This is really a follow up on my post a month ago about 5 hours of AF in which I casually mentioned I had toothache. It is well known that there is a relationship between oral health and heart health and it is suspected that poor oral health affects Arrythmias.
The first dentist I saw took x-ray and said looked like there was an infection in the root but the root was still alive and wanted to prescribe antibiotics - err No. I was not all happy so sort another opinion at a much bigger practice where they took a much more pro-active approach and recommended root canal filling. Now it is some 54 years since I had a root canal and still remember the trauma so that wasn’t a pleasant thought so asked for the tooth to be removed. No, I was told - too high risk (immune suppressed with osteoporosis and anticoagulanted). Well that was telling it straight so I went for the root canal with great trepidation. RF Ablation seemed far preferable!
I am pleased to report that things have moved on in the last 52 years and I had an amazing dentist consultant who does nothing else but root canals. She began by giving me paracetamol and a low dose steroid (prevent inflammation) before numbing up. It wasn’t a pleasant experience but very far from the trauma suffered 54 years ago.
The result - everything, including my heart, settled down within a few days and I can now chew food on that side of my mouth - realised I had been avoiding doing that for a few years with the tooth pain coming and going.
I now have to wait 3 months to ensure the treatment worked before having the tooth crowned. No antibiotics required, thankfully.
Moral - when you have tooth pain - go to the dentist and get to the root of the problem - but you will need deep pockets!
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CDreamer
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So happy you are feeling better CD. I have always said I would rather have ablation that root canal treatment.
Yes there is a strong link between dental infections and heart problems. I rememeber a young chap in the bed opposite me who had endocaraditis as a result of a botched wisdom extraction. I stayed in touch with him for months and visited each time I had to go to outpatients as he was there for a very long time until they finally got on top of the infection.
Glad all OK now. I had a root canal last year and was referred to a specialist who only did root canals. It was amazing. So quick and painless. Yes it was verrry expensive!
tell me about it!! Stayed with a dentist 15 yrs thinking he was good, till all of a sudden I needed the far back tooth looked at! Saw lady dentist, no X-rays even though filling was broken letting debris in, had to wait 2 months for it to be treated and then she had to remove it😡 Hate dentists, had fear since a child. She had no clue how to treat someone with T2 diabetes OR PAF 😳
Since moved to private dentist and had to have 3 new crowns as old ones were 36 yrs and apparently nothing wrong!! The fourth crown needs root canal but dentist can’t find the top of the root so having to see a specialist this Saturday to see if he can do it IR looks like an extraction and I’ll have a gap 😡😡
That seems very steep! It’s really difficult to know who is good when starting from scratch again. Golly I had implant + gum regeneration for that price! Hope you get sorted.
You have to wait 4 months to do anything and i don't want any sticking in bits, been there done that decades ago with years and years of braces that have ruined my teeth, got a cross bite. The situation I'm in is because of the lovely FREE treatment on the NHS. Oh yes, I know, had to have a far back molar removed due to neglect of dentistry, not on my part and theres no room for implant which means the bottom tooth is also redundant.
Oh dear, looks like your orthodontic treatment has given you another orthodontic problem with a cross bite! No wonder Americans in particular joke about British teeth!
All free on the NHS. Yes, when I was a terrified kid, cos I HATE dentists. The orthodontist had me going for years collecting the money from NHS. I didn’t know any better as I went alone. Various braces, teeth removed etc. Now bottom front teeth are overlapping. It’s affected my jaw, hence TMJ. Our wonderful FREE service!
Over the last 18 months I’ve had seven fillings four extractions one crown replaced and nearly completed a bridge at the front. All done privately. Prior to this had repeated abscesses on either side of mouth which necessitated antibiotics. During all this time was diagnosed with AF. Connected or what? I’d say so.
I would suggest it is unlikely. The oral bacteria causes inflammatory cardiac conditions such as endocarditis, and AF is not one of those, so I would think it is just a coincidence, however the question raised is why were the abscessed teeth only treated with anti-biotics and not root treated, was this a public or private dentist?
I just read a paper asking if prevalence of gum disease and dental decay increased risk of arrhythmias as well as CVD and the results of the limited study seemed to indicate yes. Lot more research required of course to show it causes arrythmia.
On a positive note an article talking about healthcare systems based on being paid for positive health outcomes - the exact opposite of our current systems - would include Lifestyle advice & coaching & include dental, vision & hearing well being. Way to go as far as I’m concerned.
Yes I've read that too, but the study is very limited and if you really try you can make the outcome fit your postulations. Certainly, if you have an artificial valve or have had rheumatic fever, you must have antibiotic cover before any dental treatment is undertaken, so maybe there is a connection, but much more research needs to be done.
Except I cannot have many of the antibiotics and my understanding was that antibiotics are often recommended but are not an imperative - risk:benefit and for me the risk of antibiotics can be high.
