carolinemc
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Do not soak razor blades because they can rust, just use a alcohol wipe carefully.
How do you prevent endocarditis and blood infections?
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Here are the things which I do to reduce my risk of endocarditis. Some probably reduce the risk more than others.
1. Try to keep the best oral hygiene possible. More details on my routine below.
2. 2,000 mg of amoxicillin before each dental appointment, even if just a cleaning. This is in accordance with the guidelines for those with prosthetic heart valves.
3. Rinse with antiseptic mouthwash prior to every dental appointment.
4. I always keep some amoxicillin on hand at home and when I travel. If I get a deep enough cut, I will take 2,000 mg of amoxicilln. I ran this idea by my cardiologist and he agreed that it was a good idea. So, I always have a couple of 2,000 mg of amoxicillin available, with prescription refills ready. I have used this twice in the past 2 years. One example was when a training partner in jiu jitsu had not cut his fingernails and gave me a pretty decent cut on my head by accident. I popped 2,000 mg of amoxicillin as a precaution. On the other hand, if I were to cut myself shaving I doubt I would take the dose, unless it was bad, like I lopped off my ear or something.
5. Store my shaving razor stored in alcohol. I've noticed that the blades seem to last longer doing this, perhaps due to less oxidation.
6. If I get a little cut or scrape, I clean it well with soap and water, and bandage with neosporin.
More on my oral hygiene routine. Of all the things listed above, probably the one that has the biggest impact of lowering the risk of endocarditis is having good oral hygiene. I use to get my share of cavities and then some, in my 20s, but then I made some big changes after telling my dentist that I never wanted another cavity. Not rocket science, but the key is consistency. Since getting my valve I have been even more of a stickler when it comes to my dental hygiene. The last couple of years when I've had my cleaning, on two occasions the oral hygienist asked me what my routine was, because there was practically zero plaque. Also, every wonder why your dentist or hygenist measures your gums? It is to check for signs of periodontal disease and inflammation. I have a link to that below. They are measuring the gum pocket depth. I now that some of the steps I've added in the past few years have made a difference, because my pocket depth has reversed. It usually increases with age, but I'm now in the 0 to 3mm range for all my teeth and I'm told my the hygienist that this type of reversal is unusual.
Also, regarding gums bleeding. When I was in my 20s and early 30s, I did not floss nearly enough. When I did floss my gums would bleed and when I would go to the dentist and they would floss them, they would bleed. They would tell me that I needed to floss more to stop it from bleeding. Sounds counterinuitive, but not really. Eventually, I got really consitent with flossing and, togehter with my routine below, now my gums never bleed- not at home when I floss and not when the dentist cleans them. So, I have to agree with those above who recommend regular flossing and disagree if someone says to avoid flossing to avoid making your gums bleed, although substituting with a water pik might be fine and there have been some studies on that.
Anyway, here is my routine and habits.
1. I eat all whole foods. No sugar or processed foods. Not zero, but close to zero. This means salads, legumes, unprocessed protein, (like fish or chicken), lots of veggies, seeds and nuts. I know that this is not for everyone and for most, it is about moderation, but I'm a little hardcore in this area. It turns out that the bacteria in your mouth love sugar and processed foods, especially processed carbs.
2. I brush at least 2- 3 times/day. My personal brush of choice is a Phillips Sonicare brush, although I'm not sure that the electric brush makes any difference.
3. Floss every day. I keep floss in convenient places, other than the bathroom. I keep some in the drawer in my living room, so I can floss as I watch TV. I keep it in my car. I haven't yet seen the billboards that caution against flossing and driving, lol. It can actually be done safely at stop lights and such. I keep some at my desk so I can floss during work breaks.
4. In addition to flossing I also use a Water Pik every day. This may be a little overkill, but it's gentle enough on the gums that I see no harm in doing both. I think that there are advantages to both flossing and the water pik, so I use both.
5. I use a between tooth brush several times/day. Like the floss, I keep these in the car and handy everywhere. The brand I prefer is G.U.M, which I buy in bulk at Costco. They have soft rubber, ribbed tips and are very gentle on the gums. Pretty much after every meal I will use these, to try to have as little as possible between my teeth for any amount of time. Because you can use them with one hand, it is easy to use while driving or watching TV ect.
6. I use a listerine mouthwash. I always use this before dental appointments, and a few times during the week, but one goal I have is to be more consistent with this. I think that it is probably a good idea to use it before brushing and flossing, maybe even doing it afterwards as well.
