Heart Condition and Dentistry - British Heart Fou...

British Heart Foundation
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Heart Condition and Dentistry

Some will recall that I queried pre-empting dental work with antibiotics. There was no overall conclusion and the advice I got was I did not need them.

Last week the root canal work was completed and the crown fitted. There were various delays in the referral to the oral surgeon for the tooth that needed extracting. This finally happened on Monday after an uncomfortable weekend as the tooth split on Friday evening. It was quite an unpleasant experience that lasted an hour as when it broke it left part of the root. Currently my gum is stitched up.and quite sore which is part of the reason I have not been about. I am watching it like a hawk as any sign of infection I will be demanding antibiotics. After everything I do not want anything jeopordised for the lack of a few tablets.

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Wow timely post, thank-you and I wish you a speedy uncomplicated recovery! I hate having root canal treatment, had one years ago, am in the process of another now, and my feeling is it's awful no matter how good the dentist.

I'm in NE Scotland and up here the NHS Scotland Dental Guidance re prophylactic antibiotics is it depends on the severity of some conditions - with some it is automatic, and with some it is ultimately the patient's decision after discussion with the dentist.

I 'qualify' to decide yes/no as I have RHS with aortic valve scarring (the cardiologist calls the scarring I have as 'trivial' and I can't tell you how happy I was to hear that after spending the last 55+years with RHS!). I also have recurrent pericarditis, and pericardial effusion - after discussing it with the dentist it was decided I should have the antibiotics. He wasn't as concerned about the valve scarring as he was the pericardial effusion, interestingly.

The day before something more invasive than a simple cleaning or filling is scheduled, I pick up a written prescription from the dental surgery front desk, take it to the chemist and receive three antibiotic doses. One the day before, one the day, and one the day after.

Very much the anxiety reliever, those three doses. I go in on the 29th of July to pick up the prescription (round2 root canal treatment set for 30th July) and owing to that I'm not over-anxious about the treatment. I'm also on record for having the antibiotics should a 'deep clean' be required, and again, the dentist seemed more concerned about the effusion than the valve.

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Blimy Sunnie2day you're falling apart what with your eyes & your teeth!! On a more serious note, good luck with the treatment xx

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Thank-you, and all things considered I think it could be so much worse - truly a happy day when the cardiologist said 'Trivial' about the valve scarring:)

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I'm in pain just reading your post!! Could your GP/dentist issue an antibiotics prescription to be cashed in only if necessary?

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Because of my diabetes I always had an Amoxicillin one on standby as my then GP trusted me to use them if appropriate. Nowadays, with all the NICE guidelines they will not issue a "just in case prescription".

As an aside the oral surgeon keeps "hypo" treatment on standby for diabetics as the stress can cause BG to go up or down. I had a softee ice cream about an hour later as I was going low. It was incredibly soothing!

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My husband was recently given an "in case" antibiotics prescription as infections are quite dangerous for him. I think it's on his notes. My concern would be its getting close the the weekend! Glad the ice cream helped, was it not too cold after dental treatment?

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No! I am a scientist! I had it in a tub, spooned to the right and glided to the left as it melted. My mate said I overthink! 😁

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Ha ha, I’m gonna try that scientific approach. I’m having a lot of dental treatment I’m sure ice cream will sooth them 🍨 thanks for overthinking🤔

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Sorry to hear that Michael. I am actually surprised to see that you didn't have Antibiotics, especially for Root Canal Work. My Consultant and Dentist have always insisted I take an Antibiotic powder an hour before for any Dental work whatsoever!! That was even when they changed the rules a while back. If it were me, I would definitely try and get Antibiotics sooner rather than later just to be on the safe side.

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Dentists!

I have every sympathy with anyone who has to visit the dentists, so I'm glad you've got your root canal work sorted.

I went to mine in March- got read the riot act as build up of plaque on teeth/gums - had to explain I'd been a bit poorly just recently so brushing my teeth properly not top of my priorities. If she'd been bothered to look at the list of my medications I'd just handed to her she might have treated me a bit more kindly.

Was commanded to come back in 3 months to ensure that I as taking care of my teeth (and told to go and stand on the naughty step) - went back yesterday - dentist nice as you like and I passed the test with flying colours!

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I am surprised the oral surgeon didn’t give you a/b before or after the procedure. But I’d like to think real thought went into the decision not to prescribe. Take care and yes watch out for any signs of infection.

Just as an aside - there is s condition called dry socket which is very painful- again call your dentist if you start to experience pain.

Hope it all heals well

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Someone told me you could not get "dry socket" when the opening has been stitched up. So that was rubbish.

I had the opposite tooth out prior to my bypass as it developed an abscess. Again I was refused antibiotics till about two weeks after when the gum was still painful and more swollen than ever - I had been refused a week earlier. Allegedly removing the tooth removes the source of infection NOT! This delayed surgery as you need to complete the course of antibiotics and wait two weeks. I get fed up with (not)NICE guidelines!

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Hi I've just read your post with interest as something similar has happened to me. An hour in the chair to remove a tooth which had broken into pieces and stitches in the wound. I then went on to develop dry socket which has been very painful. A week and a half later I'm now on antibiotics. I think I should have been given the antibiotics immediately after such a complicated extraction. Hope you recover well and I would definitely be keeping a close eye o out for any signs of infection.