I understand that they are becoming less pedantic these days with various aspects of cardio involvement and dentistry and are giving patients a choice, but the one condition that it appears to remain the hard and fast rule is that premed is vital with a prosthetic valve. So you are absolutely correct to make the choice that you feel is appropriate for your case, you know what is right for you, the text book doesn't !!!!
Just as the vow of the medical doctor is 'Do no Harm' - the vow of the competent dentist should be 'never remove a tooth without a very valid reason, overcrowding, mobility due to extreme bone loss' , but if removed should be replaced with some form of artificial prosthesis. Endodontics, which is specialisation in root canal treatment is newer than other specialities such as orthodontics and periodontics, but none the less has been around for at least 40 years.
One of my bottom teeth has given me problems for over 40 years. No fillings last including a very expensive gold one that the dentist assured me would last till I died and which actually lasted 7 years. Every time I have work done on it I feel under the weather for several weeks afterwards. Now it has crumbled away in parts and gives occasional very painful twinges when I bite on something hard on that side. When I get round to going to the dentist it is coming out as I sick of it.
I recently required a root filling and crown on a back molar. the dentist I saw specialises in root fillings.
After 2 hours in the chair with my mouth propped open, only part of the root filling was completed because the tooth roots were calcified. I had to return for another 2 hours of root filling.
After all that the tooth was not fully successfully filled, had to be filled and levelled off and left and can't be capped . It will have to be removed if it causes a problems in future. 4 hours of filling with your mouth propped open is not to be recommended. As luck would have it the procedure took place on a rare days when I was not in P-AF.
Unfortunately if you are elderly there is a chance you may have calcified roots and a root filling not possible. I did get a reduction on the price because the work was not completed.
Last week I had a crown fitted on another tooth which had broken , a root filling was not required just reconstruction of the broken tooth, a temporary cap then the permanent cap.
I was in AF at the time but coped, the most painful part was a bill for £750 .
Both dentists who did the work were kind and considerate and used a non adrenaline anaesthetic, they were very competent keeping a check on my pulse rate.
The risks of the root canal treatment not being finished in one go was explained to me but thankfully they were able to complete the procedure and I am now a lot more comfortable. I will need the tooth crowned as it has been extensively filled over the years so there is danger that it will disintegrate if left.
The price you paid was about the same as what I was charged - £800 for the root canal but another circa £800 for the crown.
A few years ago I suddenly developed acute toothache in one of my upper teeth. I went to the dentist who took x rays and said there was no sign of caries or infection but none the less recommended a root canal. I was not keen on the idea as I am aware that there is some controversy in the dental world about root canals though it is a minority view. As the tooth was tiny( I have several tiny and missing teeth as my mouth is too small and the missing ones never appeared) and hidden I said I would prefer to have it out. Since I was on Apixaban the dentist was unsure as to whether I would need to stop it and for how long so she said she would find out and gave me an appointment for a few days later. Meanwhile she filed the tooth down a bit. Miracle - the pain diminished and by the time I went back had disappeared completely. I had done some digging online and came up with the condition of " tooth strain ". Sounds weird but apparently all our teeth have ligaments that can become " strained" just like other ligaments in the body. I thought the most likely explanation as to why this had happened was that it was a result of the floxing as teeth problems are common after FQs as are ligaments and tendon problems all over the body. I asked the dentist if it could be the ligament and she went back to the xrays and said yes. So if anything showed she had missed it on the first look and in my opinion was much too quick in her recommendation of an unnecessary root canal.
Interesting, thanks for sharing. I think I had something similar with another tooth before we moved - one of my upper teeth had dropped very slightly and the filing down put it back in line with my other upper teeth and I had no further problems.
Yes you can strain the periodontal ligament , that is why it is important that the bite is correct, they usually check it with bits of paper that looks like blue carbon paper, the dentist usually adjusts the bite with a bit of filing, and if he is happy with the impression on the blue paper, you should feel more comfortable too.
The funny thing was that I had had no work done that would have altered my bite in that area for several years and had had no problems till the toothache suddenly came on. That tooth has since broken at the back after biting on a bit of very hard chocolate. I need to go to the dentist but I hate going. She nags me because I don't wear the device on my upper teeth that protects my lower ones at night. I find it uncomfortable and suffer from problems sleeping on and off anyway. A lot of my problems stem from there not being enough room in my mouth for all my teeth and refusing to have braces when I was 12. The dentist then said I would have problems later in life but what 12 year old kid cares about problems they will have when they are 60?
So you're a naughty bruxer who won't wear her bite plate - you can change your bite and do all sorts of damage with your nocturnal grinding that you are not even aware you are doing -off you go to the dentist, they are lovely people !!!!!
I am suspecting you of being a dentist/ a retired dentist / married to a dentist! Dentists might be lovely people but professionally they are bringers of pain.
Glad you had a good outcome. For those that worry about these things with no recent experience, I can confirm 4 root canals & 1 extraction later that today it is unpleasant but you don't suffer any significant pain.