Gum measurement
https://anthonymartindmd.com/learn/...rt of your,determine your overall gum health.
1. Try to keep the best oral hygiene possible. More details on my routine below.
2. 2,000 mg of amoxicillin before each dental appointment, even if just a cleaning. This is in accordance with the guidelines for those with prosthetic heart valves.
3. Rinse with antiseptic mouthwash prior to every dental appointment.
4. I always keep some amoxicillin on hand at home and when I travel. If I get a deep enough cut, I will take 2,000 mg of amoxicilln. I ran this idea by my cardiologist and he agreed that it was a good idea. So, I always have a couple of 2,000 mg of amoxicillin available, with prescription refills ready. I have used this twice in the past 2 years. One example was when a training partner in jiu jitsu had not cut his fingernails and gave me a pretty decent cut on my head by accident. I popped 2,000 mg of amoxicillin as a precaution. On the other hand, if I were to cut myself shaving I doubt I would take the dose, unless it was bad, like I lopped off my ear or something.
5. Store my shaving razor stored in alcohol. I've noticed that the blades seem to last longer doing this, perhaps due to less oxidation.
6. If I get a little cut or scrape, I clean it well with soap and water, and bandage with neosporin.
More on my oral hygiene routine. Of all the things listed above, probably the one that has the biggest impact of lowering the risk of endocarditis is having good oral hygiene. I use to get my share of cavities and then some, in my 20s, but then I made some big changes after telling my dentist that I never wanted another cavity. Not rocket science, but the key is consistency. Since getting my valve I have been even more of a stickler when it comes to my dental hygiene. The last couple of years when I've had my cleaning, on two occasions the oral hygienist asked me what my routine was, because there was practically zero plaque. Also, every wonder why your dentist or hygenist measures your gums? It is to check for signs of periodontal disease and inflammation. I have a link to that below. They are measuring the gum pocket depth. I now that some of the steps I've added in the past few years have made a difference, because my pocket depth has reversed. It usually increases with age, but I'm now in the 0 to 3mm range for all my teeth and I'm told my the hygienist that this type of reversal is unusual.
Also, regarding gums bleeding. When I was in my 20s and early 30s, I did not floss nearly enough. When I did floss my gums would bleed and when I would go to the dentist and they would floss them, they would bleed. They would tell me that I needed to floss more to stop it from bleeding. Sounds counterinuitive, but not really. Eventually, I got really consitent with flossing and, togehter with my routine below, now my gums never bleed- not at home when I floss and not when the dentist cleans them. So, I have to agree with those above who recommend regular flossing and disagree if someone says to avoid flossing to avoid making your gums bleed, although substituting with a water pik might be fine and there have been some studies on that.
Anyway, here is my routine and habits.
1. I eat all whole foods. No sugar or processed foods. Not zero, but close to zero. This means salads, legumes, unprocessed protein, (like fish or chicken), lots of veggies, seeds and nuts. I know that this is not for everyone and for most, it is about moderation, but I'm a little hardcore in this area. It turns out that the bacteria in your mouth love sugar and processed foods, especially processed carbs.
2. I brush at least 2- 3 times/day. My personal brush of choice is a Phillips Sonicare brush, although I'm not sure that the electric brush makes any difference.
3. Floss every day. I keep floss in convenient places, other than the bathroom. I keep some in the drawer in my living room, so I can floss as I watch TV. I keep it in my car. I haven't yet seen the billboards that caution against flossing and driving, lol. It can actually be done safely at stop lights and such. I keep some at my desk so I can floss during work breaks.
4. In addition to flossing I also use a Water Pik every day. This may be a little overkill, but it's gentle enough on the gums that I see no harm in doing both. I think that there are advantages to both flossing and the water pik, so I use both.
5. I use a between tooth brush several times/day. Like the floss, I keep these in the car and handy everywhere. The brand I prefer is G.U.M, which I buy in bulk at Costco. They have soft rubber, ribbed tips and are very gentle on the gums. Pretty much after every meal I will use these, to try to have as little as possible between my teeth for any amount of time. Because you can use them with one hand, it is easy to use while driving or watching TV ect.
6. I use a listerine mouthwash. I always use this before dental appointments, and a few times during the week, but one goal I have is to be more consistent with this. I think that it is probably a good idea to use it before brushing and flossing, maybe even doing it afterwards as well.
