Different ??? to spineys with hardware

[carolynms]

How many of you have to pre-medicate before seeing the dentist, and what do you take?
Carolyn

[slipnslide]

Carolyn,

I have mitral valve prolapse so I have to take an antibiotic before any surgery or dental procedure to prevent an infection going to my heart. Also, Since I had new hardware in my body from the ACDF surgery, when I went for the hernia surgery, the General surgeon put me on an antibiotic prior to and after the hernia repair, just as a preventive measure. They don't want an infection to go straight to the hardware site.

Hope that helps you some.

Kim

[carolynms]

My heart problems were misdiagnosed as mitro valve prolapse, and in those days I did have to premedicate to see the dentist, and to give birth. But I do not have MVP, but I do have to premedicate (because of the hardware) to see the dentist this week. My sister has had a cervical fusion with hardware, and she had never heard of premedicating. Go figure!
Carolyn

[slipnslide]

Carolyn,

I say better safe than sorry! Could you imagine going for another surgery to have the hardware removed cuz of infection?....oh my gawd, UGH!:eek:

Kim

[Ponyguy]

4 x 500 mg Amoxicillin an hour prior to the appointment.

(Reminds self to make dentist appointment...)


Much love and

[Ponyguy]

The surgeon that did my cervical fusion told me that I did not need antibiotics..I will have to ask the surgeon that did my lumbar fusion to see if he is of the same opinion...

Opinions vary on this topic, but I'd rather play cautious and take 4 inexpensive antibiotic capsules an hour before a cleaning/filling than risk undergoing any sort of further surgery.


Much love and

[Mark N]

I checked with my OSS and my PCP and both said I don't need any before dentist work. I know that others say you do so go with the one you feel comfortable with.

[Shirl]

Hi Carolyn ~

I also asked my NS about this because someone had asked on BT just before the crash. I was curious so as always I asked and I was told also that I don't need to take any antibiotics before my dentist does any work. I was told however that if I had a heart valve or knee replacement I would.

Shirl :)

[Gimpy]

The American Heart Association sets the guidelines for this, or so I was told by my surgeons. I have hardware in my neck and knee and I no longer need to pre-medicate. They have reduced their guidelines to a smaller time frame, only a few months if I remember correctly.

Gimpy

[Tbackpain1]

Here's the FAQ on it from the ADA. Linky: http://www.ada.org/public/topics/health_oral_faq.asp

PREVENTIVE ANTIBIOTICS AND YOUR DENTAL TREATMENT


Frequently Asked Questions (FAQ)

Overview


Why do I need antibiotics before my dental appointment?
What types of heart conditions pose a risk?
Who determines what type of antibiotics I should take?
What about a joint replacement?
Do any of these high-risk situations apply to you?
How long are antibiotics good for?


If you are a patient with certain kinds of heart disease or a special heart condition, or you've had a joint replaced, taking good care of your teeth and gums is a must-not just for a healthy smile, but also for your overall health.

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Why do I need antibiotics before my dental appointment?

During dental treatment, bleeding sometimes occurs. As a result, bacteria from the mouth can possibly enter the bloodstream and work their way to the heart. This presents a risk for some persons with cardiac abnormalities because the bacteria may cause bacterial endocarditis, a serious inflammation of the heart valves or tissues. Antibiotics reduce this risk.

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What types of heart conditions pose a risk?

Certain heart conditions are more often associated with endocarditis than others. To determine if an existing heart condition poses a risk, your dentist needs complete health information on your medical history form. The form should also include the name and address of your family physician or cardiologist as well as the names and dosages of all medications that you take.

Do any of these apply to you?


Heart surgery within past six months
Pacemaker
Vascular surgery (replaced artery) within past six months
Artificial heart valve
History of rheumatic fever
History of heart murmur (mitral valve prolapse)
Previous bacterial endocarditis
Systemic pulmonary shunt
Congenital heart defect
Acquired valvular dysfunction

If you have any of these conditions, if you have been diagnosed with other heart ailments, or if your health status has changed since your last dental visit, tell your dentist.

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Who determines what type of antibiotics I should take?

The American Heart Association routinely publishes guidelines so that physicians and dentists can protect patients who are at risk for developing bacterial endocarditis.
The guidelines, which the American Dental Association helps develop, recommend the use of antibiotics prior to dental treatment, based on the patient's medical condition and on the treatment to be performed. Your dentist or physician may prescribe antibiotics for dental procedures that would result in bleeding from the gums or mucous membranes in the mouth. Such procedures could include professional teeth cleaning, incision and drainage of infected oral tissue, some types of injections, extractions and some surgeries that involve the maxillary sinus.

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What about a joint replacement?

The bacteria commonly found in the mouth may travel through the bloodstream and settle in your artificial joint. This increases your risk of contracting an infection. Your dentist and your orthopaedic surgeon, working together, will develop an appropriate course of treatment for you.

For the first two years following a total joint placement, antibiotic prophylaxis is recommended for everyone. After two years, only high-risk patients may need to receive antibiotics for high-risk procedures.

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Do any of these high-risk situations apply to you?


Rheumatoid arthritis, systemic lupus or other medical conditions that cause you to be Immunocompromised or immunosupressed
Immunosupression caused by drug or radiation treatment
Malnourishment
Hemophilia
HIV infections
Insulin dependent (Type 1) diabetes
Cancer
All patients in these high-risk categories may need antibiotics for all high-risk dental procedures. High-risk dental procedures are those involving bleeding or producing high levels of bacteria in your blood. They include:


all dental extractions
all periodontal procedures
dental implant placement or insertion of teeth that were knocked out
some root canal procedures
initial placement of orthodontic bands (not brackets)
certain specialized local anesthetic injections
regular dental cleanings (if bleeding is anticipated)

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How long are antibiotics good for?

Don't try to stretch the useful life of your medicine. Always check the bottle's expiration date. Prescriptions that have passed their prime will not help you. Dispose of them promptly. If you are taking antibiotic pills orally, be sure to fill your prescription before your next visit. Carefully follow instructions for the dosage and frequency



I have heart issues, so I always pre-medicate before any dental work. I'm allergic to penicillin products, so I have to make sure they don't just prescribe the usual Amoxicillin (sometimes they forget). Usually it's Erythromycin for 4 days, 2 days before the procedure, 2 days after. Its true, they've updated the guidelines for orthopedics, as stated above, it's now recommended that you premedicate for dental work for 2 years after joint replacement, and then only high risk patients need to continue after that. But like other's have said, the last thing you want to have to do is contemplate hardware removal because of infection.

Theresa

[Kathi49]

Wow, I have never even thought to ask my NS nor my dentist about this! Interesting. I do know about infection from the gums, etc. traveling through the system and affecting internal organs. But I never knew it could settle into an artificial join. I am like Kim, the thought of having another surgery to clean out infection in an artificial joint or to remove it is just a hateful thought! I go about every 6 months to the dentist for cleanings and he knows I have had a fusion but has never said anything. But on a lighter note, I have been spending more on my dogs teeth lately because of potential infection of internal organs. If infected teeth or gums could kill them, I can imagine what it could potentially do to us.