Recommended Amoxicillin for Dental Office Visits.......

[dbbrooks]

but,in my experience, nary a recommendation, mention, or concern voiced about a dentist's recommendation for frequent and thorough flossing. Wouldn't one be risking dragging the same problematic oral organisms below the gum line for possible introduction into the blood stream? Seems to me that multiple flossings per day versus six month cleanings would generate a greater risk profile even if a dental cleaning may be MORE probing and individually a greater risk.

Andy Rooney's just asking?

 

[Marge]

Will be very interested to see what the replies will be!!!

I just had my teeth cleaned in preparation for next month's surgery. At that time, my dentist, knowing of my upcoming surgery, reiterated recommendation for flossing, followed by immediate use of Water-Pik. According to her, that is the way to ensure that bacteria DON'T accumulate below the gum line and cause problems.

 

[ALCapshaw2]

Don't forget to swish with Listerene or equivalent.

I brush first, swish Listerene equivalent for 30 to 60 seconds, then floss. Not sure if this is the recommended method, but it seems to make sense to kill as much bacteria as possible before flossing. Anyone have any other thoughts?

'AL'

 

[Harpoon]

Listerine, floss, brush, repeat.


Ok, maybe not the repeat part... =)


I've wondered about the idea that flossing might introduce bacteria to the bloodstream as well but I think it's a matter of how severe the bleeding is. Unless your gums are REALLY bad (in which case you're probably not flossing anyways) there shouldn't be enough bleeding to allow bacteria where it shouldn't be, however a dental cleaning (or other proceedure) is a protracted affair which may inflict some real "injury" to the gumline and elsewhere and I think that's why the prophylaxis is neccesary.


Of course the other problem is, if you're flossing every time you brush and you take amoxicillin (or whatever) when you brush because of that, the bacteria amoxicillin is supposed to protect against will mutate to a form that's unaffected by the antibiotic.

Antibiotics are prescribed WAAAYYY too much these days and there are mild forms of antibiotics in all kinds of things now like soaps and hand creams and baby wipes and dishwasher detergent and and and....

I cringe at the thought of all those bacteria these products are supposed to protect us against developing immunities to all the antibiotics we have....

 

[KathyH]

Geez, I always have a cleaning every 6 months, but I admit I do not floss daily. That is a good point, and it may give me more incentive to floss more regularly.
I guess that if you floss every day, you would not have to worry as much about the bacteria build up. You certainly wouldn't want to take Amoxicillin every time you floss because you would become resistant to the antibiotic as someone else mentioned some people use antibiotic way too much.
Kathy H

 

[McCln]

Take antiobotics before dental work

Take antiobotics before dental work

I recently went to the dentist and was premedicated in the office. I have to take cephalexin, due to allergic reaction to amoxicillin. When I took the premed, I was able to go on the cleaning without waiting for an hour. They found in research that as long as your are premedicated, you do not have to wait an hour before cleaning. I do not know about for extensive dental work. But thank you for being so through on premedicating. Some people ahe problems with that, I just want the protection from infection going to the heart, encarditis. Take care and good luck on the dental project. Be sure to get informed before any procedure.

Caroline
09-13-01
Aortic valve replacement
St. Jude's valve

 

[Shirley]

I hope to help explain the antibiotic prophylaxis before dental cleanings a little bit. Please bear with me and I hope not to get too long winded. I am a dental hygienist. Our mouths are teeming with bacteria: some good and some bad. You would not want to premedicate daily to floss because then you would end up killing off all the good bacteria. However, flossing every day is the best way to stave off additional problems. If you hug the floss on the side of one tooth and then the other tooth in the same space you can go under the gums slightly. Done properly you have less chance of making yourself bleed and the gums stay healthier so you have less risk of problems down the road with your heart. In a healthy mouth you typically will not bleed when you floss. They have linked gum disease and heart disease so you want to keep the gums really healthy.
The standard of care for prophylaxis is 1 hour before any treatment that may cause bleeding. However, many offices allow scaling after 20 minutes if the patient is premedicated in the office. That is because the amount of antibiotic in the bloodstream is high enough by that time. If someone comes into our office and has forgotten their premed we will give it to them and then do everything in reverse. First I may make the appointment for next time, have the doctor check their teeth, polish their teeth and then finally do the scraping. The scraping and flossing are where I want to make sure the antiobiotic is in their bloodstream.
The person who talked about Listerine had a good point. If you have bleeding gums or gum disease use a Listrerine (or other mouthwash with alcohol in it) before flossing. It decreases the load of the bad bacteria and then also swish with it after flossing. Do this until you no longer get any bleeding when flossing. That way you have protected yourself and improved your health. For most people who have not been regular flossers the bleeding will stop within 2 days to 3 weeks once you have become a daily flosser. If you have problems getting the bleeding to stop please feel free to email or pm me.

