Root Canal, Antibiotics, etc.

[John & Joann]

Calling all Root Canal Patients!!!!!

Joann has always had antibiotics via the drip for all dental procedures. She was told today that she must have a root canal or an extraction. Coumadin is NOT an issue.

The question regards the root canal. How many times did you require the antibiotic treatment for the process. List the appointment procedures and the related antibiotic prophaletic. We realize that most of you received you antibiotic via pill or injection. Help Please!

Thanks for your assistance.

Joann =still double clicking since 1971

 

[geebee]

Hi guys,

All the root canals I have had were 1 visit procedures. For 2 of them, I had an infection show up which indicated the need for the root canal. For those 2 procedures, I was on a 10 day regimen of antibiotics (500mg 4X day) and had the root canal once the swelling went down (around the 6th or 7th day). For the other root canals, I just did the regular pre-med (2 grms.) and then took 1 grm at 4 and 8 hours past the procedure.

There were a couple of root canals that required crowns after and I just did the normal pre-meds for any of the "fitting" visits.

I have never had any problems with this routine.

 

[tobagotwo]

You only need the antibiotic for the actual removal of the roots, which go below the gumline. Once the root hole - or holes (some have two) have been plugged, and a temporary has been installed, the antibiotic phase should be over. Switching from the temporary to the permanent doesn't actually require antibiotics, according to the guidelines, which refer to root canals needing antibiotics for heart conditions only beyond the apex.

From earlier posts:

The guidelines of the American College of Cardiology, the American Heart Association, and the American Dental Association:
http://www.americanheart.org/presenter.jhtml?identifier=1745

They also have a handy, downloadable wallet card: http://www.americanheart.org/presenter.jhtml?identifier=3003000

Quote from dental guidelines:

Table 2. Dental Procedures and Endocarditis Prophylaxis

Endocarditis prophylaxis recommended*

Dental extractions
Periodontal procedures including surgery, scaling and root planing, probing, and recall maintenance
Dental implant placement and reimplantation of avulsed teeth
Endodontic (root canal) instrumentation or surgery only beyond the apex
Subgingival placement of antibiotic fibers or strips
Initial placement of orthodontic bands but not brackets
Intraligamentary local anesthetic injections
Prophylactic cleaning of teeth or implants where bleeding is anticipated

Endocarditis prophylaxis not recommended

Restorative dentistry? (operative and prosthodontic) with or without retraction cord?
Local anesthetic injections (nonintraligamentary)
Intracanal endodontic treatment; post placement and buildup
Placement of rubber dams
Postoperative suture removal
Placement of removable prosthodontic or orthodontic appliances
Taking of oral impressions
Fluoride treatments
Taking of oral radiographs
Orthodontic appliance adjustment
Shedding of primary teeth


*Prophylaxis is recommended for patients with high- and moderate-risk cardiac conditions.

? This includes restoration of decayed teeth (filling cavities) and replacement of missing teeth.

? Clinical judgment may indicate antibiotic use in selected circumstances that may create significant bleeding.

Ain't modern dentistry fun?

Best wishes,

 

[geebee]

The reason I had antibiotics for the permanent crown placements was because I always required "packing" around the gum line which caused a lot of bleeding. So it really depends on a particular person's teeth.

 

[tobagotwo]

Not trying to dispute you at all, GeeBee. I just posted the ADA Guidelines as a baseline.

John and Joann are smart enough to realize that experience like yours can weigh in decisions like this, and can have great value when developing a perspective of how they feel most comfortable proceeding. I just threw in the official "starting point."

Best wishes,

 

[geebee]

I did not take your post as a dispute. Just wanted J&J to know there are always exceptions to the guidelines.

I actually appreciated the guidelines being posted. It helps to see things as they are altered since new things are always being discovered.

Thanks.

 

[Superbob]

Apprciate this info from Bob H and Gina, too. For whatever it's worth, my docs prescribe the taking of four antibiotic pills one hour before any dental procedure. For some procedures, I wonder if that's too little, and for some if it's too many, but that's what I go with. Had some long-delayed crown prep just last week.

