Dental questions (heart related)

[Ovie]

Just read the other thread about endocartias(I know that's wrong) and didn't want to hijack that thread so figured I'd ask here.

I go in on Wednesday for my dental appointment, oddly enough my Surgeons secretary called today asking if I had gone to the dentist yet, I knew that taking good care of my teeth and gums after surgery was essential, however didn't know it was that serious. I found out today that my dentist actually has to sign off on the OK for me to have my surgery?

So when I go to the dentist, are there any questions I should throw his way? I'll obviously tell him about my procedure next month but do I treat this as a regular cleaning or have him look for specifics?

Any help on the topic would be greatful, thanks.

 

[epstns]

A couple of things come to mind. First is the question of pre-medication. Many cardios and dentists recommend the patient take a preventive antibiotic dose prior to any invasive dental procedure, including cleanings. I say "many docs" because IIRC the guidelines have recently been changed to make the prophylactic antibiotic treatment optional. I would suggest you discuss this with your cardio and then with your dentist - before your dental visit, in case they do want you to take the meds. (I take 600 mg of clindamycin before each dental procedure.)

Second, discuss your future dental care plan and schedule with your dentist. My surgeon didn't want me to have any invasive dental procedures for 6 months after surgery, as a precaution. After that, I have regular cleanings - now 3 or 4 times a year instead of once or twice.

All of this is because there are many bacteria in our mouths, and the gums and oral tissues are easy places for them to enter our bloodstreams. We need to avoid this if at all possible, as we are more susceptible to infection than the general population.

All of this stuff is precautionary. They want your dentist to sign off prior to surgery to ensure that any active infections you may have in your mouth have been treated before surgery. After surgery, you pretty much go back to your usual dental care routine, with the possible addition of antibiotics before procedures.

 

[Jkm7]

Most surgeons require dental check to assure you have no infections in your mouth prior to surgery. I had to bring a letter from my dentist with me to my meeting with my surgeon pre-op. You also should have any dental work seen to before your surgery as most surgeons do no want you having any dental work, including cleaning, under six month post op.

My surgeon, PCP, cardiologist and dentist all agree I should take antibiotic premedication one hour prior to any dental visit especially including cleanings. They worry about the direct path of dental/mouth bacteria to the heart.

 

[AgilityDog]

Ditto.
Premeds before dentals after valve repair/replacement.
No dental work for 6 months after OHS.

If you are scheduled for surgery, your cardio may prefer you take the premeds when you do your presurgical dental work, even though the protocols no longer require it for people in lower risk groups (existing murmurs without OHS). I think once you are scheduled for surgery, your risk group goes up!

 

[Mentu]

My dentist and family doctor are quite adamant about using prophylactic antibiotics before any dental work including cleaning. If you call your dentist and tell them that you have a heart issue they will most likely order antibiotics for you in order to dramatically reduce your chances for developing endocarditis. It is better to ere on the side of caution.

Larry

 

[marc_kowal]

I had to get a dental clearance letter prior to my cath. Also told no dental work for 6 months and will need to continue to pre-med before dental appointments.

 

[debster913]

I had to get a dental cleaning 4 months after surgery because I developed gingivitis. I was all freaked out about it, too because it was so soon after surgery. I had always been really good about brushing, just not flossing. My cardio put me on a megadose of antibiotics and I was fine. Now, I am very good about brushing/flossing/rinsing every day. My husband will scold me if I try to go to bed without brushing my teeth every now and then when I'm very tired. He reminds me, "You don't want to get a gum infection and then end up with endocarditis, do you?" and that sends me right back to the bathroom to brush.

The rule is, no dental procedures 6 months after surgery, as people here have stated. I did get my teeth cleaned the week of my surgery, but unfortunately had that gingivitis problem 4 months after. If by chance you do need a dental procedure within that 6 month time frame, I'm sure your cardio, to be on the safe side, will fill you up with antibiotics beforehand.

 

[Boston Tiger]

Your dentist may very well want to talk to you when he has to sign those forms. Mine made a note in my permanent charts in big bold letters that I would always need the prophylactic treatment before I came in for any treatment. Now it is just something we chat about whenever they don't have my mouth filled with their instruments.

 

[Ovie]

So I just checked the site. I have my dental appointment today, I'm going to try and call my cardio early, but if I don't hear from him before my apt think I'll be alright? I have yet to have my surgery.

 

[bradvo]

My surgeon never required me to get signed off by my dentist, we discussed the importance of teeth care, or rather he did and wanted to know if I had any dental work that needed to be done. Fortunately I had all my big stuff done last year.
Seems he took my word for it.

 

[Mom2izzy]

My surgeon didn't ask for the clearance, but he did tell me I should have it done. My dentist was floored that the actual clearance wasn't required,so he was already familiar with the "protocol" for clearing a heart patient for surgery. In my case they took a mouthful of xrays and will do a super thorough cleaning right before surgery, since (as everyone stated above) they don't want any dental work for 6 months post surgery. I'm glad I was already having regular cleanings, so this wasn't too bad. There was a point when I hadn't been to a dentist in 7 years. If I had to have 7years worth of dental work done in a couple months I would really have some anxiety. I actually think the thought of another crown scares me more than OHS...I just freak out when I hear the drill!!! And yes, my dentist lets me listen to loud music on my headphones, but nothing can completely drown out that sound when it's coming from inside your head.

 

[epstns]

Ovie - Talk with your dentist. It may be possible to get one visit's worth of antibiotics from the dentist. I know my dentist has some on hand in case patients forget to pre-medicate.

 

[Jkm7]

So I just checked the site. I have my dental appointment today, I'm going to try and call my cardio early, but if I don't hear from him before my apt think I'll be alright? I have yet to have my surgery.

My cardio, dentist and PCP ordered I pre-medicate with antibiotic prior to my dental appointments from the time I was diagnosesd with regurgitation and they were watching and waiting for when I would need surgery. I never had a cleaning or anything at the dentist without pre-meds.

As Steve says, the dentist can prescribe and provide the antibiotic but you must take it one hour prior to your appointment.