Dental Cleaning PreMed + Post Med ?

[ALCapshaw2]

Attention Artificial Valve Recipients -

If you had a 'thorough' Dental Cleaning where there was 'moderate' bleeding from the gums when the hygenist cleaned close to the gumline using both an ultrasonic cleaner with water rinse and suction followed by scraping with the usual dental instrument for a better 'feel' of the surface would you be inclined to request approval to Post-Medicate in addition to the usual 1 hour Pre-Medication?

If so, would you take a second dose that evening or wait until the next day?

 

[Greg a]

with what they do to my bowels, I'll be happy just doing pre

 

[Ross]

with what they do to my bowels, I'll be happy just doing pre

Greg you gotta try Colchicine! Who needs a colonoscopy prep with a drug like that?

 

[Ross]

Al I'm not so sure it makes any difference taking it afterwards. The pre meds take a while to act, so I would think there would be plenty to cover the later exposure, still in your system. I'm only guessing here though.

 

[lance]

Al,
I've been pre-medicated for scaling for as long as I remember.
I'm very content taking 8 x 250 mgs prior to the appointment. This one is a lot easier on my stomach than the before and after I used to take and all is fine so far. Besides taking the second dose could be forgotten.

 

[Maryka]

The only remaining question is really: are you having any feelings associated with heart involvement (that is, edocarditis) or gum infection. If you suspect possible infections, then you should consult a doctor ASAP. On the other hand, with all of that bleeding from the deep cleaning, most of the bugs were probably washed away. Personally, I have pretty good gums and teeth and I always warn teeth-cleaners to be gentle with me because I am on anti-coagulants. (Sone new hygienists seem to feel they must be brutal, I have found.) Also, because we all are prone to heart involvements from bad teeth or gums, we should do our best for good oral hygiene every day.

 

[olefin]

I always premed one hour before ALL dental procedures.

After the endodontics put in 3 stitches from a root procedure I also took a full round of antibiotics for 10 days.

 

[dick0236]

It used to be 2000mg one hour before any invasive dental work and 1000mg a few hours after the appointment. Since the change to pre-med only, I have not taken a post-med. I'm good about getting a cleaning twice per year....sometimes with bleeding, sometimes no bleeding.

 

[Jkm7]

I always pre-medicate with 2000 mg amoxicillin but never medicate after teeth cleaning.

 

[Bill B]

My surgeon is very worried about endocarditis and recommended amoxicillin 1hr before and a smaller dose 6 hrs after, acknowledging there was no concrete support for the after dose. I have no problem with that.

 

[Mentu]

Al, I asked this question of my Cardio who said that, if taken an hour before going to the Dentist, the pre-med antibiotic should be entering the blood stream by the time any bacteria from dental proceedures is introduced. The big dose of antibiotic should wipe out almost everything for perhaps 10-12 hours so he doesn't think post-medication is necessary. The critical period appears to last only a short time after the Dentist finishes unless something more invasive was done such as a tooth extraction or other oral surgery. In that case, my Cardio says antibiotics need to be continued for at least a week afterwords.

Larry

 

[mecretired]

I'm allergic to penicillan. Do any of you know what antibiotic is recommended in that case?

 

[Mentu]

I'm also allergic to Penicillin. The drug of choice seems to be Clindamycin.

Larry

 

[sweetbanker]

I've always taken Clindamycin before any dental procedures . Clindamycin can leave a icky taste in your mouth for a few hours, but goes away. No biggie if you only need to go Dentist couple of times.

 

[ALCapshaw2]

re: Alternatives to Amoxicillin for pre-medicating before Dental or GI Procedures

Several years ago a Cardiologist gave me a wallet sized foldout brochure produced by the American Heart Association in conjunction with the American Dental Association.

Item III - Amoxicillin / Ampicillin Allergic Patients

1. Clindamycin - Adults 600 mg (children 20 mg/kg) given orally 1 hour before procedure OR,

2. Cephelexin or Cefadroxil - Adults 2 g (2000 mg) (children 50 mg/kg) orally 1 hour before procedure OR,

3. Azrithromycin or Clarithromycin - Adults 500 mg (children 15 mg/kg) orally 1 hour before procedure.

Note: Follow-up dose no longer recommended for 'most' patients.

FWIW, my Cardio, and a Dentist friend, were not opposed to taking a full follow-up dose after a 'deep cleaning'.
I'm thinking no one knows for sure about the effectiveness of follow-up doses but conservative Doctors tend to take a "better to be safe than sorry" position.

'AL C'

 

[ALCapshaw2]

Larry -

Thank you for taking the initiative to ask your Cardiologist about this issue
and Thank Him for his informative response.

My Cardio's nurse called me back this afternoon informing me that it was OK to take the rest of my Z-pack over the next few days. I took that as an agreement that he had no objection but did /would not typically make such a directive.

 

[Luana]

My surgeon is very worried about endocarditis and recommended amoxicillin 1hr before and a smaller dose 6 hrs after, acknowledging there was no concrete support for the after dose. I have no problem with that.

That sure beats 6 weeks of IV vancomycin. Better safe than sorry when it comes to BE.