had surgery then you are less exposed to the higher risk of endo and are about par with the general population. This is because your endothelial lining in the heart has not been cut (and therefore have scar tissue).

even with antibiotics cover?

I've not read any studies but it would seem to me that as long as you have the cover at the right timing pre the appointment (half life of amoxicillin is short) you'll have the best chance of anyone of not getting (what is really quite rare).

If I were you I'd take the cover anyway.

Best Wishes

 

[MdaPA]

Went to see my dentist who recommended to take all 4 wisdom teeth out.

Did your dentist say why? i.e. are they causing a problem or expected to in near future?

 

[jadams]

Hi

extractions are regarded as less of a problem than dental cleans. Imagine that your teeth are covered in a film of bacteria (but your gums not so much, then look at that as scraping the old paint off a bunch of chairs in your living room vs just picking them up and taking them outside.


to the best of my understanding the most important aspect is if you've had your valve operated on or not. There's nothing in your bio (except a rather useless point of your birthday being the same as racehorses, a year would help, the date of the month is irrelevant). However what's there implies you've had AVR (so clearing that up would help).

If you have not had surgery then you are less exposed to the higher risk of endo and are about par with the general population. This is because your endothelial lining in the heart has not been cut (and therefore have scar tissue).



I've not read any studies but it would seem to me that as long as you have the cover at the right timing pre the appointment (half life of amoxicillin is short) you'll have the best chance of anyone of not getting (what is really quite rare).

If I were you I'd take the cover anyway.

Best Wishes

Thanks Pellicle for your response. Sorry I am new to this so wasn't able to establish my profile correctly. I am 42 years old. Haven't had any surgery yet but it will be in April due to aortic valve regurgitation.

I am going to take the cover as you suggested. The treatment plan comprises of cleaning first, an implant and 4 wisdom teeth extractions in this order. I wanted to ensure i am doing everything to cover all my basis.

 

[jadams]

Did your dentist say why? i.e. are they causing a problem or expected to in near future?

Hi MdaPA,

Yes, there are some carries and he thinks to get them out now before they cause issues after the surgery. For most folks wisdom teeth causes issues since they are not well maintained due to their positioning and they are just extra teeth that doesn't assist in chewing or anything else. Hope this helps.

 

[MdaPA]

Yes, there are some carries and he thinks to get them out now before they cause issues after the surgery.

Normally, dental clearance is required prior to OHS so you should get any recommended dental work completed sooner rather than later.

 

[hostapasta]

Hi All,

Went to see my dentist who recommended to take all 4 wisdom teeth out. I have a bicuspid aortic valve and I am planning to have my aortic valve surgery in April. Based on your experience (if any) is it better to do the extractions now or do it after the surgery? Also, would you suggest maintaining the wisdom teeth using fillings or get them extracted? Read a lot about IE (endo) and just want to make a right decision.

Also, does Bicuspid valve expose you to higher risk for Endocarditis after invasive dental work even with antibiotics cover? Anyone has any experience or know of anyone that had Endocarditis with a bicuspid valve and was it due to any dental work after taking the prophylactic antibiotics?

Thanks very much

FWIW, I was just at the dentist last week. OHS with a bicuspid replaced early September. Surgery had me not have a scheduled cleaning before and made me hold off for (90?) days afterwards.
Cleaning was only interesting in that (I took my 4 amoxy pills an hour before) my dentist is dental faculty at our university. He was telling me the history of how doctors used to write full regiments of antibiotics for just about anything pre-dental. He said there was a real rebellion from the dental world and they've cut it down a good bit. He won't write the prescription as he doesn't want to be liable.

He said all the surgeons for hip/knee replacements now are all writing antibiotic scripts, even though the ADA (american dental association) and the AMA (american medical association) have put out guidelines that it's not needed at all. As pellicle pointed out, the risk is very low for an infection.

This just reminded me of a microcosm of the ebb and flow, and slow reaction time, of the various medical disciplines and advancements. (slow advancing, on our personal time scale, is still better than a good bleeding and the doctor tasting your urine for a diagnosis .

 

[pellicle]

Good morning and welcome to the forum btw ... didn't pay attention to that detail last night

.. I am 42 years old.

handy to know (although not so much for this topic)

Haven't had any surgery yet but it will be in April due to aortic valve regurgitation.

Right ... that makes the difference, but in this particular case not so much because you haven't had surgery. I asked because your "about" (bio) is where people (should) go to when answering questions (because everyone can't know all the things about each person like they know themselves). Currently your "about" seems to suggest you've already had AVR.

Surgery: AVR

Anyway, good luck with that in April

I am going to take the cover as you suggested. The treatment plan comprises of cleaning first, an implant and 4 wisdom teeth extractions in this order. I wanted to ensure i am doing everything to cover all my basis.

so yes, with such a situation I'd suggest that the likelihood of you having calcification (which provides nooks an crannies for a happy little planktonic bacteria to settle down and become sessile and grow a great little colony.

Such a thing could exactly set you up for endo after your surgery, and it may indeed go unnoticed prior to surgery without (say) CRP and/or white blood cell tests to identify any elevated situations implying (not identifying) a (possible) infection.

So by all means take that cover 1 hour prior to the procedure.

2mg

I note a total absence of questions about valve choice, which I'm taking to mean that you are across that and comfortable with your choice. I applaud that.

Best Wishes