Gum measurement
https://anthonymartindmd.com/learn/...rt of your,determine your overall gum health.
Gail in Ca
Well-known member
I was just living my life, taking amoxicillin before dental appointments sometimes going barefoot in backyard, but living healthy. I got bacterial endocarditis on Halloween in 08. I had no cuts or visible wounds. The bacteria I got lives on the skin of 20% of population. At that time I was told it didn’t live in the nose or mouth but that has changed. It was a particularly nasty bacteria and did its best to try to kill me. I still live the same way as before. I feel there’s no way to know how I got it so how does one protect oneself from the higher risk of it happening again?
Here's what I do to reduce my risk of endocarditis:
My dental hygiene:
I used to have a lot of tooth decay because as a child and teenager I ate all the wrong things that are bad for teeth and I didn’t brush my teeth very well, this means that by the time I was in my thirties I had a lot of crowns and a couple of bridges in my mouth.
Nowadays:
I floss my teeth twice a day. Once a day I use interdental brushes inbetween each tooth. Twice a day I brush my teeth with an electric toothbrush, I generally take at least 6 minutes each time to make sure I clean thoroughly. I soak my toothbrush head and interdental brushes in a hydrogen peroxide solution once a week or so. I eat a low carb Paleo diet which has the added benefit that there’s no starches or sugars in it which I can tell has helped my teeth and gums. My gum measurements are all 0 or 1 which dentist and I am pleased with.
I have a hygienist clean three times a year and dental check ups twice a year.
I do not use antiseptic mouthwash, principally because there are beneficial bacteria in the mouth as well as "baddies", the mouth is full of bacteria. I once asked an oral maxillo facial surgeon why they were not disinfecting my mouth before a difficult extraction, he told me that there are so many different types of bacteria in the mouth that it would be impossible to kill them all, and you wouldn’t want to kill the beneficial ones.
Before any invasive dental work I take an antibiotic, Cephalexin as I cannot have a penicillin, and ”invasive" being the operative word there. My gums are so strong that they never bleed, not even with the hygienist, so I don’t need to take antibiotics before a visit to her as it’s best not to mess up the microbiome unnecessarily. I make sure I have some in date Cephalexin always to hand in case of unexpected invasive dental work.
Hygiene elsewhere:
If I cut myself, for example when doing gardening or DIY, I wash the cut very well and disinfect it with a hydrogen peroxide solution if necessary, cover with elastoplast too for a day or two.
Basically I try to keep a healthy lifestyle so my immune system is strong enough to cope with viruses and bacteria which come along.
That's the best I can do !
My dental hygiene:
I used to have a lot of tooth decay because as a child and teenager I ate all the wrong things that are bad for teeth and I didn’t brush my teeth very well, this means that by the time I was in my thirties I had a lot of crowns and a couple of bridges in my mouth.
Nowadays:
I floss my teeth twice a day. Once a day I use interdental brushes inbetween each tooth. Twice a day I brush my teeth with an electric toothbrush, I generally take at least 6 minutes each time to make sure I clean thoroughly. I soak my toothbrush head and interdental brushes in a hydrogen peroxide solution once a week or so. I eat a low carb Paleo diet which has the added benefit that there’s no starches or sugars in it which I can tell has helped my teeth and gums. My gum measurements are all 0 or 1 which dentist and I am pleased with.
I have a hygienist clean three times a year and dental check ups twice a year.
I do not use antiseptic mouthwash, principally because there are beneficial bacteria in the mouth as well as "baddies", the mouth is full of bacteria. I once asked an oral maxillo facial surgeon why they were not disinfecting my mouth before a difficult extraction, he told me that there are so many different types of bacteria in the mouth that it would be impossible to kill them all, and you wouldn’t want to kill the beneficial ones.
Before any invasive dental work I take an antibiotic, Cephalexin as I cannot have a penicillin, and ”invasive" being the operative word there. My gums are so strong that they never bleed, not even with the hygienist, so I don’t need to take antibiotics before a visit to her as it’s best not to mess up the microbiome unnecessarily. I make sure I have some in date Cephalexin always to hand in case of unexpected invasive dental work.
Hygiene elsewhere:
If I cut myself, for example when doing gardening or DIY, I wash the cut very well and disinfect it with a hydrogen peroxide solution if necessary, cover with elastoplast too for a day or two.