Bob

 

[geebee]

....For whatever it's worth, my docs prescribe the taking of four antibiotic pills one hour before any dental procedure. For some procedures, I wonder if that's too little, and for some if it's too many, but that's what I go with. Had some long-delayed crown prep just last week.

Bob

4 pills is the usual (4X 500mg = 2 grms) dose when antibiotics are required. Years ago we used to take pills before and after but, for most procedures, this is no longer indicated.

 

[Granbonny]

J and J

J and J

Just wondering why Joann..is not going for the Extraction? She and I are the same age..a few months back..had a very loose tooth..bottom..3rd from back..Dentist never mention root canal..Just took the sucker out.. ..I had pre med with antibodies..the same 4 ..1 hour before..I can still smile and the gap cannot be seen.. B/T/W..stayed on my coumadin..No big deal for my dentist..Never bled..Not even a tad.. Bonnie

 

[LUVMyBirman]

I will jump on Bonnies soapbox. Had a heck of a time with a failed root canal. We went around and around with that tooth and I ended having it extracted. Root canal works for some folks. I seem to be an excpetion to that rule.

In answer to your question John......I would pre-med for any type of dental work. The only time I have had IV antibiotic is for an extraction.

Give JoAnn my best.

 

[MarkU]

I take 600mg of Clindamycin before every visit to the dentist (I'm allergic to penicillin).
Mark

 

[tobagotwo]

Clindamycin is a good choice. I had been taking amoxicillin, but after some short-term, repeated visits for dental work, found that it was taking a big toll on my intestinal tract and its vital flora.

Switched to clindamycin, which is another of the approved premeds, and that problem hasn't surfaced again for me. By the way, I was informed by my GP that taking it intravenously doesn't make amoxicillin any easier on your stomach, although logic would have predicted otherwise.

I find myself on the other side of the fence from Bonnie and Gina, insofar as root canals have always been successful with me, and I will go as far as I reasonably can to keep teeth in my head.

Best wishes,

 

[John & Joann]

Joann has the highest risk for infections . Cleveland Clinic (right or wrong) wants more protection than the typical oral recommendations. We formerly used a drip bag prior to the procedure. This is NOT covered by Medicare, but was covered by our previous insurer. Over $500 expense out of our pocket. Plan B has been to administer the medication with injections in the hip. This causes a swelling the size of a softball on each hip. (2 shots) In addition, she then must take the oral medication for several days.

We are taking the xray to the endo dentist today. We know him and highly respect his skills and opinion. If he feels that the procedure can be done without multiple antibiotic treatments (confirmed by your comments) than she will have the root canal. If he has ANY doubts, then she will go the route of extraction.

With either procedure, the coumadin will not be adjusted AT ALL!

Will keep you all informed of the process.

Joann and I are determined that 33 years of clicking will not go down the drain because of infections, etc. Things have gone fairly well this winter and spring, but we need to get this behind us quickly. The leg circulation is going down hill and that will be the next issue.

Joann's new T-Shirt will say, " John did not hit me"!!! Her jaw is all black from the infection and related bleeding due to coumadin.

Have a Great Day!

 

[geebee]

Joann and I are determined that 33 years of clicking will not go down the drain because of infections, etc. Things have gone fairly well this winter and spring, but we need to get this behind us quickly.
Joann's new T-Shirt will say, " John did not hit me"!!! Her jaw is all black from the infection and related bleeding due to coumadin.

Have a Great Day!

Know what you mean. I got an infection from an ingrown toenail and things got really ugly for awhile. I remember thinking my epitaph would be "she made it through 3 OHS & her toenail did her in". I am very careful now with ANYTHING that can cause infection.

As far as the "John did not hit me", my S/O has always said he sometimes feels that people are staring at my arm bruises, leg bruises, etc. from all my misc. bumps. He is surprised no one has called family services on him.

Take care and good luck with the tooth. I certainly can empathize since I have a mouth full of root canals (like Bob I insist on keeping my teeth as long as possible- when safe).