Shirley

 

[Abbanabba]

Any tips on how to floss when you can't get it between your teeth to start with? Most of my bleeding is caused because I try so hard to pull the floss through my teeth and when it finally gets through it ends up tearing my gums - ouch!! I've tried the waxed stuff and the ribbon/tape, but still have the same problem.

A : )

 

[Shirley]

OK, Hi Abbanabba,

I will try to explain this by words. It's easier in person. First, try Glide or Johnson & Johnson Easy Slide if they are available in Australia. They are slipperier than regular floss and may make it easier.

Your teeth are all pushing on each other. If you try to floss straight in and out or one piece going on one tooth and the other piece going on the tooth next to it your teeth and the pressure they put on each other will fight you. In order to have them help make it easier just barely start to slip the floss between 2 teeth. Then pull both pieces of the floss to the right and hug the floss all the way down while going side to side. The pressure you exert shoud be more sideways than downwards. The floss should slip easily down the tooth and slightly under the gums. Then pull it back up slightly and pull both pieces to the left and go back under the gums on that side and then follow the tooth back up on that side till it comes back out. For the back you would do the same procedure but to the front and the back instead of right and left. Some people have really flattened their teeth from grinding. If that is the case start by laying a small piece of the floss against one side of the teeth in the "crack" between the teeth and then gently try to follow the previous instructions.

Hopefully this will work for you - if it doesn't please get back to me and we will work something out for you.

Shirley

 

[Tony]

Shirley,

An excellent job of explaining how your office reverses dental procedures to fit in the antibiotic prophylaxis.

I have been refused treatment when I forgot to take my amoxicillin.

Thanks!

 

[Raverlaw]

My hygenist said that frequent flossing will keep the number of bacteria down, reducing the chance of accidental infection. I rinse first with an anti-placque rinse, floss (not every day), brush, then do a final rinse with Listerine or equivalent, just to be sure.

I'm going to try out a water pik, as I never have time to floss adequately, and I'd like to keep those germs from building up.

 

[Abbanabba]

Thanks Shirley - I'll let you know how I go.

Anna : )

 

[Shirley]

Hi Bill,

I am glad that you are flossing. I just want to let you know that the flossing stirs up the bacterial load and that makes them have to start over at the beginning. The ideal is to floss once a day - not because dental people love to give others more to do - but because the bacterial load increases much faster after 24 hours undisturbed. Keep up the good work everyone.

Shirley

 

[catwoman]

Shirley:

My dentist suggested that I come in 3-4 times a year for cleanings -- in addition to flossing each day. I settled for 3X year this first year after MVR.
What's your info on this?

 

[Georgia]

This is a terrific thread to use as a resource. I've been doing my flossing thing really well since last year and also wondered about the bacteria. Thanks for the info, Shirley. It's so interesting.

And for those who can't get the floss between teeth - there's one made with a flat, plastic thing that you put between the teeth just above the gum - and the floss is attached to the plastic thing. I had to use them for years until I had an old crown replaced.

 

[Shirley]

Dear Catwoman,

The number of times a person comes a year is very individualized. It is not a one size fits all. The benefits of more regular visits is that we can stir up all the bacteria easier than you can. That cuts down the bacterial load. Also, sometimes I can go deeper under the gums than the patient can - this means I get down to the really nasties - most virile germs. When we clean your teeth we actually smooth off the tartar which gives the tooth a smooth surface and makes it easier for the patients to keep them clean. I have patients that the Dr. and I recommend come in every 3 months, 4 months, 6 months or an occaisional 12 monther. I would recommend at least every 6 months for all people with valve replacements. Trust your dentist and hygienist - cleanings are one of the least profitable things an office does - it's a service for your health. (I know that may be hard to believe when you get the bill. ) Regular cleanings also mean that a true need for any additional services is found when the problem is small so it can be fixed before it gets to be a big, expensive problem.

Shirley