Seen dentist today, need opinions...???

[Creed3]

Hi Everyone!
Well, I went to see my dentist today. He didn't do anything except an exam. He wanted to take a look at the condition of my teeth and gums before he made a decision regarding my coumadin. Here is what happened. I haven't been to the dentist in about 2 years. He told me my teeth look good but that my gums need to have a little extra work when I have my cleaning done. He said by the looks of it that I will definately do a lot of bleeding. He told me that my cardio told him that I could have the cleaning done w/o coming off the coumadin or I could go off the coumadin for three days prior to the deep cleaning. The dentist said that it is my choice, but that there is a chance the bleeding may not be able to be controlled. He also said that it will be a little harder for him to do the deep cleaning with so much blood. He has other coumadin patients who have their teeth done and never have to stop their coumadin because their gums are in better shape. He told me that once he does a real good deep cleaning, if I floss every single day along with my brushing, I will not have to stop my coumadin for cleanings. So, here is my problem. Do I go ahead and get the deep cleaning done knowing now that I am going to bleed significantly or do I go with coming off my coumadin for three days prior. He told me I am still going to bleed a lot even if I go off the coumadin for a few days. He understands how concerned I am because he also said that if the bleeding didn't stop, I would need to be given blood but it usually can be controlled. He said that if I throw a clot, there is nothing you can do about that. He also said I have to consider the type of valve I have and where it is. The St. Jude in the aortic position is supposed to have very low rates when it comes to throwing off clots because of the tremendous force and flow of blood. If it were in the mitral position, my chances of a clot would be higher. I am going to check with my cardio again and let him know the shape my gums are in and see what he thinks. I'm just wondering what you all think.

Thanks & Take Care!
Gail

 

[Simon Gee]

tricky one!

tricky one!

Hi Gail,

as always, these decisions are very personal and I can only suggest what I might do in your situation. My choice would be to stay on the coumadin, as I prefer the risk of some bleeding to the risk of a clot, even though I also have a St Jude valve in the aortic position. I have never yet found bleeding a problem, although I have not, fortunately, had to undergo the treatment you face.

Good luck with the cleaning,

Simon

 

[Ross]

Gail, stay on the coumadin. I had mine deep cleaned not to long ago and sure my gums bled, but it wasn't crazy and stopped shortly after the appointment was over. I have the worst dentition of anyone here I'll bet. My gums were really inflamed and red before the appointment. Now, they look really good though they still bleed when I brush.

If it were really necessary to have to have some blood, that's not a problem. If you develope a clot and/or infection, that IS a MAJOR problem. You can always have more blood, but a stroke isn't worth the risk in any scenario I look at. Stroke out is not an option.

Just make sure he pre medicates with the antibiotic 1 hour before your appointment. You'll be fine, honestly!

 

[JimL]

Stay on the coumadin.

I too have had the deep cleanings, even since AVR, without excessive bleeding. In fact, I couldn't tell any difference between the cleanings I've had on coumadin and the cleanings I had years ago before coumadin.

 

[Les]

Gail,
Over the last ten years on Coumadin, I have had several deep cleanings and didn't notice any difference in bleeding than before.
However, I have postponed some minor oral surgery because they wanted me off Coumadin for three days before the procedure and I can't get a straight answer...clot/bleed/clot...it's like "just accept the risk, you "valve person". Well, I'm like others here, a little bleeding whether "subjectively" excessive or not is much better than tossing a clot.
__________________
Les AVR '93 / '95

 

[Ross]

I think it would be absolutely wonderful if ALL health care professionals (Guessers) would get on the same page and realize what is at stake with us valvies. Short of a miracle, I don't think that's ever going to happen. I get so ticked at how many supposedly know the latest research and technique, all to find out that they are giving advice from 10 or more years ago. It's down right aggravating and dangerous. We really have no choice but to be our own advocates.

 

[Les]

Ross,
"Our Own Advocates"... That's the best said!
__________________
Les AVR '93 / '95

 

[EVELYN]

Hi Gail

Tyce is going in for a cleaning next Wednesday---no question about it, he's staying on the coumadin--both from the words of our dentist and cardio. He takes his amoxicillin an hour prior and goes for it. I look at it ---bleeding will stop, a clot can destroy a life.

Good luck with your decision.

Evelyn

 

[Phil]

I personally think that when the dentist says "deep-cleaning" and hands you a bill for five hundred dollars (or more) he's ripping you off!

But then again, I HATE THE DENTIST! it was a dentist that caused me to have my heart valve in the first place.

 

[Creed3]

Another Question???

Another Question???