Finding a good dentist can be a minefield though. After my initial AF diagnosis, I decided to consult a specialist dentist (who advertised in a magazine...note this warning) to have old mercury fillings removed and other work. Her service was not appreciably better or safer (re the mercury) and I left after circa £7K bills.
I would urge everyone here to spend double the time with your daily clean.
Yes my hygienist says do the standard 2 minutes then do 2 more. Also her mantra is push ( if using electric toothbrush) not brush. Push harder than you would think but without getting the red light on your toothbrush. Apparently at nearly 80 I am a victim of the brand of dentistry in vogue when I was young " see a black dot, get a wide margin of healthy tooth and fill". So most of my teeth have been over treated. Re mercury fillings, I think it's like asbestos, not a problem unless disturbed?? I know there was a time when they were linked with MS??
There are various papers as early as 2014 citing mercury amalgam as linked to depression, anxiety, fibro, MS and more, who knows. Aspartame sweetner was another which I seem to remember caused symptoms mimicking MS. Today on news as may be linked to cancer.
I have a tooth that my dentist calls a "hot tooth" which niggles now and again. Unfortunately, the nerve in it is so fractious, it won't numb up so the last filling (a deep one) in it was anaesthetic free ........... not a pleasurable experience. He's obviously concerned about numbing it up to take it out. It flared up again 3 weeks ago and I told him I knew it was infection pain rather than hot tooth pain so he reluctantly have me antibiotics (not ones Id heard of before) and that did sort it out. 3 days later it started up again. At my choice, I had another set of antibiotics (Amoxocilin this time) and so far so good. I was told by my heart surgeon to keep on top of my oral health during to the impending valve repair so I didn't want an infection lurking. I already visit the hygienist every 3 months instead of 6 and have done for years.
I may have to bite the bullet, literally, and have the tooth out (root canal is not an option with this one) He has a different anaesthetic my EP has approved which he can try otherwise it's GA at the hospital with a long waiting list.
I've been reluctant to have it out as the tooth is fine, it's the bloomin nerve that is the problem. It had been fine for a long time but I got something trapped (bit of errant cream cracker I believe) and obviously hadn't managed to hoik it all out. I've been in Denplan for 20 years (which is why I take advantage of 3 month hygienist visits) so at least there's never any massive bills in one go, especially useful when I've had a couple of crowns.
If you are having a valve repair, speak to your Cardiologist about ongoing anti- biotic cover for dental procedures and he will advise you- I presume your dentist knows about it. If it's the nerve and it's infected, why won't the dentist do a root canal treatment on it.?
Had been advised a long time ago by my cardiologist about this and current guildlines are to no longer to use antibiotics as prophylactics.It was the gum that was infected as I'd trapped something in between it and the tooth. Dentist said it's something to do with the structure of the tooth that would make root canal not an option. The structure would also affect the ability to crown it following root canal as well. 🫤
Can't you get a second opinion on your tooth? I was PA to the professor who started and held the chair of Oral Rehabilitation at a well known University. He also had practices in South Africa and London (he commuted between the two), We had post graduate students at the practice all the time and hundreds of photos and radiographs to be sorted for lectures he gave in various countries and unusual locations (Yachts, Ski Chalets for example) and I never ever heard him tell his post graduate students something can't be done. He viewed the mouth as a holistic unit not individual teeth. His personal patients were all referrals from other dentists who did not know how to handle a problem, and in the 10 years I worked for him, I never knew him to fail to solve the problem by one method or another. Unfortunately it was costly, but if you have insurance surely you are covered for second opinions from a specialist? Because I spent so much time in that environment and what I learned from his lectures. I can't bear to hear about a tooth being extracted unless there really is no alternative, So I apologise for being such a bore.
Youre not a bore at all. I suppose that's a possibility regarding a second opinion but to be fair to my dentist, he doesn't want to pull the tooth but obviously doesn't want me to keep having problems. Also, the tooth is a little loose.I did a bit of research myself and, as its a rear tooth, it would need a crown following root canal work but, he says that the amount of work needed on the tooth wouldn't leave enough to crown.
I had a root canal on one of my top teeth some years ago which was just filled. About 4 years later, the tooth had become that brittle, it split in half whilst I was out for a meal on a Friday night so I had to wait, in agony, until the Monday.
I will investigate further before making a decision but thank you very much for your reply.
Thank you for not writing me off as a crank, but there are solutions in the right hands, All root treated teeth become brittle and dicoloured because the nerve is dead , so it's pretty routine to place a post crown in shortly after especially if it's an incisor and cosmetically important. Amway, I'll shut up now and wish you well with your teeth and AF!!!!!!!!
Teeth are the pits IMHO. After hygienist or any procedure, my teeth in all quadrants " jangle" for a couple of weeks. My dentist always cheers me ( I am awaiting permanent crown my 6th, including one that had root canal through crown then had to come out anyway!) with the words "you know 1 in 5 crowns fail.......but it needs a crown" . Because I have so many huge fillings, I tend to fear the worst, but things often settle down. I think I'm the dental equivalent of inheriting a gold mine.
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