anti-biotics prior to even the tiniest dental treatments???

[liona]

IWell, I have been hassled in a very major way today over this legalistic nonsense. A week ago I had preparation for a crown with a new dentist. I took my anti-biotics beforehand. After 15 hours the temp crown they made for my tooth disintegrated and I was back there, having a new temp made.

Today the new crown fell apart, despite my best efforts to go easy on it. I was in town and called the dentist. They said come right over, which I did. No one asked me to take the pills, and I thought it would be silly, since there has never been any blood in the last 3 appts. Anyway, I didn't have the time to go home.

When I got there they asked if I had taken the pills, and I said no, they hadn't asked me to. So they said wait to talk with the dentist. So I waited and then I told him that it was un-needed since I bleed more every time I floss my teeth than I do there. He insisted that I go to a drugstore, take the pills and then wait 1 hour before begining the temp. I said that I had asked the Dr. about it and he said that it was only for major dental work. They stood fast. I went to the drugstore and they wanted me to give them my life history, I argued with them. They finally filled the prescription giving me 50 pills, which I would not pay for because all I needed was 4 pills. We argued some more. Eventually I got my 4 pills at a reasonable price.

I went to the dentist's office and took the pills and waited 1 hour. Then they began to make the prep. At one point the technician pulled some floss through my teeth and said, see, there's a little bit of blood. I laughed and told her that was an unbelievably stupid remark, since I draw 20 times that much blood 4 times a day when I test for diabetes.

The whole business took 5 1/2 hours of my time, upset my stomach and my blood sugar dreadfully, and was just plain dumb to boot.

I'm so sick of meaningless legalistic nonsense, I could scream. If the only way to protect myself from nonsense such as this is to lie, I'm going to have to prepare myself to lie more from now on.

[mtlieb]

Re: anti-biotics prior to even the tiniest dental treatments

Hi Liona,

My PCP simply wrote me a prescription for 40 capsules, which is good for 10 visits to the dentist. Amoxicillin is so cheap... i just pre-medicate prior to every visit, regardless of what procedure i'm having. It's probably overkill i know, but i'd rather be safe than sorry. It's not just a matter of whether they cause bleeding or not during the procedure, it's whether there's a potential to push bacteria from the mouth into your bloodstream. Heck, that could happen just while you're getting the numbing shot... or maybe if your teeth are messed with a lot during the procedure, bacteria from around the roots could seed into the bloodstream. I also have a sneaking suspicion that while i'm sitting there with my mouth numb, i get jabbed in various wrong places by dental instruments more often than i would like to believe.

The mouth is just so much different than any other part of the body, in that it harbors especially nasty bacteria that love to get into the bloodstream and go straight for our hearts. So it's not quite the same thing as testing your blood sugar. At any rate, i think i'd rather have an over-cautious dentist like yours, than some of them that don't even worry about pre-medication at all.

Sorry, i don't think i made you feel any better, but hang in there

Jim

[Reenie]

Re: anti-biotics prior to even the tiniest dental treatments

Sorry, but I'm going to agree with the doctor. Premedicating before any dental work is a good idea. Even cleanings, which is not major dental work, are cause for meds. Think of it this way. If you want to chance it, it's literally your life. HOWEVER, the dentist is liable if he knows you need the meds and doesn't insist on you taking them. He can be held for malpractice if you sue him because you got endocarditis and suffered a stroke when he was aware that you had a heart condition and treated you knowing you didn't premedicate. Just my two cents worth.

