More things to worry about

[blanka]

I received a letter from Dr. Cohn's office (he's doing my AVR on 8/17) asking me to please have my dentist fax him a letter stating that I'm free from any active oral infection. I have an appt. with my dentist on 8/12. I have notoriously bad teeth and have spent a fortune to keep them healthy, but invariably the hygienist finds something wrong, hopefully not this time, but i worry just the same. Does everybody get this letter prior to heart surgery?

Tomorrow I go for my heart cath. Was fine until today......now I'm scared, nervous and restless.

I'm so glad I found the Forum. I've learned a lot from scanning the postings,
and have taken comfort from all the support and good advice, and best of all it has given me the chance to vent my feelings.
Thank you, all.
blanka

 

[Tbone]

Yes I had to get one last week from my dentist, and I'm just going for a surgery consult. They told me if I would have surgery that I would need one so I got it ahead of time.

 

[danb1983]

Did you already have the oppt pre-booked and it was a coincidence it was just before your surgery? If not then call them and ask for a sooner one as an emergency - I called my dentist and got an appointment 2 days later when I told them why I needed it...

But if this isn't possible you should be fine still, I think it's just a precaution rather than anything and you should be okay - just to check that you havent got big holes in your teeth, youd probably know about it if you had toothache etc.

 

[Braveheart]

A clearance from the dentist seems to be S.O.P. for these kinds of procedures. I had to get one too. The concern is "active infection", so I would not be concerned about a few cavities. If possible, try and get an earlier appointment, so that if something needs to be done by the dentist, it can be done in time.

I would suspect that there is some connection between oral infections and heart problems. After I got my AVR, I received a card from my surgeon detailing the types of antibiotics that I would need before having certain dental procedures.

It is my understanding that the A.D.A. no longer requires antibiotics before surgery, but recommends it after the AVR.

The turbulent blood flow across the stenotic aortic valve predisposes the valve to infection. Infection of a heart valve is called endocarditis. Patients with aortic stenosis who are to undergo a dental or medical procedure in which there is the risk for bacteria to enter the blood should inform their dentist or physician of their condition. These patients may require an antibiotic prior to undergoing the procedure. Administering antibiotics to prevent valve infection is called endocarditis prophylaxis.

Endocarditis prophylaxis may be administered prior to the following:

Certain dental procedures (e.g., extractions, cleaning)
Certain invasive imaging procedures (e.g., bladder cystoscopy)
Surgery

http://www.cardiologychannel.com/aorticstenosis/symptoms.shtml

 

[Jkm7]

It is very standard for the surgeons to have your dentist confirm you have no infection in your mouth. Dentists are accustomed to this and are usually very accommodating about having their staff get patients waiting heart surgery an ASAP appointment. They know how important it is they have time to do whatever dental work is mandatory before the cardiothoraxic surgeons will operate.

Also, you may wish to keep in mind that most of us are required to wait at least six months post op to have any dental work done including a cleaning. There is a direct link between bacteria in the mouth and infections to the heart.

Good luck. Hope it all goes smoothly for you.

 

[dl_mooney]

Yes I had to get one too,The wife & I go to get cleanings 3 times a year.So the Dentist did X-rays.Then faxed the report to the Surgeon,That was before I had seem him. Surgeon said 90% of Heart Infections come from the mouth.Also wanted to make sure I wasnt going to have a Root Canal.My Dental Group was pleased that surgeon wanted the ok.

 

[netmiff]

although here in Canada we don't need letters from the dentist, my cardio suggested, and I think the surgeon may have done too, that I get my dental work caught up.

and yes, I was also "....required to wait at least six months post op to have any dental work done including a cleaning. ". The mouth is the germiest place in your body, and infection in your mouth can cause endocarditis, as can getting germs in the bloodstream during a cleaning.

 

[Bryan B]

My surgeon suggested strongly that I get my teeth checked out to rule out any possible infections before I had surgery. He said that he stressed this not only to eliminate the possibility of infection affecting the heart, but even more importantly to eliminate the possibility of infection from your mouth entering your lungs while being intubated.

 

[Braveheart]

My surgeon suggested strongly that I get my teeth checked out to rule out any possible infections before I had surgery. He said that he stressed this not only to eliminate the possibility of infection affecting the heart, but even more importantly to eliminate the possibility of infection from your mouth entering your lungs while being intubated.

Aha! Now things are becoming clearer. During pre-op, I was given a small bottle of Listerine mouthwash. I was told to gargle for at least 30 seconds, three times, the night before my surgery. In the light of what you are saying, it makes perfect sense.