Here are the things which I do to reduce my risk of endocarditis. Some probably reduce the risk more than others.
1. Try to keep the best oral hygiene possible. More details on my routine below.
2. 2,000 mg of amoxicillin before each dental appointment, even if just a cleaning. This is in accordance with the guidelines for those with prosthetic heart valves.
3. Rinse with antiseptic mouthwash prior to every dental appointment.
4. I always keep some amoxicillin on hand at home and when I travel. If I get a deep enough cut, I will take 2,000 mg of amoxicilln. I ran this idea by my cardiologist and he agreed that it was a good idea. So, I always have a couple of 2,000 mg of amoxicillin available, with prescription refills ready. I have used this twice in the past 2 years. One example was when a training partner in jiu jitsu had not cut his fingernails and gave me a pretty decent cut on my head by accident. I popped 2,000 mg of amoxicillin as a precaution. On the other hand, if I were to cut myself shaving I doubt I would take the dose, unless it was bad, like I lopped off my ear or something.
5. Store my shaving razor stored in alcohol. I've noticed that the blades seem to last longer doing this, perhaps due to less oxidation.
6. If I get a little cut or scrape, I clean it well with soap and water, and bandage with neosporin.
More on my oral hygiene routine. Of all the things listed above, probably the one that has the biggest impact of lowering the risk of endocarditis is having good oral hygiene. I use to get my share of cavities and then some, in my 20s, but then I made some big changes after telling my dentist that I never wanted another cavity. Not rocket science, but the key is consistency. Since getting my valve I have been even more of a stickler when it comes to my dental hygiene. The last couple of years when I've had my cleaning, on two occasions the oral hygienist asked me what my routine was, because there was practically zero plaque. Also, every wonder why your dentist or hygenist measures your gums? It is to check for signs of periodontal disease and inflammation. I have a link to that below. They are measuring the gum pocket depth. I now that some of the steps I've added in the past few years have made a difference, because my pocket depth has reversed. It usually increases with age, but I'm now in the 0 to 3mm range for all my teeth and I'm told my the hygienist that this type of reversal is unusual.
Also, regarding gums bleeding. When I was in my 20s and early 30s, I did not floss nearly enough. When I did floss my gums would bleed and when I would go to the dentist and they would floss them, they would bleed. They would tell me that I needed to floss more to stop it from bleeding. Sounds counterinuitive, but not really. Eventually, I got really consitent with flossing and, togehter with my routine below, now my gums never bleed- not at home when I floss and not when the dentist cleans them. So, I have to agree with those above who recommend regular flossing and disagree if someone says to avoid flossing to avoid making your gums bleed, although substituting with a water pik might be fine and there have been some studies on that.
Anyway, here is my routine and habits.
1. I eat all whole foods. No sugar or processed foods. Not zero, but close to zero. This means salads, legumes, unprocessed protein, (like fish or chicken), lots of veggies, seeds and nuts. I know that this is not for everyone and for most, it is about moderation, but I'm a little hardcore in this area. It turns out that the bacteria in your mouth love sugar and processed foods, especially processed carbs.
2. I brush at least 2- 3 times/day. My personal brush of choice is a Phillips Sonicare brush, although I'm not sure that the electric brush makes any difference.
3. Floss every day. I keep floss in convenient places, other than the bathroom. I keep some in the drawer in my living room, so I can floss as I watch TV. I keep it in my car. I haven't yet seen the billboards that caution against flossing and driving, lol. It can actually be done safely at stop lights and such. I keep some at my desk so I can floss during work breaks.
4. In addition to flossing I also use a Water Pik every day. This may be a little overkill, but it's gentle enough on the gums that I see no harm in doing both. I think that there are advantages to both flossing and the water pik, so I use both.
5. I use a between tooth brush several times/day. Like the floss, I keep these in the car and handy everywhere. The brand I prefer is G.U.M, which I buy in bulk at Costco. They have soft rubber, ribbed tips and are very gentle on the gums. Pretty much after every meal I will use these, to try to have as little as possible between my teeth for any amount of time. Because you can use them with one hand, it is easy to use while driving or watching TV ect.
6. I use a listerine mouthwash. I always use this before dental appointments, and a few times during the week, but one goal I have is to be more consistent with this. I think that it is probably a good idea to use it before brushing and flossing, maybe even doing it afterwards as well.
What is Periodic Periodontal Probing? When you visit our office for your routine cleaning, you may notice that your hygienist measures your gum depths using a probing tool. This small part of your dental appointment helps us identify potential gum or periodontal disease. By monitoring your gum meas