Reenie

[angall]

Re: anti-biotics prior to even the tiniest dental treatments

liona
I must agree with the doctor. The dentist I had been seeing since I moved to Minnesota retired. Recently another dentist took his place. I was going there to have a very small cavity in my tooth filled and she didn't think I needed to take my antibiotic. I ALWAYS take antibiotics before any dental procedure. I asked that she call my cardiologist, knowing that my cardiologist would say, DEFINATELY. A cardiologist in the 70's drilled me to NEVER have any dental work without taking my meds. I even take antiobotics when I go for my 6 month checkup knowing that is cleaning is in order.
Please take antiobotics before any dental procedure, it could save you from having a stroke....or worse.
Take care

[cynthiaG]

Re: anti-biotics prior to even the tiniest dental treatments

I have to agree with the dentist also. I know it's a real pain when you forget or feel you don't have to. A few years ago, I arrived at my former dentist's office to have my teeth cleaned. It was a half hour drive and it was snowing hard. I got there and she asked if I pre-medicated and realized I had not. She said, sorry, she can't clean them. I was so mad and told her that it's just a cleaning but she wouldn't budge. When I returned home, I must admit it was my fault and she was doing the right thing. As I said, it is a pain, but they are responsible if anything went wrong

[Burton Borrok]

Re: anti-biotics prior to even the tiniest dental treatments

Liona,
Truthfully, the life you save may be your own. Your mouth is extraordinarily susceptible to allowing bacteria into your bloodstream, leading to endocarditis. At worst it can kill you. Middle of the road you can have a stroke and be crippled the rest of your life. At best you’ll be very lucky and only be sick for a long, long time.

Four 500 mg capsules of Amoxicillin is so cheap my druggist will not give me less then twelve, as their minimum charge for filling a prescription covers that many. I had my first heart cath back in 1985 and have never sat in a dentist chair since without being pre-medicated. Even x-rays can set the ball rolling – think of the way the edges of the film press into your gums.

I am also somewhat concerned about your bleeding gums when flossing. There’s something wrong there. Ask your dentist about PreviDent Rinse, which reduces caries by up to 55%, or some other mouthwash which will help heal your gums.

Dear heart, we like you too much to let you win this one. Always, always pre-medicate – and I don’t mean a shot of courage before seeing the dentist. Take care now.
Burt

[liona]

Re: anti-biotics prior to even the tiniest dental treatments

Well, I'd agree with you folks if the dental work involved any gum cleaning, any injections, etc. but this did not.

Are you saying that one should premedicate each time you floss?

That is truly what we are talking about here

I intend to start lying about it. The pills sour my stomach for 3 days. I can't stand it.

If what you folks are saying is true, I would have died decades ago. I have had this heart condition and been complaining of it since I was 10. I was only diagnosed at the age of 56. All those years I had all kinds of dental work done without any anti-biotics, some of it 2quite bloody, and I never got any kind of infection.

I think everyone in this idiot country has lost all hold of any common sense.

[felixdacat]

Re: anti-biotics prior to even the tiniest dental treatments

Liona,

One more vote for your doctor.
I am well aware of dentists who jump the second they find out you have a heart condition. Most of the time they are being very over cautious.
I too was put off by having to get anti-biotics each time that I went to the dentist.
Well I was floored when I found out that HCM is one of the conditions that cause them being over cautious.
Actually it's HOCM that can really be a problem. When the mitral valve begins to physically hit the septum each heartbeat, it can cause the surface of the septum to get rough. This roughness makes it easier for bacteria to stick.
I actually had a neighbor who died after his heart caught something following some dental work.
If anyone watched NYPD Blue back in the 90's, Jimmy Smits character, Bobby died when his heart caught a virus.
When a dentist works on your teeth they are working deeper, and churning up a great deal more than flossing. That's the nasty stuff with all kinds of bacteria.
Yes its rare that somebody can get sick or die from some dental work. But just a few inexpensive pills makes the risk non-existent.

[liona]

Re: anti-biotics prior to even the tiniest dental treatments

Sorry, replacing a broken temporary crown is NOT working on your teeth any deeper than flossing!

You people are well intended, but you aren't addressing the actual situation!

[Burton Borrok]

Re: anti-biotics prior to even the tiniest dental treatments

Liona,
We are each responsible for our own actions, or lack thereof, and suffer whatever happens as a result.

In this idiot country of ours you are free to lie to your dentist and run the risk of endocarditis any time you want. I just hope I’m never in a position to say, “I told you so.”

It is possible to cross a busy street without getting hit, but then to conclude you can do it at all times without ever getting hit is something else again. If you don’t tolerate the pills you have, get something else. (Amoxicillin comes in capsules.)

