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British Heart Foundation
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Crawling up the wall tooth abscess

I only phoned my dentist last week to find out what the procedure is due to me having AVR and needing to take antibiotics before I visit, receptionist didn’t know and was supposed to get back to me after speaking with my dentist, she never did. On Friday I yawned and my jaw made a very loud crack and sort of locked, I wiggle it and it went back, but since then I started to get aching in the lower jaw, this seemed to turn into chronic toothache and today my face is swollen, jaw line and part of my neck. I can’t relieve the pain, I have some antibiotics from a chest infection so I’ve taken them as I’m scared of developing endocarditis. Do you think if I contact my cardio nurse she could help me by pass my dentist and go to the orthodontist at the hospital. Any ideas to get shot of the pain, I’m crawling up the walls. Or has any heart Warriors been in this position.

Thanks Kaz💕💖❤️

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The clinical guidance is by NICE is crystal clear:

"No antibiotics prophylactically" - this stands for all heart patients and unless told otherwise your dentist will not be able to prescribe antibiotics. So do check with your cardiac nurse.

This said the abscess needs to be treated and the treatment for abscess would probably include antibiotics. Leaving the abscess is far more likely to result in endocarditis than going to the dentist without taking antibiotics and having it treated.

I have has my hard palate reconstructed with an open wound in my mouth for 8 weeks. Followed all cleaning instructions, refused antibiotics and never got endocarditis- reason: the same as that behind the guidance given by nice. Taking them before going to the dentist makes little difference to the prevention of endocarditis. What does make a big difference though is being able to spot the infection if it does occur, as such I received multiple lectures on the signs of infection, was required to take my temperature daily and if it was high immediately request antibiotics.

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Thanks I will ring cardio nurse first thing tomorrow morning.

Kaz💖❤️💕

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Hello KazSumm - You poor thing - a tooth abscess can be excruciating and is usually classed as a dental emergency. There are usually Out of Hours emergency dentists in most areas so you could contact one this evening.

From my own experience , and as Midgeymoo17 says, a Dentist will usually prescribe ( very specific) antibiotics for a tooth abscess, he may also drain it and may sometimes remove the tooth .

As regards the"cracking jaw" you descibe. That could be a coincidence....and can be caused by yawning. I think there is a technical name for it....something like mandibular joint disorder. I have had my jaw click out of place a couple of times and as you say it clicks back when you wriggle your jaw.

I do hope you manage to sort your tooth abscess out.

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Thanks bernie51 for your reply

At the moment I’ve got the pain under control, just hope it lasts 😂 will phone my cardio nurse first thing to get advise.

Kaz💖❤️💕

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You poor thing Kaz, nothing worse than raging toothache added to which the worry over Endocarditis.

I do hope you get it sorted quickly and your cardio nurse gives you helpful advice.

For what it is worth my surgeon and dentist recommend 5gms of amoxicillin 1 hour before any dental treatment including checkup and clean, as I have a mechanical mitral valve there is a risk of Endocarditis.

Good Luck and I hope you feel better soon,

Dory x❤️

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I have antibiotic cover for all dental work but my cardiologist wants that

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How long is it since your AVR? When I was discharged I asked my surgeon about this and he told me that I would not need antibiotics for dental treatment if it was six months after the op. I can't quite remember his explanation, but it was something to do with my new valve having developed it's own protection. I hope you get relief soon. Love Margaret x

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Hi Margaret it’s coming up to 9 mths since my AVR. It’s quite confusing regarding dental work, it seems guidelines differs between NHS areas.

I come under Wessex (Dorset)

Who have decided that antibiotics are to be given before dental work . Hoping you are keeping well. Kaz ❤️💕💖

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Well, it is probably better to err on the side of caution. I hope you get sorted out soon anyway, as there is nothing worse than toothache. Thinking of you. Love Margaret xxx

PS. Thanks I'm doing okay. I'm just waiting to have the 24 hour BP monitoring thing next month. Hopefully that will be my last visit to a hospital for a very long time!

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