What precautions do I need to take when seeing hygienist?

[lamm]

Post heart attack (stents and meds), cardio rehab nurse warned us to take care when having dental treatment. Hygienist due to poke around the gums re periodontitis. Any advice?

[Red_Baron]

The advice I was given was to tell the dentist/hygienist before you visit. Some will give you antibiotics to take in advance. Double check with nurse/doctor though

[TMeditation]

My surgeon recommended antibiotics when visiting my dental hygienist and also when having any dental work done. If you contact your dentist he will supply them for you.

[NorthantsSteve]

Hi Lamm. As others say - you’ll need to tell them and also complete the usual health form. I found they were a lot more careful (actually not a bad thing as I hate dental stuff) knowing I was having anti platelet therapy and could bleed for ages. After Ticagrelor was dropped (12 months) bleeding was a lot more controlled but I still tell them.

[Purplecross]

My dentist says he will give me antibiotics I hour before any treatment and both dental and hygienist app are back to back so I only need one lot of antibiotics and check ups once a year now instead of every 6 months. My dentist says the antibiotics are to prevent any chance of infection getting into the blood.

[Sunnie2day]

Like the others have said - talk to the dentist and hygienist to see if you can get them to give you antibiotics. I live in NE Scotland where certain conditions mean the dentist and all his/her team schedule routine prophylactic antibiotics for anything more than a routine filling (extraction, crown, root canal, periodontal treatment, deep clean/scale), and some stages of those conditions meaning the patient can decide yes or no after a consult with the dentist.

My dentist and I talked about it after my cardiac results were in and on record - and now I go to the surgery the day before the procedure (anything except routine fillings) to pick-up a prescription for the antibiotics. I take one the day before, one the morning of the procedure, and one the day after.

Every surgery is different as to when the antibiotic is taken - some up here (and Down South according to my friends in Devon, Dorset, and Yorkshire) have the patient come in an hour before the procedure for a 500mg dose of Amoxicillin.

So, again, as others here have said - talk to the surgery staff (usually your dentist and the hygienist who does your hygiene work) before the procedure - and I'd try getting that talk done at least a week before your next scheduled appointment to give them time to sort the details.

[Berkoff]

i went to dentist yesterday and was told to go to hygienist but no mention of any antibiotics was told it wouldn't be a problem ...had my ha in early May

[MichaelJH Heart Star]

A few years ago I would have been given antibiotics both because of Type I diabetes and heart issues for "deep" treatment. These days it is a NO because of NICE guidelines - I have queried with both dentist and cardiologist. Recent root canal work went well but an extraction before my bypass and one year after went pear shaped (posted in threads on the forum) with stronger antibiotics needed a week or so after extraction. So something that should have been sorted in a few days became weeks of misery. If I need another extraction I will argue for antibiotics till the cows come home! 🐄

[Sunnie2day in reply to MichaelJH]

I told my dentist I was terrified to have round2 of the root canal treatment and he promptly agreed I should have antibiotics. I know it's quite difficult for men to say that 'I'm terrified' thing to anyone much less a dentist but it does seem to swing things towards prophylactic antibiotics if the patient has a heart condition.

ETA: I was brought up on a cattle ranch - trust me, the cows come home every night at 5pm for their grain

[MichaelJH Heart Star in reply to Sunnie2day]

I was brought up on a farm that had an award winning cattle herd. Sadly all history as new owners suffered short-termism! ☹️

[Sunnie2day in reply to MichaelJH]

One of the saddest days of my life was the day I watched my Angus bull loaded to go to his new home (had to sell off the ranch as no-one in the family was interested and my children were too young to be much help at the time). Nearly 30 years on and I still miss that big daftie. My only consolation was he lived a good and long life at his new ranch, and the ranch I had to sell is still a cattle ranch.

[Kristin1812 Heart Star]

Ours doesn’t give them, even knowing my extensive heart history. Mine are only really interested in whether you’ve ever had rheumatic fever.

[Milkfairy Heart Star]

NICE advises antibiotics for patients who have had their heart valves replaced see below for the summary of the guidance published 2016.

'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

bjgp.org/content/66/650/460.3

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

[HHH2017]

My dentist told me that in the past she would have given me antibiotics but couldn’t due to NICE guidelines changing. She sent me to ask my GP for them instead.

[Qualipop]

My dentist said I needed an extraction but absolutely refused antibiotics. She was adamant they weren't necessary. I refused the extraction.

[Alison_L]

I have a deep clean every 3 months because of gum disease. I keep my dentist updated with with my meds (although I've never had to sign anything), and she takes extra care with the cleaning, especially because of the Ticagrelor (which I've recently stopped), but there is no question of antibiotics, and she is more concerned with making sure the instruments she uses are compatible with my ICD.

[Lee180 in reply to Alison_L]

Hi 👋 I’ve got really bad gums as I’ve been unable to sit in the chair and have any work done, since my heart attack I’m getting braver and am starting to visit the dentist and need deep cleaning done on my teeth, I was just wondering how it feels and how long you’re gums are sore after? Sorry to jump in with questions

Lee

[Alison_L in reply to Lee180]

Hi Lee. Unfortunately it's not very pleasant as the dentist is effectively sticking a pointy thing between the tooth and the gum to clean out the gunk, but the first time I had it done, the dentist offered me an anaesthetic - I can just about cope without.

Because I was on Ticagrelor, I'd get the bus home trying not to open my mouth as I was doing an excellent impression of Dracula! The gums didn't continue to bleed for long, but the blood sticks to your teeth for some reason.

Your teeth will be slightly loose for about 4 or 5 hours, so best not to eat anything, and avoid hot or very cold drinks. After that, try some soft food and see how it feels. After 6 or 7 hours you should be able to eat normally, but leave the pork scratchings alone for 24 hours...

You might find it's not as bad as you fear, but it does need doing, so best to (gently) bite the bullet.

Do take a list of your medications and make sure the dentist knows what they are for.

Good luck xx

[Lee180]

Thank you for replying, I’m booked in for September now as I can’t get there before so have a long time to get ready for it 🤪