I am going to the dentist Monday for a cleaning. Is there anything I should concern myself with as far as infections go?
When was your resurf? I was told no dentist for 6 months and then antibiotics before for the rest of my life.
JG, You should take the antibiotics an hour before your appt., even for just a cleaning.
Well, I think the standard advice is to take antibiotics before any "major" dental work, but that's a bit open to interpretation. I think most would say cleaning doesn't merit any, but I'm not sure there's really any downside to a short course to cover even that.
Dr. Gross wants antibiotics taken before any dental work for the rest of your life.
Dr. Gross does suggest antibiotics for life, even for cleanings. The theory is that cleaning can sometimes involve some bleeding, meaning that bacteria from the mouth could enter the blood stream. I just had my teeth cleaned yesterday, and took the standard amoxycillin; four 500mg tablets.
I had dental work on Friday. I was already on anti-biotics because I had a tooth ache and the dentist couldn't get me in for 2 days. I'm on amoxiciilin 500 mgs 3X/day. However, for any further dental work, including cleanings, I have to take antibiotics one hour before the procedure for the rest of my life.
Incidentally, my tooth was cracked and had a cavity. Even though it was fixed, it still hurts in my gums and my jaw on that side hurts. Should I be concerned? I've been on amoxicillin since Thursday and naturally I'm worried about my hip after having 2 recent surgeries on it. I know infection isn't good for a metal hip.
What is the reason for this? Is there a fear that the bacteria from your mouth would get into your blood and make it's way to your hip and infect it???
I don't think it will bother me to have to take antibiotics before i do dental work...but it makes you worry..... I mean...what do i do if i am playing sports and got hit in the mouth and bled..do i need to go on antibiotics too?
Quote from: 23109VC on January 23, 2011, 02:14:23 AM
What is the reason for this? Is there a fear that the bacteria from your mouth would get into your blood and make it's way to your hip and infect it???
Yup.
Am I right that the infection issue would be the same with a THR?
Thanks for all the responses. I had my resurf Oct 22. Is this something I should call my doc about? My dentist appt. is Monday. Sounds like I should reschedule til I get some antibiotics.
By the way, the new hip feels amazing...I still can't believe it!
JohnnyG
Quote from: Dayton96 on January 23, 2011, 09:01:46 AM
Am I right that the infection issue would be the same with a THR?
Yes, it's the same.
It sounds as though the USA view is a bit different to that in the UK. Prophylactic antibiotics are a bit of a hot potato over here, but, as I mentioned previously, I don't really see much downside. Whereas I see a lot of downside if your hip gets infected!
Andy
Quote from: andybc on January 23, 2011, 01:35:52 PM
It sounds as though the USA view is a bit different to that in the UK. Prophylactic antibiotics are a bit of a hot potato over here, but, as I mentioned previously, I don't really see much downside. Whereas I see a lot of downside if your hip gets infected!
Andy
According to the hand out Dr. Gross gave me at my six week checkup, "This is controversial in the medical and dental community, but it is
my recommendation to you. Lifetime risk for infection spreading to your joint is less thank 1/2%."
It sounds like one of those things where you would rather be safe than sorry.
jg, you could call the doctor in the am and ask then to put in a script you can take 1 hour before if you don't have an early appointment. As I said, I was told no dental work at all unless it's an emergency prior to 6 months, after that antibiotics like everyone else has said. Healing increases the blood flow to that area most during the first 6 months. We need to be careful with all infections actually for the rest of our lives I've been told.
Even though the uk view may differ, I think I would go with Dr Gross. The difficulty is whether there's any hard and fast evidence of benefit. So called "evidence based medicine".
Downside is the risk of spreading resisitant bugs in the community. Realistically, it will only be a relatively small number of people taking the antibiotic for this quite specific scenario.
I'm sure there's no published data that proves which view is correct.
Johhny, your dentist should be able to scrip you the antibiotics also, they're used to dealing with this.
I was bitten by a dog recently and went on the meds, not taking chances.
There is a history of patients losing their hip/knee replacements in the past before the medical community realised that infection could spread this way. Better safe than sorry.
Great to hear that you are doing so well Johnny!
moe
I just picked up my amoxiciilin. My dentist wouldn't work on me without taking them. I'm glad we have this site with so many great people. Thanks to all! My doc confirmed that this a lifetime deal befoe a trip to the dentist.
Hey Moe, it's awesome to be able to climb in and out of submarines without any pain whatsoever. Heading to Pearl Harbor next week to work on one. Looking forward to some swimming in Waikiki. Going through security with my new hip should be a treat! haha
That's great Johnny, I don't miss going in those torpedo tubes but I could if I had to! lol
Have fun out there, I'm sure you'll get the full body feel at the airport.
I had a couple of ex coworkers ask how my hips are and does the cold weather bother them today, I told them they are the best part of my body! lol!...Dr Marchand is the man....moe
You guys are freaking me out. How does bacteria mess with chromoly? or whatever the MOM implants are made of. I presume once the wounds heal from surgery you don't have much blood interaction with the device, right? Does someone with a stainless bracket in their tibia need antibiotics before going in for dental cleaning?
Does anyone have a study on this, with some numbers? I'd like to think that my immune system is pretty solid. Does chromoly somehow lower your body's immune system?
