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why dental screening before valve replacement?

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  • why dental screening before valve replacement?

    Hi, I called the cardiac surgeone's office to schedule thje date for my aortic and mitral valve replacement surgery and the secretary told me I would need a dental screening before I can get the date scheduled. I made an appointment with a dentist for Thursday, but I can't help but wonder why a dentist needs to give the go ahead for this surgery. Do any of you know? I realize that I need to take antibiotics before dental work, but I didn't realize that there had to be dental approvall before heart surgery. What's up with that? Marcie

  • #2
    This is needed to see if you have any dental work that needs attention prior to your surgery. As happened to me I had to have three teeth pulled that had become infected and I was down to the wire for my valve replacement, otherwise they can't do the surgery until all infection is cleared up. Also you will find that after your heart surgery most dentist will not touch you till after six months post-op, and even then you will need to pre-med. Apparently any work done on your teeth without pre-med can cause you to develop a infection that can travel to your heart and death can result, at least that is what my dentist tells me. Recently went in for a oral cleaning, and forgot to take my pre-med, dentist refused to clean until I had taken the pre-med.

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    • #3
      That just about sums it up.

      I must admit to being quite terrified when they wheeled me off to the dental school, x-rayed my whole mouth and then examined my teeth when I had endocarditis. The nurses told me that sometimes they removed most if not all the teeth of patients who have endocarditis! I don't mind telling you, I was more scared of the prospect of losing any of my teeth than I was in having OHS. Fortunately my teeth were perfectly fine.

      Yes, forever more you will need antibiotics with most dental treatments to avoid endocarditis. Also, if you need extractions then it is better before you go onto anticoagulants, if you are having mechanical valves.
      Lithotripsy for kidney stones 8 December 2004.
      Began to feel unwell 19 December 2004, with hindsight, the beginning of endocarditis.
      Stroke 12 March 2005.
      Endocarditis diagnosed 16 March 2005.
      MVR/AVR - ATS 30 June 2005.
      Discharged 10 July 2005, taken ill on journey from hospital.
      Admitted to hospital 14 July 2005, complete heart block.
      Discharged from hospital 22 July 2005.
      Returned to work 9am on 7 November, dismissed 9am 7 November 2005.

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      • #4
        Infection, infection, infection. The surgeon wants to make sure you do not have any infections...especially in your mouth. While you have the endotracheal tube (i.e. vent tube) in, if you have any nasty bacteria in your mouth the this tube leading directly into your lungs makes for an easy pathway for the bacteria to get into your lungs and cause major complications. I had some major work done before my surgery...a root canal and a crown/bridge done plus a couple of old fillings repaired. I was still having some pain where they did the crown/bridge so I was sent to a oral surgeon who did a "emergency" root canal on one of the crowned teeth the day before I left for NC to have my surgery (was living in TN at the time).
        VSD Repair & Ross Procedure 3/17/04 - Dr. James Jaggers
        Bentall Procedure 2/22/11 - Dr. G Chad Hughes
        Both performed at Duke University Medical Center

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        • #5
          I pre-medicate before dental cleanings. I now have to have a cracked filling replaced. Do I need to pre-medicate before that appointment?

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          • #6
            I have had a couple of fillings without antibiotics. My dentist said that was fine as there was no blood involved, but best check with your own dentist I would think.
            Lithotripsy for kidney stones 8 December 2004.
            Began to feel unwell 19 December 2004, with hindsight, the beginning of endocarditis.
            Stroke 12 March 2005.
            Endocarditis diagnosed 16 March 2005.
            MVR/AVR - ATS 30 June 2005.
            Discharged 10 July 2005, taken ill on journey from hospital.
            Admitted to hospital 14 July 2005, complete heart block.
            Discharged from hospital 22 July 2005.
            Returned to work 9am on 7 November, dismissed 9am 7 November 2005.

            Comment


            • #7
              Thank you, Sue.

              I'll check with both my Cardio and Dentist. It would seem silly to take a needless risk.

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              • #8
                I had to have my two remaining wisdom teeth pulled before my first OHS back in 1974. One was impacted and the other was starting to bother me, and the heart surgeon wanted them both out. The only problem was after they were removed, I got a dry socket and was on antibiotics and had packing in place where the dry socket was. A hospital oral surgeon was examining me up until the day of the surgery. Everything went on as scheduled though. LINDA
                mitral valve repair 1974
                mitral valve replacement with St. Jude Mechanical 1981
                defibrillator
                pacemaker dependent

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                • #9
                  i'm just sorting out an appointment to have all four wisdom teeth out and probably one other filling done before my surgery.

                  If you end up on warafin its just a big nightmare to arrange dental work, some want you to stop the warafin (run if they say this) others just want your inr within certain limits before it can be done.

                  & if you are on this site you should be taking anti-biotics before any dental work being done, if the dentist says it doesn't matter, find another dentist..
                  Bicuspid Aortic Valve From Birth :( .
                  1990 Valve Stretched Freeman Hospital UK NHS Unkown Surgeon due to risk of sudden death during sport :eek: .
                  2006 Bentalls (St Jude) With DHCA Nov 20 Mount Hospital Dr David Andrews due to Ascending Aortic Anurysm.

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                  • #10
                    Interesting you mention this, Marcie. Dental screening wasn't even brought up before my surgery, although I went ahead and got my teeth cleaned the week of, but maybe I wouldn't be dealing with all my dental issues now if I had done the screening before surgery.

                    Debi (debster913)

                    P.S. Hope everything is awesome with your teeth! :D
                    Debi (debster913)

                    [FONT="Verdana"][SIZE="2"][COLOR="Indigo"]Congenital heart attack, 1975
                    Minimally invasive mitral valve repair June 16, 2006
                    USC University Hospital/Dr. Vaughn Starnes
                    American Heart Association Go Red for Women/ Heart Walk volunteer

                    My flesh and my heart may fail, but God is the strength of my heart and my portion forever.--Psalm 73:26[/COLOR][/SIZE][/FONT]

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                    • #11
                      Thanks for clearig that up

                      Thank you to everyone for answering my question. I imagine all well go well at my dental appointment. Marcie

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