Dental treatment and antibiotics

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Dental treatment and antibiotics

Postby lizzyie » Sat Oct 02, 2010 1:32 pm

Hi, this is a question for transplant patients - do you take antibiotics before dental treatment? I always used to take a sachet of Amoxsilin before any treatment and was told if I needed a root filling I couldn't have one but would have to have the tooth removed (3 gone already!!) due to infection.

My dentist has told me I need a root filling and to check with the hospital, which I did. I was told I could have a root filling and no need for antibiotics!

Just wondered if it's the same in other clinics? I don't want to take any risks with infection as things are stable at the moment with my kidney.

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Postby JMan » Sat Oct 02, 2010 4:00 pm

My dentist checks with my and my consultant, tho I'm not on immune drugs any more. I think I had some for having a tooth out, but for hygienist and fillings/cap I didn't
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Postby amanda in CA » Sat Oct 02, 2010 4:40 pm

even though I don't have a working transplant, my dentist always recommends that I take an antibiotic before any dental treatment. Looking after teeth in general is important because of gum overgrowth with some immuno-suppressants and also because gum disease can lead to heart issues as well (I think that it's to do with bacteria getting to the heart from the gums causing problems with the valves etc.)
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Postby Aileen » Sat Oct 02, 2010 4:45 pm

Hi folks, I'm super vigilant with regard to dental health and fortunately have not needed treatment since some time before transplant ... I do however, attend my dentist 4 monthly so that he can keep an eye on my gums, given the effect of the immunos. No problems so far. I have checked though and it's no to antibiotics if I need a filling or other intervention, my renal consultant says 'surplus to requirement'
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Postby missyh » Sat Oct 02, 2010 9:00 pm

Hello,
I had a wisdom tooth out in January and I was told by my consultant that anitbiotic cover was not necessary, but as I was on pred, do double my dose on the day of the extraction.
I had no problems and the gum has healed well.
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Re: Dental treatment and antibiotics

Postby M3Riddler » Sun Oct 03, 2010 12:51 pm

lizzyie wrote:Hi, this is a question for transplant patients - do you take antibiotics before dental treatment? I always used to take a sachet of Amoxsilin before any treatment and was told if I needed a root filling I couldn't have one but would have to have the tooth removed (3 gone already!!) due to infection.

My dentist has told me I need a root filling and to check with the hospital, which I did. I was told I could have a root filling and no need for antibiotics!

Just wondered if it's the same in other clinics? I don't want to take any risks with infection as things are stable at the moment with my kidney.

Lizzie


i always take the pre meds an hour before going to my dental appointments... Have been doing this for over 20 years.
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Postby Pam » Mon Oct 04, 2010 11:24 pm

I have always taken antibiotics before dental treatments--even when they just clean my teeth. I'm not sure if this is only because of my transplant meds (which I don't take anymore) or not. I also have heart issues, so that may be a factor as well.
Haven't been to visit the dentist since I stopped the anti-rejection meds last month, so I guess I'll see when I go in for my annual check-up.
There are many bacteria released during dental procedures...even cleaning the teeth results in a flood of them into your bloodstream--but your doctor should know when it is necessary to take antibiotics and when it's ok not to. Depends on the protocol, I guess.
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Postby chronic » Wed Oct 06, 2010 5:58 pm

Hi, i have "gum overgrowth??" nearly the length of one of my teeth. I don't have a dentist, just wondered if it was normal?
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Postby amanda in CA » Wed Oct 06, 2010 7:15 pm

chronic, you should definately get your teeth checked. immuno-suppressant meds. can cause gum overgrowth as mine did when I was on them. The problem with gum overgrowth is that it makes the pocket between the gum and tooth much bigger (I never had my gum pockets checked in the UK but they measure them in the US) resulting in the deposition of plaque and bacteria in these areas.This increases the rsk of gum-related diseases including those which can migrate to the heart and cause problems with the valves.
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Postby Aileen » Thu Oct 07, 2010 5:50 am

Happy to report that a good dentist in the UK will be aware of the need to measure gum pockets post transplant and will do so on a regular basis for comparison purposes. If you are post transplant and on immunos, and your dentist is not doing this at check ups, you could always make her/him aware of the potential problem. I don't attend a private practice, my dentist is steadfastly NHS, no fancy prices, and I just pay the standard check up fee along with everyone else. I realise that the standard of care may vary.
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Re: Dental treatment and antibiotics

Postby Doolally » Wed Feb 02, 2011 12:10 am

Antibiotics used to be given to renal patients, heart patients, immune-suppressed etc. prior to dental work because of the belief that infections in the teeth/gums could damage the heart. But then about three or four years ago they disproved this theory, or rather decided previous evidence wasn't substantial enough to prove anything one way or another, so its no longer standard to give antibiotics prior to tooth work. My cardiologist told me this so I guess he knows the latest in cardiology research!!