Quote from: Tin Soldier on February 03, 2011, 12:03:17 AM
You guys are freaking me out.
Don't get freaked out. Merely take antibiotics before you see a dentist.
Quote from: Tin Soldier on February 03, 2011, 12:03:17 AM
How does bacteria mess with chromoly?
The bacteria is very sticky and likes hard surfaces with little blood supply, like the enamel on your teeth.
Quote from: Tin Soldier on February 03, 2011, 12:03:17 AM
Does chromoly somehow lower your body's immune system?
No.
I get it. That's sounds like a perfectly reasonable answer. Thanks. But is it only the dentist? What happens if I chew up my knuckles while messing with firewood? or I cut myself in the kitchen, or any other event where I break the skin? Like I said earlier, I hardly ever get infections, and that goes for regular colds too. I assume that will all be the same after new hips, right?
right, just follow the rule, take your antibiotics before seeing the dentist. Cool, I can do that.
Thanks
Just use common sense, someone on here had a cut on the foot that got infected, didn't catch it in time and lost her resurf. The bacteria can travel and get under the metal, once that happens it can be difficult (but not impossible) to treat.
moe
I'm getting ready for a March 23 resurfacing. I knew, from other surface hippies, to get any dental work done before my HR. I was told by my surgeon to get it all done at least six weeks before the surgery. I talked to my dentist today after a cleaning and exam and he said that in the future, they will "flag" my file, indicating a hip device. That means the dentist will automatically prescribe an antibiotic for any dental work. The dentist even knew enough to ask if my HR surgeon wanted it for just two years, or for life.
Mac
Blimey...now Im freaked out too. I cut myself on an almost daily basis when Im at work....and half the time I dont even notice. Plus...once Im feeling 100%.....I want to be able to live a normal life..not wrap myself in bubble wrap...this is crazy......what if I fall of a pushbike onto tarmac????.....or I go back to martial arts and get hit in the face??.....or I do any one of the million and one other things that normal people do????
My surgeon hasnt mention anything at all about antibiotics or infection...but now I think Im gonna give him a ring.
let's not get carried away! I understood the risk was from bacteria entering the skeletal bone via the jawbone, hence the dental precaution.
My gums bleed sometimes and I often have broken skin on my hands, cuts in the mouth are common in contact sports, runners have blisters, cyclists fall off. There are thousands of sporting hippies out there doing fine. I don't propose to take antibiotics every five minutes, they don't agree with me anyway and often do more harm than good.
UK/USA opinion very divided on this issue.
As far as I know the UK official dental advice is no antibiotic cover, even for people with heart valve problems.
I think the dichotomy over whether to take or not take antibiotics reflects the relationship of benefit to the individual relative to the overall detriment to society in the production of antibiotic resistant strains.
No opinion ventured here, just a comment.
Andy
I was also advised to use an antibiotic before dental work; not a major consideration as I have not been to a dentist since 1982. My teeth are fine, I have one filling from childhood and I do the periodic scraping procedure myself, I've been known to deburr chips with a diamond file.
I did a bit of reading today and it seems the infection route is not through the bone but the synovial fluid, via the bloodstream. The problem with antibiotics for general use, apart from the resistance you mention, is that the only way to protect against a specific organism is to make a culture first and find out what it is, otherwise you take a broad spectrum drug which will wipe out most of the body's flora and might still not provide protection against your infection.
Hip infections, though serious, seem to be pretty rare considering the number of procedures performed every year. I suspect it mostly occurs in a compromised immune system.
The bone cement contains 2 antibiotics, I've not been able to find out how long the protection lasts.
http://www.medsafe.govt.nz/profs/datasheet/Simplexcement.htm
I think some of us are getting a little carried away. In the US, people who have hip replacements, heart valves and murmers, and those with shunts are advised to have a short corse of antibiotics prior to any dental work since the mouth does carry a lot of germs that if introduced to the blood stream can lead to infection in the artificial joint, valve or shunt (murmers can be caused by faulty valves allowing bacteria to get stuck in the heart and cause infection to breed there). I have a resurf, I have one child with a shunt and another with a murmer. The odds are very low but if you are in the 1-2%, it's a very big deal. Who knows who is in that small persentage, but personally I'm not taking the risk when it's just a low level of antibiotics.
My daughter had a shunt placed in infancy and my son has always had the murmer - he never out grew it. Kids are much more rough and tumble on their bodies. Simple soap and water with a bandaid, sometimes peroxide or neosporin if there was alot of dirt in the skin break and we were good. Watch if the cut or scrape starts to look infected. Just normal everyday precausions.My daughter is now 31 and only one shunt infection from an ear infection, it was a very frightening month in the hospital but all worked out fine. My son is 25 and nothing out of the ordinary. They weren't psychologically scarred by needing to take the extra care. My daughter knows she need a quick course of antibiotics each time she adds to her tatoos. They haven't had any issue of needing stronger antibiotics when they get things like strep etc.
I'm hoping I haven't offended anyone. I just wanted folks to know that it's not hard to be cautious and peace of mind has a lot of value.
Never thought about tattoos...Ive got a few and want many more....so its more antibiotics for that too I take it :o :o :o
Yup. We took extra care with earrings as well. Not antibiotics, just watched carefully. When she finally escaped Katrina the doctors put her on a full course of antibiotics just to be safe because the situation was out of the ordinary.