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Did they x-ray afterwards to check they had got all the broken bits out? I went to a dentist a couple of years back who left a chunk of root behind which set up an infection weeks later.

Take care

Pat x

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No they didn't but the roots I was shown looked complete. I am doing "gum" selfies! ☹️

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Think I was either unlucky, or had a rubbish dentist. I have changed to a new one who is great & understands my dental anxieties.

Pat x

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I had endocarditis in 2004 in those days N I C E recomended 3g of antibiotic 12 hours before treatment and my dentist followed that .

NICE have since dropped the recommendation.My old dentist would also make me rinse with cordosil ? before she prodded or poked

I have a young dentist now and she just followed the guidelines and said nothing needed...until I asked her about her liability insurance !

she now writes me a script for antibiotics

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Good tip! 😎

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Michael, does this mean that any of us having had open heart surgery and on blood thinners will have to be referred to a hospital dentist for extractions - if they are ever needed?

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No but you need to discuss any concerns with your dentist. The referral was because it was deemed "complex" which it definitely was! Last year I may have been referred as I was weeks away from surgery and had severe angina. And maybe because the dentist at that time was petite?

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Hi, I've got a mechanical heart valve and for years I was given antibiotic cover for dental procedures (even a scale and polish). Recently though, the dentist explained that it was no longer the protocol because of the risk of antibiotics becoming ineffective from overuse. Hope this helps

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IMHO the overuse was prescribing them for coughs and colds where they are ineffective. I had to get a dental sign off for teeth and gums, which involved a couple of fillings and three extractions, before surgery. The story was that infection can spread to the heart via the bloodstream so surely the risk is still there. I believe there has been an increase in carditis cases in recent years!

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Thanks for that. I'm facing a possible extraction or r oot canal and my dentists just shrugged when I mentioned antibiotics. Don't realoly want them as they play havoc with my gut but if needed I would.

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I’ve had endocarditis and I have antibiotic cover for all dental work, because I’ve had antibiotic resistance I also take probiotics often to prevent antibiotic resistance when I need antibiotics.

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Hope all goes well Michael. xxx

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Very interesting post and responses. Prior to my AVR and CABG x 2 in January my cardiologist told me that I didn’t need antibiotics for any dental procedures.

I have now been told that antibiotics are recommended for any invasive dental treatment following AVR.

I am due to see my hygienist in a couple of week’s time, and am booked in to see my dentist an hour before my appointment for the antibiotics.

I used to see my hygienist four times a year, but may have to reduce this to maybe twice.

It’s a difficult one, with a risk of taking too many antibiotics or a risk of infection.

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Well still painful so emergency appointment later! ☹️

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Hope you haven't suffered all weekend & that you get your emergency appt.

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For the first few days after extraction it was quite painful but settled. It flared up over the weekend but I was traveling back from a weekend visiting family yesterday. I have an appointment later today.

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So after doing an impersonation of Dustin Hoffman in Marathon Man guess what - I have now been prescribed a five day course of antibiotics. This is the second time in a row this has happened so I am not happy. Hopefully I will get antibiotics next time I need similar treatment - these (not) NICE guidelines are starting to wind me up now! 😡

Picking up prescription then a lie down!

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Michael the guidelines are simply that! Insist on in case antibiotics prescription, they certainly still do them as they did for my husband just recently!! I hope they kick in soon for you, must be very painful

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Take it easy.

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So I have now had three lots of antibiotics and it is a bit more comfortable - I am taking 2 x paracetamol alongside each dose. Also feeling slightly better in myself after a decent night's sleep not waking at 4:00am to (phantom) toothache but will be taking it easy. I imagine having to take a course of antibiotics is worse for resistance than the preventative dose for treatment! Probably would have avoided the rubbish days I have had as well! ☹️

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Glad yo hear you're feeling more comfortable

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That's nothing to do with lack of antibiotics or dental infection per se. . . .

My brother is a dentist.

Do you generally have rubbish teeth all your life?

I do recall you have an autoimmune disease.

You have a history of chronic conditions, which are positively pro-inflammatory and these are systemic. In other words, it affects anywhere (and potentially widespread).

In other words, your immune system is dysfunctional.

It's not infection, it's your aberrant immune system.

If you think about it, it's fairly *unusual* that you had to have three lots of antibiotics for one molar and had to recuperate in bed. . .

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Well thank you! Whilst I have Type I diabetes I do not have a defunct immune system - in fact I generally heal quite well.

If you go back to the previous thread on the subject I went for a check up a few months ago and one tooth was marked down for root canal work and another for extraction (decayed below gum line). The root canal work has been successfully completed and a crown fitted. The extraction was referred to an oral surgeon but because of administrative errors did not happen till last Monday. A few days before the tooth broke making it a difficult one hour extraction (of many parts). I was started on antibiotics yesterday and had my third tablet when I posted (i.e. not three courses). I had a duvet day as I was tired through lack of sleep and felt out of sorts. Hopefully in a few days it will be the end of this saga.

Whilst I do not have fantastic teeth they are not rubbish. What I have suffered from are a number of rubbish dentists - the first in my teens who carried out totally unnecessary work damaging my teeth, those of my sister and many other people. At one time I had a twenty year period with minimal work being needed. Unfortunately that dentist who was a brilliant caring individual had to retire early because of heart disease. The next dentist destroyed two teeth because of her incompetence. The jury is still out on my latest one! 😁 or ☹️

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