I guess I’ll go join my idiot country mates and try to fit in. I wish you the best of luck in beating the odds. It is possible after all.
Burt

[mtlieb]

Re: anti-biotics prior to even the tiniest dental treatments

Liona,

I think we all understand what you are saying... having a temporary crown replaced is about as non-invasive as it gets, and the chances of picking up any kind of infection at all from such a procedure has to be next to nothing. Pre-medicating for such a tiny thing must have seemed pretty silly, and you went through a whole lot of hassle because of it. I also think that perhaps you have been misunderstood by some as saying that pre-medication is never necessary. I don't think that is your intention.

However, the reality of the situation is that most dentists now require us heart patients to medicate prior to every procedure, regardless of what it is. Yes, to some degree they're covering their butts. But at the same time, if there's even a miniscule risk of infection and a single dollar's worth of amoxicillin will prevent it... then it just makes common sense to medicate before every appointment and be done with it. It's such a small price to pay for a little extra security.

I'd been going to the dentist for forty years prior to finding out i have HCM... and like you, i never medicated for any of that and obviously never had a problem. But there's also a lot more virulent strains of viruses and bacteria running around hospitals and clinics now than there used to be, and my dentist certainly never had to wear latex gloves when i was growing up either. You floss your teeth every day and don't worry about infection... but having someone else stick their hands in your mouth to do it is a different story altogether.

Take care,

Jim

[Reenie]

Re: anti-biotics prior to even the tiniest dental treatments

Liona, as I said before, you are free to do as you feel best. I was just wanting to point out the doctor's liability in the situation if he/she works on you without you taking the prophylaxis. It's totally your call. But please inform the dentist on your decision. They might ask you to sign a waiver of responsibility on their part if there is an adverse reaction.

Reenie

PS: I took it from your original post that you were asking for opinions on whether or not you really need the antibiotics for every dental visit. My opinion is yes. If you were looking for someone to agree with you and not for our opinions on that matter, then I'm sorry I didn't understand it that way.

[liona]

Re: anti-biotics prior to even the tiniest dental treatments

Well, Jim, Mtlieb, I'm glad to see that SOMEONE on this thread was capable of reading what I said in my post and reacting appropriately.

This dentist is so incompetent that I have had to come there 3 times in a week. My own dentist is on medical leave, and if I had known just how bad this guy would be, I would never have allowed him to work on me at all. His temporary crowns have crumbled immediately after insertion.

This is an example of incompetent medical care by people who follow the book rather than considering the patient. People who don't seem to care how much they put me through in the process.

I find you people's reactions to this situation rather shocking. As mindless and uncaring as the deadhead dentist who just got out of med school.

[Burton Borrok]

Re: anti-biotics prior to even the tiniest dental treatments

I find you people's reactions to this situation rather shocking. As mindless and uncaring as the deadhead dentist who just got out of med school.

I’m sorry Liona but I object to being called mindless and uncaring. You go do whatever you want to. Obviously you don’t consider the concerns or feelings of anyone who does not agree with your intension of lying to the dentist and having your dental work done un-medicated. You also seem to think the rule was made solely to pick on heart patients.
Good luck,
Burt

[Debbie]

Re: anti-biotics prior to even the tiniest dental treatments

Hi,
Have to weigh in on this, too. I, also, have arrived at my dentist's office unmedicated, for a cleaning, to be told to go home. They said that a cleaning is even more dangerous than another, more invasive dental procedure. The reason? A cleaning could be dislodging a massive amount of bacteria that could possibly get into your bloodstream. This is dangerous to anyone, but especially to us heart patients. You cannot premedicate right then and there, then go directly into the procedure... the antibiotics aren't in your bloodstream yet. It can literally be a life or death situation.

I know it is frustrating, but everyone really just has your (our) best interests, (health), at heart.

Ask Lisa... or is it Sarah? Sorry don't have time to look up previous posts about this, but one of them can tell you a horror story about a dental procedure.

Anyway, just remember, we all just want to help, not take sides.