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My Wife is a dental hygienist and I just had AVR 4 weeks ago. Her advice is not to go to the dentist right now unless it is an emergency. Her office has installed a new HEPA air filtration system and an extra-oral suction (sits outside the patient's mouth to catch aerosols) and they are using N95 masks and shields. Good precautions for the staff. The problem is there is no way to really screen for asymptomatic patients who you might be exposed to in the office.
She advised you correctly , please send the following link to your wife <<is relative to the quality of the masks>>
HSE issue safety warning against face mask – Dentistry Online
 
Yeah, my dentist considers me a high risk due to my valve and warfarin and will not see me unless it is an emergency, which is fine with me.
 
For sure, also good to remember for bacterial endocarditis prevention to use chlohexidine mouth wash starting several days before and for several days after each dental appt. You can get a script from your dentist.
 
I've been in for cleaning every 4 months for over 2 years now since my avr but not since the shutdown. It's time to make an appointment but I've got to say, I'm a little hesitant.
It might be irrational but I'm not sure how comfortable I am with having a hygenist a a foot or two away from my face which will be open to exposure.
 
Every four months?? I don't think many of us get such services anywhere near that often, and I doubt that we've developed cases of endocarditis because we've waited longer for a thorough cleaning. (It might even be argued that exposure of your gums to bacteria as part of the enhanced cleaning may actually pose more risk of getting the bacteria into your system than just leaving things alone).

You (and your dentist) may want to re-think the frequency of your dental hygiene visits.
 
(It might even be argued that exposure of your gums to bacteria as part of the enhanced cleaning may actually pose more risk of getting the bacteria into your system than just leaving things alone).

You (and your dentist) may want to re-think the frequency of your dental hygiene visits.

I’m ~4 years removed from AVR. My dentist asked me to come 4x yearly for cleanings.

His hypothesis, which isn’t backed by any data beyond our anecdotal experience in my case, is that coming more often reduces the overall amount of plaque & bacteria that could be shed during the cleaning. Further, that the overall shape of my gums is healthier at each cleaning. This leads to less blood on the gums overall, which seems to be the vessel (pun intended) for the bacteria to enter your body.

Counterintuitive perhaps, and YMMV obviously, but that’s one dentists take on why more visits vs less is more favorable.
 
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HKAPLAN - although I don't really deal in these things, it may be useful to do a risk/benefits analysis of this.

How big, really, is the risk of endocarditis as a result of poor oral hygiene? I have seen extremely few posts on this site from people who actually HAD endocarditis. I suspect that the prevalence (and this, risk) is extremely low. Im sure that there are many who haven't had good tooth cleanings, or, for that matter, aren't very good about regular brushing.

Although I doubt that your dentist has any interest other than reducing your risk of getting endocarditis, I have extreme doubts that extra cleanings are of any benefit (plus, as I noted in a previous post, may actually expose your gums, during cleaning, to bacteria that's already in your mouth).

To me, such aggressive oral procedures just don't make much sense -- the risk of BE (bacterial endocarditis) is already low, and overdoing prevention probably isn't going to reduce that risk.
 
How big, really, is the risk of endocarditis as a result of poor oral hygiene? I have seen extremely few posts on this site from people who actually HAD endocarditis. I suspect that the prevalence (and this, risk) is extremely low.

Could easily be that risk is low. In my case, it’s *the* reason for my AVR. Not due to poor hygiene, but as you noted, due to the non-zero risk in going for regular cleanings 1-2x a year. It was a different dentist, and no way to know whether the amount of bacteria had any effect, or if I just got “lucky”.
 
I had endocarditis 6 years ago. It hasn’t changed my 2x a year dental routine. I take 2,000mg amoxicillin. I am, however, nervous about going to the dentist at this time. I rescheduled once already and have an appointment in mid July. They seem a bit pushy for business, which I understand, but I will ask if they are still following guidelines. They should be like a doctors office after all.
 
Yeah, my dentist considers me a high risk due to my valve and warfarin and will not see me unless it is an emergency, which is fine with me.

"Ignore your teeth and they will go away." Old ADA advertisement in buses.

I believe you are much more likely to die of endocarditis from an infected tooth or infected gums due to poor dental care than you are to die of Covid infection from your dental hygenist or dentist. Do a search on Covid traced to dentists and hygienists; I didn't find anything worth repeating. The people in my dental office have three layers of protection, mask, N95 mask, face shield. I went in a few weeks ago and will go tomorrow for a cavity. I was routinely tested for Covid as part of an experiment and did not get it when I went for a cleaning.

Dentists and hygenists have been doing their job for years w/o difficulties in the presence of more virulent diseases than Covid. Remember the scare of catching Aids from the dentist that was proven untrue?
 
OK. Lets assume that it's perfectly safe to go to the dentist for a cleaning, or for a deep cleaning.

This doesn't answer the question: how much cleaning is enough?

Is the risk of bacterial endocarditis so high that annual, or twice annual or, gulp, four times a year cleanings are necessary to reduce the risk? Will too frequent cleanings actually strip away enamel or expose the gums to bacteria that standard brushing won't do? Can aggressive cleanings actually INFECT you with bacteria that otherwise just live, relatively benignly, in your mouth, not there to do damage unless introduced through a broken gum?

I'm really unconvinced that these cleanings reduce the risk of B.E., and I'm not sure of the frequency where they actually do good at preventing the transfer of bacteria into the gums.
 
Every four months?? I don't think many of us get such services anywhere near that often, and I doubt that we've developed cases of endocarditis because we've waited longer for a thorough cleaning. (It might even be argued that exposure of your gums to bacteria as part of the enhanced cleaning may actually pose more risk of getting the bacteria into your system than just leaving things alone).

You (and your dentist) may want to re-think the frequency of your dental hygiene visits.
I need to go every four months to save my receding gum from receding more, but not of the fear of other heart issues!
But it’s been 8 months now!
 
I made an appointment three weeks ago, I cancelled it the morning of that day! Receptionist was understanding and said that though they take all necessary precautious measures, it’s better to wait until I feel more comfortable due to my heart and age!
 
I guess it also depends if your dentist is a Republican or a Democrat. Maybe some sarcasm. Not sure myself.
 
My damned hospital has a portal where I can see 'conditions' listed. Some fool decided that I had endocarditis (presumably because I have a prosthetic valve). This idiot din't bother to ask why I got the valve and assumed that it was damaged by Endocarditis.

They also decided I had valvular heart disease (same reasoning, I guess). Someone decided to enter Acute Renal Failure.

I'll see if I can get them to correct their records - who knows what health plan in the future will look at my history and decide that they won't cover me because of these false conditions?

Quick follow up -- I called Medical Records at the hospital. They're sending me a form that I can fill out to challenge the records. They told me that it will take 4-6 weeks to make the changes (they have to check the charts, and probably check with the labs or the people who entered this stuff into the records).
 
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