Dentist & antibiotics

[Rosanna75]

I had a mitral valve replacement in Nov 2018 and on the six week appointment with surgeon he reccomended to take antibiotics before going to the dentist even just for an hygienist appointment.

I asked who will prescribed them and he said that my dentist will.

I am due for a routine hygienist appointment and I called the dentist clinic and explained all of the above.

They told me that unfortunately they will not be able to help unless they have a request in writing from the consultant.

Does anyone takes antibiotics before swing the hygienist or dentist?

If so what are the quantities and for how long?

I have amoxicillin at home in case the consultant doesn't get back to me asap.

I really don't want to lose the appointment with the hygienist as I could only have one in the next 3 month as it is a very busy clinic.

Thank you

[Fredders]

I have had an AVR and a splenectomy so have to have antibiotics when I see the dentist but only if I’m having anything done, not a check up, and I don’t go to the hygienist as I had a bad experience with one some years ago and won’t go back. My dentist gives me the prescription and he never asked for a letter from my gp or consultant.

Wendy

[Nathan53]

Hi Rosanna - as is often the case there are differing opinions on anti biotics prior to dental work. If you Google 'antibiotics before dental work after mitral valve replacement' one of the article brought up is on the BHF site and questions the need for anti biotics as a routine precaution. It indicates that the Dentist will decide after consulting GP or Consultant if necessary. Maybe give one of the BHF Nurses a call to discuss on 0300 330 3311 if in doubt. I have only had stents (very different to your situation I know) and needed some dental treatment recently. I asked Dentist about anti biotics and he advised not required in his opinion as I had no sign of infection and he did not envisage a problem. He was prepared to prescribe if I was very concerned but I declined and was fine. He was good in telling me not to hesitate in seeking advice if I noticed any problems in the days after treatment.

[Milkfairy Heart Star]

The advice has been updated and your dental practice should be aware of this change.

bjgp.org/content/66/650/460.3

This is the updated advice from NICE

Antibiotics should be given to the following group of patients.

'Patients at high risk: replacement heart valves or prior endocarditis.

Patients at moderate risk: native valve disease.

High-risk dental procedure: extraction, deep descaling.

Antibiotic prophylaxis: indicated for people at high risk having high-risk dental procedures. Record details of consent process in the dental notes. Use amoxicillin 3 g or clindamycin 600 mg orally 1 hour before.

Other advice: dental surveillance 6-monthly (high-risk patients) or annually (medium-risk patients); avoid tattoos and intravenous drug use.

Warning: consider infective endocarditis with unresolving fever or night sweats, especially with systemic symptoms. Consider blood cultures before starting an antibiotic course.'

We had a discussion about this recently

healthunlocked.com/bhf/post...

A dentist can prescribe the antibiotics.

sdcep.org.uk/published-guid...

[Rosanna75 in reply to Milkfairy]

Thank you so much for your help! This forum.is amazing for this! I wasn't aware of the change in the guidelines for this matter and thank you ever so much for sharing the link.

You are right, my dentist should know about it...story of my life having to fight all the times even when it shouldn't be the case.

Again thank you

[dawnz]

I have antibiotic cover for dental hygiene and any work.

I have mine prescribed by my GP

I have a letter from my consultant stating I should have this cover.

Luckily the dentist and my Hygienist agree with this.

They are led by the NICE guidelines which fairly recently revised the recommendation and deemed cover unnecessary.

My dentist advised that there is growing data to support a change in these guidelines.

Hope that helps

[Rosanna75 in reply to dawnz]

Amazing! This is very helpful. I didn't even know about the change on the legislation guidelines.

Thank you for sharing and I will now get back to dentist with that in mind.

Thank you again for your precious help.

[Mary_Janet]

Hi

I am classified as a high risk person as I have previously had endocarditis and a mechanical aortic valve replacement. My cardiologist insists that this occurs.

My dentist contacted his colleagues and a programme has been discussed and planned. I see the dentist every six months and the hygienist every three months as despite very careful brushing and flossing my gums become inflamed very quickly. Prior to seeing the hygienist I take antibiotics -2g of penicillin one hour pre appointment, these are prescribed by the dentist with no issue.

I have been told that because of changes in recommendations in who should have anti biotics I am the only patient in the surgery who routinely has anti biotics pre treatment.

Best wishes

Mary

[Rosanna75]

Thank you Mary

I think my dentist is not up to date ...and sadly I will have to be the one to let him know.

Thank you again

[Madsometime]

Thanks very much for this information. My old dentist always gave me antibiotics. I had an AVR in 2011 and my surgeon said the guidelines are not to give antibiotics, but they are guidelines not rules, and I say you must have them. She thought the guidelines were dangerous, and said they were not changed in Europe or N America.

My dentist changed to a new one who was a guidelines follower. We compromised by him not scaling my teeth, and just doing check ups. I have had a filling, but that's low risk. I think I will ask him to prescribe antibiotics now, and do a scale. My teeth could do with a clean.