Tooth extraction

[Guest]

Hi all. I am new to the forum. I had a bovine aortic

valve replacement in in June after collapsing during exercise. At the time I already had 2 loose teeth which were due to be extracted. The hospital weren't sure if was best to take them out before or after the operation. In the end they decided to go ahead and leave them in place. Since then I have been eating carefully, waiting for the right time to have them removed. That time has come but there seems to be some confusion over the use of pre extraction anti biotics.
I spoke to the dentist who is quite young and a bit of a drip believe it not. My GP has said he will give me the 3gm of antibiotics himself. From what I have read the reasoning behind no longer giving them seems to be that they don't think antibiotics actually do anything to stop endocarditis, which has me a little worried as I have gum disease. I am thinking of asking the GP if I might have them removed in hospital.
I would be grateful for your thoughts and experiences as I could do with some peace of mind on this. Thanks.

 

[tom in MO]

I have my cardiologist make these types of decisions. He is quite adamant that pre-dosing with antibiotics is important for mechanical valves. I am not sure about bovine and have never asked him, since mine is mechanical.

In the past, I was told to premedicate before tooth work due to my bicuspid valve by my GP and then when I started going to a cardio, he said the medical community changed their minds and did not do that any more for bicuspid valves. I didn't premedicate again until I got my mechanical valve. Talk to your cardiologist's nurse. This shouldn't require an office visit. They can call in your prescription.

If you have to medicate, the dosage is usually 2g of amoxicillin taken 30min before tooth work. It can disrupt your intestinal flora and fauna, but taking it when you don't have to shouldn't be harmful.

My dentist always asks if I have taken my meds and has amoxicillin on hand if I ever forget. He knows the dosage too.

 

[DanielB]

My cardio oversees my antibiotic details for dental visits, but since my mechanical valve was put in, I have been instructed to have the antibiotic he prescribes in me just before any dental work, including basic cleaning. Not sure if all this applies to tissue valves, but I think it's worth asking your doctor.

 

[Warrick]

There are many heart conditions that pre dental antibiotics are no longer recomended for from days of old.

However a prosthetic heart valve is NOT one of them and from memory is at the top of the American Cardiologist Society's list FOR taking antibiotics for dental work.

My dentist knows I have a prosthetic so he writes the prescription a week or so before the appointment (if he doesn't I chase him for one)so I can get from the pharmacy.

 

[epstns]

My dentist, my cardio and I are in agreement -- I always pre-medicate for any invasive dental procedure. If we are just taking impressions or X-rays, no need. If we are drilling or cutting, take the meds. My dentist writes me a prescription for enough antibiotics for 3 or 4 dental visits, and when I get low, I ask for a re-write.

I don't stay current on all the tech data, but IIRC, for some heart conditions, the pre-medications became optional, at the discretion of the doctors and patients involved. My cardio would rather be safe than sorry, and I cannot disagree.

P.S. At my cardio's advice, I schedule dental cleanings 4 times per year. That way, nothing ever sneaks up on us.

 

[dick0236]

My dentist, my cardio and I are in agreement -- I always pre-medicate for any invasive dental procedure. If we are just taking impressions or X-rays, no need. If we are drilling or cutting, take the meds. My dentist writes me a prescription for enough antibiotics for 3 or 4 dental visits, and when I get low, I ask for a re-write.
.

This is the same routine I have followed for the last 3 decades. I probably would not stop that routine even if it was suggested by my docs.


An ounce of prevention is worth a pound of cure!

 

[MarkU]

My dentist, my cardio and I are in agreement -- I always pre-medicate for any invasive dental procedure. If we are just taking impressions or X-rays, no need. If we are drilling or cutting, take the meds. My dentist writes me a prescription for enough antibiotics for 3 or 4 dental visits, and when I get low, I ask for a re-write.

I don't stay current on all the tech data, but IIRC, for some heart conditions, the pre-medications became optional, at the discretion of the doctors and patients involved. My cardio would rather be safe than sorry, and I cannot disagree.

P.S. At my cardio's advice, I schedule dental cleanings 4 times per year. That way, nothing ever sneaks up on us.

My cardiologist has had me pre-medicate since my AVR. My dentist is on board with it and won't touch me, even for routine cleanings, unless I have pre-medicated an hour before.
I'm allergic to penicillin, so I take 600mg of Clindamycin.

 

[Zoltania]

The recommendations have changed over time. I used to premedicate for cleanings even though I only had mitral valve prolapse. That recommendation was removed a few years ago. Even though I have now had a mitral valve repair, with implanted ring and chords, my cardiologist does not recommend premedication for cleanings. Apparently the implanted material becomes fully covered with one's own cells (endothelialization) within about three months after surgery, and it then poses no extra infection risk.

If I needed more extensive dental procedures or other surgical procedures, I would definitely check with my cardiologist and get the most current recommendation.

 

[ForeverThankful]

My Dentist, family doctor, cardiologist and cardiac surgeon all agree that pre-medicating is needed. My surgeon even commented once that he's seen an increase in endocarditis since the recommendations were changed so he's very adamant about pre-medicating.

Definitely better to be safe than sorry!

 

[astle9]

My dentist yesterday had to speak to his more newly qualified dentist partner who has he said are very up to date on these things and the answer was no pre medication was required so that is what we have done. He stated that this argument has been ongoing for years and years and with the new warning about overuse of antibiotics in the UK at least it is more important than ever. My AVR is within the next few weeks so i have been at the dentists a lot to finish work i should have had done a while back.