So in terms of the heart issue, its not such a worry. But it doesn't stop us being prone to infection. When I had my wisdom teeth out I got an infection afterwards. I had asked for antibiotics as a preventative but wasn't given any, shame really, it would've been helpful. My GP is often quite obliging when I ask him for antibiotics to keep at home just in case, so the first sign of infection I can start them. He knows I'm not a fan of drugs and wouldn't take them unless I had to. So maybe worth trying to get hold of some, either to take before treatment, or to keep at home ready.

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Re: Dental treatment and antibiotics

Postby kisekishiawase » Fri Feb 04, 2011 1:14 am

Hello, i have heart problem (tachycardia and palpitation) and need to have dental work soon.
And recently after i got root canal my heart problem got worse for 2-3 days, although now i feel better. Some people said its because i didnt take antibiotic before the dental work so im worried if my next dental work it could happen again if i dont take the antibiotic. But some people said antibiotic is needed and some people said the opposite.
So should i need to take antibiotic before the dental work?
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Re: Dental treatment and antibiotics

Postby Doolally » Fri Feb 04, 2011 1:11 pm

Hello, i have heart problem (tachycardia and palpitation) and need to have dental work soon. And recently after i got root canal my heart problem got worse for 2-3 days, although now i feel better. Some people said its because i didnt take antibiotic before the dental work so im worried if my next dental work it could happen again if i dont take the antibiotic. But some people said antibiotic is needed and some people said the opposite. So should i need to take antibiotic before the dental work?


Are you under the care of a cardiologist? They'd be the best person to advise you? I have a leaky heart valve (sorry can't remember the medical name for it!) which causes the same symptoms you have. I used to be told to take antibiotics before dental work. Now my cardiologist says I no longer need to.

Here's an article I found which details the latest standard advice and treatment given. In the past antibiotics used to be given a lot more readily in relation to dental treatment / heart problems. Since 2007 it has been decided this is un-necessary and its only in the more serious heart conditions that antibiotics are needed.

http://www.simplestepsdental.com/SS/ihtSS/r.==/st.31848/t.32260/pr.3.html

Heart Disease and Dental Treatment
Patients with certain heart conditions have a higher risk of endocarditis. This is an infection of the heart. It can be life threatening. It happens when bacteria in the bloodstream attach to damaged heart valves or other damaged heart tissue. People with certain heart conditions may need antibiotics before they have certain types of dental procedures. Make sure to inform your dentist of any heart issues.

In 2007, the American Heart Association updated its guidelines on the use of antibiotics before dental treatments. The new policy advises antibiotics for fewer people than the old policy did.

Pre-treatment with antibiotics is still recommended for people who have had endocarditis in the past. It is also recommended for people with artificial heart valves, and people who had heart transplants and later developed heart valve problems.

Pre-treatment with antibiotics also is recommended for people with certain heart conditions that were present at birth:
* Cyanotic heart disease that has not been repaired or was repaired incompletely. This includes people with shunts and conduits.
* A heart defect that was completely repaired with a prosthetic material or device. In this case, antibiotics are advised only for the first six months after the procedure.
* Any repaired heart defect that still has some defect at or next to the site of a prosthetic patch or device

Antibiotics before dental work no longer are advised for people with:
* Acquired heart valve dysfunction (for example, rheumatic heart disease)
* Mitral valve prolapse
* Bicuspid valve disease
* Calcified aortic stenosis
* Congenital heart conditions, such as ventricular septal defect, atrial septal defect, and hypertrophic cardiomyopathy

The American Heart Association guidelines recommend pre-treatment antibiotics for dental procedures that involve an incision or manipulation of the gums or the tissues around a tooth root.

Antibiotics are not required for the following:
* Routine anesthetic injections through noninfected tissue
* X-rays
* Placement of dentures
* Placement or adjustment of removable orthodontic appliances
* Placement of the bracket part of braces (not bands)
* The natural loss of baby teeth in children
* Bleeding from trauma to the lips or mouth
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Re: Dental treatment and antibiotics

Postby Doolally » Fri Feb 04, 2011 1:19 pm

Here's a link on the same website as above giving advice to renal patients. Doesn't say anything about the need for antibiotics, just gives other advice...

http://www.simplestepsdental.com/SS/ihtSS/r.==/st.31848/t.32645/pr.3.html
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Re: Dental treatment and antibiotics

Postby AmandaClare » Mon Sep 30, 2013 10:09 am

This very old thread has come back up because someone is spamming. However it's actually been quite useful.

I'm having root treatment in a couple of weeks, first time I've needed such major work. I'm a tx patient but on fairly low doses of immunosuppressants. Is the consensus now that anitbiotics aren't needed?

I have a very good and experienced dentist so I imagine she would have mentioned it if I needed anything out of the ordinary.
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