Basically I try to keep a healthy lifestyle so my immune system is strong enough to cope with viruses and bacteria which come along.
That's the best I can do !
Last edited:
Thanks again to everyone who replied. Right now I use an electric sonic care toothbrush twice a day, and floss only in evenings. After reading some of your replies, I think I will up the flossing to twice a day, and look into interdental toothbrushes after meals (never heard of these before). I'm using mouthwash, right now twice a day, but not sure if it's antiseptic (it's the purple Listerine without alcohol). Anyways, thanks again for the input. Much appreciated from this valve newbie
Do you just floss whenever you remember to? Randomly? Or mostly after meals...
Is this just any mouthwash? Do you also use it before dental cleanings? Right now I'm using Listerine (without alchhol) twice a day to be cautious
Do you just floss whenever you remember to? Randomly? Or mostly after meals...
Is this just any mouthwash? Do you also use it before dental cleanings? Right now I'm using Listerine (without alchhol) twice a day to be cautious
When do you use this? Exclusively after meals?
Hi Daniel - re interdental brushes: these are tiny brushes which specifically clean in the spaces inbetween the teeth. I use these in the evening before I brush my teeth. The routine is interdental brushes followed by floss followed by electric toothbrush.
The interdental brushes I use are TePe. There are different sizes depending on the size of spaces between the teeth - maybe your dentist or hygienist can advise you on the size you need ? There’s an angled one for back teeth too.
I floss additionally during the day after lunch. I keep floss in the bathroom and in the living room and have some in my handbag too !
The interdental brushes I use are TePe. There are different sizes depending on the size of spaces between the teeth - maybe your dentist or hygienist can advise you on the size you need ? There’s an angled one for back teeth too.
I floss additionally during the day after lunch. I keep floss in the bathroom and in the living room and have some in my handbag too !
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I don't have a set time. Last night, after dinnner, I flossed as I watched TV. Sometimes while I'm stuck in traffic I'll floss. I end up flossing about once per day. But, I use the between tooth mini brush after almost every meal.
I also use Listerine. I use it before all dental cleanings and a few times per week. I'm on the fence as to whether or not it's better to use it daily. I understand that it also kills, so called, good bacteria in our mouth. On the balance, given our higher risk of endocarditis, perhaps it is best that those of us with prosthetics use it daily. I'll probably look into it more before I decide to use it daily.
Gail in Ca
Well-known member
I find it fascinating how often I see used floss piks on the sidewalk, elevators, parks. They’re the new cigarette butts of trash!
ATHENS1964
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Everything you write is correct, I would like to add only the following. You must rinse the toothbrush very well before use and periodically leave it in a solution of water with oxygen or in listerin to disinfect it. Also, do not leave it without a cover in the toilet area because there are many microbes floating around it is better to have it outside the bathroom or in a cupboard .
https://www.fastcompany.com/90822177/toilets-dirty-design
pellicle
Professional Dingbat, Guru and Merkintologist
myself I prefer a small bottle with vodka. One day I decided to break open my Oral B reach head ...
http://cjeastwd.blogspot.com/2013/05/inside-reach.html
from that day on its been a solution.
I believe that this is far less of a problem with a regular toothbrush, unless you live in an exceptionally humid environment (where it never dries out). I've only ever seen any hint of anything there right down at where the bristles are embedded in the head.
Personally I make it a point to use a standard tooth brush for a quick distribution of mouthwash around both inside and outside the run of upper and lower teeth after I've brushed with tooth paste. I don't bother to put that toothbrush into alcohol.
ATHENS1964
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The problem is not the humidity, the problem is the germs that can grow on the toothbrush not only on the bristles but also on the plastic part.
ejc61
Well-known member
I had endocarditis in 2014. The only thing I do is take amoxicillin before all dental cleaning and procedures. I was also instructed by my cardiologist to take amoxicillin before any procedure that I'm probed such as colonoscopies, biopsies, dental extractions, ect. I really just make sure that any specialist or surgeon I may come across are aware of my history so that they take it into consideration. Basically I ask my cardio if I need to do anything special or has anything changed for an upcoming procedure. Better safe than sorry.
pellicle
Professional Dingbat, Guru and Merkintologist
Hi
AFAIK having had endocarditis you are more likely to get it again, so I suspect that is what is driving that approach
AFAIK having had endocarditis you are more likely to get it again, so I suspect that is what is driving that approach
ejc61
Well-known member
Yes thats what my cardio and ID doctors say.
