Post AVR dental work

[Wizard_of_Oz]

I read in my follow up notes to valve replacement that I must be on a course of antibiotics if i have dental work. Can anyone expand on this for me please? Is this for a check up or hygienist, or only for significant procedures? Do you go to your GP for the prescription or the dentist? Thanks

[080311]

Morning,

It was explained to me that we have more bacteria in our mouths then the rest of our body put together, so if we have any treatments extractions for example because of our replacement valve which is vulnerable to bacteria they give us a course of antibiotics. Must admit I am very vigilant about seeing the Hygienist to make sure there is no plaque.

My dentist as given me the prescription for antibiotics that I needed for an extraction but that’s the only time in nearly 6 years.

So for check ups and the hygienist no antibiotics.

Hope your recovery is going well.

Pauline

[Chappychap]

My experience has been the same as Pauline's, no antibiotics for fillings or hygienist. But a seven day course of an antibiotic, prescribed by the dentist not the GP, following an extraction.

It's worth mentioning that some dentists are more reluctant than others to prescribe antibiotics. These are only guidelines so if you're determined to have antibiotics you may have to shop around for a more accommodating dentist.

[Br0chan212459q]

Had valve replacement 11 years ago and long before my operation was on antibiotics for dental treatment although that was abandoned as it was thought unnecessary. However that seems to have changed and recently had an extraction for which I was required to have antibiotic treatment. Checked with cardiology consultant and he confirmed that the view had changed again!!

[francesw47]

The NICE guidelines suggest that only those who are vulnerable to bacterial infection (endocarditis) should have antibiotic cover when visiting the dentist. Its debatable whether a replacement valve makes you vulnerable - at least according to my dentist! However, he complies with cardiologist request for antibiotic cover and I have 5mgs Amoxycillin prescribed by the dentist (taken as a powder in water) which I take for anything that is mildly invasive, ie hygienist visit and other treatments. The dental surgery are cautious around me - second aortic valve.Having seen the impact that endocarditis can have I happily swallow the antibiotic, although I prefer not to take them at all if I possible. My dad had endocarditis and it wrecked havoc with his heart.

Your dentist should be able to discuss with you, but if its in your notes then show those to the dentist?

[nilmonisikdar40]

That is correct. Your new valve is vulnerable to infection. After dental extraction , blood vessels are broken and subsequent bleeding. There is the chance of bacteria which are harmless commensals in the mouth and cannot do any harm to a healthy heart valve but likely to invade a replacement valve because bacteria recognise as a foreign body. Hope I am not confusing you but am trying my best.

[Wizard_of_Oz in reply to nilmonisikdar40]

Thanks, so only required post extraction and not for regular visits including hygienist??

[TMeditation]

I was advised by my surgeon to take an antibiotic before the hygienist and for dentist visits. What I usually try and do is tag on a visit to my dentist with my hygienist appointment, that way I only take antibiotics once. I am quite vigilant about dental hygiene as it was explained to me how important it is for us AVR people. I would say that I only take the antibiotic once about an hour before my visit. I rarely have bleeding these days because I look after my teeth much better. Also I have had some very nasty dental infections with troublesome teeth and extractions all of which needed a longer course.

Best of luck. Sue 🙏

[ScoobyDoo71]

Anything that causes turbulent blood flow or foreign object in the heart has potential to be a breeding ground for bacteria. Endocarditis can be deadly and really nasty disease which often can take a while to diagnose as often first symptoms similar to flu. A procedure that causes guns to bleed has risks associated so dental extractions and some scaling and polishing. It’s a fine balance as need to see hygienist to keep mouth healthy but more bleeding that occurs my understanding was the greater the risk. It doesn’t help as the powers that be keep changing guidance around prophylactic antibotic cover. Best bet is to check with your cardiologist and do what they recommend. The dentist is able to prescribe antibiotics. I have always had it as a sachet of amoxicillin taken an hour before procedures. Hope this helps. Just a reminder though endocarditis can occur with any break to skin so getting scratched when gardening, tattoos and piercings etc all carry risks.

[Reuben52]

Hi,AVR and double bypass 26/02/20.

I was advised to have antibiotic protection for any dental treatment, so combine check ups and hygenist in a single visit every 6 months.

I contact the dentist the week before and she issues a private prescription for 1 dose to be taken about an hour before the appointment.

Hope this helps....

[Velena]

I am in Spain and my dentist insists I have what they call a prophylactic dose of antibiotics before any treatment, including my annual scale and polish by the hygienist. He gives me a private prescription for a 1 week course of amoxicillin but I only have to take 2 tablets about an hour before my appointment.

[Wizard_of_Oz in reply to Velena]

Thank you Velena, really helpful

[BuonaSalute0823]

Sorry for the late reply your teeth need be checked by a dental hygienist who can advise you if dental work is needed as having a valve replacement requirement is your teeth fixed & in optimal condition as that’s the first point of contact for infection to get in . All the best & if in any doubt ask to speak to your consultant or cardiologist specialist nurse who can help