When I went for the exam yesterday, I had asked if I needed to take an antibiotic first, and they said no because the dentist was only going to look around and not do anything. Before he started I asked again if I should have taken an antibiotic first and he so no, no need to. It seemed like all he really was touching was my teeth, but at one point it felt like he touched my gum and then he rinsed with water. I then talked to him about endocarditis after the appt. and he said endocarditis is extremely serious and he wanted to make sure that I had antibiotics for my appt for the deep cleaning. I do. I again asked him if there was any risk of endocarditis due to the poking around he did and he said no because he didn't do anything. When I brushed the next time, I spit out a very small blood clot and I thought maybe that was due to the exam and that maybe I bled ever so slightly. Do any of you think that there is a chance of developing endocarditis? I know that there are some on VR who have developed it through dental work. I am worrying way too much??? My dentist did tell me that after my deep cleaning when I floss I will also bleed a little bit and that would continue to occur until my gums were completely healthy. Then there should be no bleeding. Is this something to be concerned about regarding endocarditis?

Thanks in advance for any responses.

Take Care!
Gail

 

[Ross]

There is always a possibility, but with premedication with the antibiotics, the risk is cut significantly. Are you worrying too much?
I think you are, but at least your asking and letting your fear be known. You'll be alright. Many of us have done this already and it's not nearly as bad as it may seem.

I really didn't bleed anymore then usual with my cleaning and believe me, the dentist did some serious cleaning. I sometimes thought he was trying to pull teeth out but it was just deep seated tartar at the bases of the teeth. My mouth feels so much better now.

 

[Christine]

i've been told both.. i'm always premedicated no matter what i'm having done at the dentist (except if i'm only having a crown placed) but cleanings, poking around etc.. you bet they want me premedicated..

i recently went to a dermatologist who specializes in skin cancer.. yearly mole patrol.. had two cut out that were pre-cancerous.. anyway, he explained to me that i didn't need to be premedicated with him, because everything he does is sterilized.. but he post medicated me to be on the safe side.. he said, procedures that involve openings into our blood stream (body) such as dental, obgyn procedures or rectal issues to name most are not "sterilized" and therefore the need to premedicate is present.. thought that served as a reminder that most procedures we might have done in our lifetime do require us to be premedicated.. just food for thought

 

[ShezaGirlie]

Phil

Phil

I agree. Just what is a 'deep cleaning' anyway?

Anyone know......

If you want to pad the undertakers pocket -- just get off Coumadin for something as simple as having your teeth cleaned. I had a wisdom tooth pulled and stayed on Coumadin.... I bled, so what??? It quit...

 

[Les]

"Girlie",
I think Phil is on to something... "Deep Cleaning" must refer to the depth your wallet is sufficiently swept "clean" of any currency.
Thus, actual excessive bleeding as a result of your dental visit would be to your finances...
____________________
Les AVR '93 / '95

 

[Granbonny]

Gail

Gail

3 months post-op I started waking up every morning with blood on my mouth. After a few days OFF to ER..They did a protime.,ect.Everything was fine. I made an appointment with my dentist and told them what was going on. They made me an appointment for an exam AND wrote a script..for Amox 500 4 an hour..Just for looking..Then was sent next door for appointment with peridontist. Same thing. Amox 500 4 an hour for exam. Then she told me to stay on coumadin..Again the same pills an hour before..Yes, I had deep cleaning and never bled..Went to bathroom and not a sign of blood. 3 weeks later one more. They do one side at a time..No bleeding. That has been several months and even when I brush I have no bleeding now.. Will go March 18th for regular cleaning...I have several scripts for Amox 500...I have 2 great dentist..I guess I would have to take the Amox to drop in and say hello

 

[Ross]

Deep Cleaning

Deep Cleaning

Deep cleaning or scaling and root planing, ( which is the correct dental
terminology), is a procedure where the roots of the teeth are meticulously cleaned.
The goal of scaling and root planing is to remove plaque, tartar,
bacteria and tooth root surface which has been contaminated by the
continued presence of elevated levels of bacteria.
The incidence of periodontal disease does increase with age, however, it
is not uncommon for people in their late teens or twenties to start
showing signs of periodontal disease. This would be treated with scaling
and root planing, ie., deep cleaning, and continued daily plaque removal
by the patient.

 

[Granbonny]

Dr. Young

Dr. Young

You missed your calling..should have been a dentist NOT too late...Bonnie

 

[ShezaGirlie]

BARF...Ross

BARF...Ross

Doesn't that HURT?? Oooooweee!

I can't stand the shrill sounds in a dental office.. So I listen to Stevie Ray reeeeel loud.

 

[Granbonny]

Nope

Nope

I did it without any numbing. Didn't want to have a needle poked in me My dentist is so sweet. Kept asking me ...are you o.k...I said sure... I told my PCP about it and told him..boy, was I brave. He laughed and said..so was your dentist.. Bonnie

 

[Ross]

I really didn't bother me much at the time of cleaning, but the next day, now that's a different matter all to gether!