ATHENS1964
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Gail in Ca
Well-known member
My infectious disease doc said the risk of getting bacterial endocarditis was 1% back when I got it in 08. He said the risk doubled now that I’ve had it, to 2%.
All we can do is practice good personal habits, medicate against dental or other infections......and be lucky. "Knock on wood", I have never had endocarditis which I attribute mostly to luck. It was 20-25 years after my surgery when dentists began prescribing antibiotics for dental services and doctors began looking at infections more closely. I don't think endocarditis is common among valve recipients.......but we have to use good judgment when dealing with infections.
pellicle
Professional Dingbat, Guru and Merkintologist
Hi
So for BAV (presumably before they get a prosthetic valve)
https://www.sciencedirect.com/science/article/pii/S2352906723000805
and
https://www.sciencedirect.com/topics/medicine-and-dentistry/prosthetic-valve-endocarditis
chapter from
Patrick T. O'Gara, ... Catherine M. Otto, in Valvular Heart Disease: A Companion to Braunwald's Heart Disease (Third Edition), 2009
so I'd call that as we need to be more dilligent with oral hygene to have a "level playing field" with "the general population"
No two ways about it, having a diseased valve and or having had a surgery to correct that diseased valve (and replace it with prosthetic valve disease) is a co-morbidity.
I will however take that over "mortality" just yet.
Best Wishes
it isn't common, but then its relatively more common.
So for BAV (presumably before they get a prosthetic valve)
https://www.sciencedirect.com/science/article/pii/S2352906723000805
Eight cohort studies were selected, with a total of 5351 bicuspid aortic valve patients. During follow up, 184 bicuspid aortic valve patients presented infective endocarditis, with an incidence rate of 48.13 per 10,000 patients-year (95 %CI 22.24–74.02), and a 12-fold (RR: 12.03, 95 %CI 5.45–26.54) increased risk compared with general population, after adjusted estimates.
and
https://www.sciencedirect.com/topics/medicine-and-dentistry/prosthetic-valve-endocarditis
chapter from
Prosthetic Heart Valves
Patrick T. O'Gara, ... Catherine M. Otto, in Valvular Heart Disease: A Companion to Braunwald's Heart Disease (Third Edition), 2009
The cumulative incidence of PVE is highest within the first few weeks and months after valve implantation, approaching 3% at 1 year and 6% at 5 years
so I'd call that as we need to be more dilligent with oral hygene to have a "level playing field" with "the general population"
No two ways about it, having a diseased valve and or having had a surgery to correct that diseased valve (and replace it with prosthetic valve disease) is a co-morbidity.
I will however take that over "mortality" just yet.
Best Wishes
Gail in Ca
Well-known member
I have never been offered any advice on how to prevent it other than take antibiotics 1 hour before dental procedures. No doctor ever gave me a list of symptoms to watch out for or directions for dealing with cuts, bites or daily dental routines.
Plus, I thought one had to have bad hygiene to get it, more or less.
But, I saw the dentist every 6 mos, exercised regularly, and was a person who took showers regularly. Yet, I got it from a rare bacteria out of nowhere.
And, I let the ER docs misdiagnose me!
Stranger, my daughter got a very rare bacteria 5 yrs after I did. Hers was in her lungs and she had to take antibiotics for 6 months! She was feeling very sick and asked her friend, who was finishing medical school, about her symptoms. Her friend told her to see a psychiatrist!!
This is how they’re training doctors at top medical schools. Yikes!!
Plus, I thought one had to have bad hygiene to get it, more or less.
But, I saw the dentist every 6 mos, exercised regularly, and was a person who took showers regularly. Yet, I got it from a rare bacteria out of nowhere.
And, I let the ER docs misdiagnose me!
Stranger, my daughter got a very rare bacteria 5 yrs after I did. Hers was in her lungs and she had to take antibiotics for 6 months! She was feeling very sick and asked her friend, who was finishing medical school, about her symptoms. Her friend told her to see a psychiatrist!!
This is how they’re training doctors at top medical schools. Yikes!!
Dodgy Ticker
Well-known member
I would also add to all of these very wise comments above, that if you are sexually active - avoid ATM !!!!!
Happy New Year 2 U All !!!!!
Happy New Year 2 U All !!!!!
