Hi,
My husband (age 45) has three stents, and suffered a major MI in 2001. He went to his dentist as his tooth cracked and she does not want to do any treatment until he can find out from our cardiologist if he needs to take antiobiotics prior to crown treatment given the stents. Last stent was put in his rca in November 2006. Dentist did put a temporary filling in, but will not do anything else. I don't blame her for her caution. We can't get through to the cardio's office as of yet. Does anyone with stents/heart disease have any information or feedback? My husband is not in any pain due to the cracked tooth or the filling that fell out...just wondering if anyone out there has been in the same position. Thanks!

I had my mi 2002 lost a third of it the first time also in the rca then i had another one almost a year to the day another mi , but i have 5 stents in me , but yes when i go to the dentist they have me take antibiotics before they do any work on me , but remember each case is different so check with his cardio Dr. first .

I was looking at some deep root scaling and an extraction or two and I have a stent. I e-mailed my doctor (PCP) and asked for a call in for an Rx for an antibiotic.
He said, "NO you don't need it. Besides it will be for too many visits and thus it would have to be taken too often."

I went into my personal stash, which I like to keep for emergencies and took 1 gram of Penicillin-V before and after each procedure...AND FIRED MY DOCTOR! I should have done it YEARS ago and this was just the last straw.
Good riddance to bad rubbish.

A case of endocarditis is nothing to be cavalier about.

I agree - best to err on the side of caution. Penicillin (assuming he's not allergic to it) is harmless so what's the big deal about taking 2 grams (that's 4 500mg. tablets) an hour before the dental procedure?

John

I'd just like to say that I've had endocarditis twice - and I can safely say that it is a horrible, nasty thing which can be easily avoided with the correct anti-biotic cover.

First time I got it - through a bad tooth, I spent three weeks in hospital on intravenous anti-biotics.

The second time I got it ( through a cut in my foot ) I had septecemia, abcesses on the heart, a DVT, and all manner of horrible things go wrong with me, before they had to replace my aortic valve with emergency surgery. If you have any worries about your ticker, I would say that it's totally and utterly necessary not to take any risks.

Good luck !

There are new guidelines recently published about 3 months ago from the American Heart Association and causing dentists to rethink the practice of patients taking antibiotics before procedures to prevent heart valve infection.

"To keep people on the safe side, the AHA has made new guidelines. It turns out that routine activities like brushing and flossing can cause the same potential danger as the occasional dental procedure."

The new guidelines say only the people at greatest risk for a heart valve infection should get antibiotics before dental work. This includes people with artificial heart valves, a history of an infection called endocarditis, heart defects and some heart transplant patients.

With the new guidelines, people with heart issues like mitral valve prolapse would not get antibiotics.

There are risks with antibiotics like allergic reactions and bacteria becoming resistant to antibiotics. Studies show these risks outweigh the benefits".

It appears Lenin fired his doctor for following AMA's new guidelines.:)

Well, it is true that the AHA has all new guide lines for taking the anti-biotic. However, it is going to be hard for us die hards who have done this for so many years to be comfortable with it. I believe it is also going to be hard for some doctors to revert to not doing something they have done for years as a precautionary thing. As I stated in another post, my Cardio gave me a card only a few months ago to carry with me about my MVP stating I HAD to have anti-biotics before any dental care. I had rather be safe than sorry. Let the new generation coming up get use to not doing the meds before dental care. I want my drugs!

Mileena

As there is some risk taking antibiotics and there is very little risk (internet, numerous studies, 1 in a milion) for endiocarditis, there is a risk benefit consideration.

If one has been taking antibiotics without an unfavorable reaction, the risk/benefit may shift in favor of antibiotics?!...as well as peace of mind.

Ah geeze Matt, I am glad that I read your history....I have a very bad tooth. It was part of a bridge that broke due to age. The bad tooth has had a root canal but has decayed below the gum line and is totally black. I have pain, even though I have no root in it. My dentist removed the old bridge, but said that he would not dare pull this tooth, because I take Plavix.

He said I would have to see an oral surgeon, due to bleeding problems. This has been over a year ago. I do not want to stop Plavix for oral surgery. I stopped Plavix this January for 6 days for sinus surgery, and a blockage formed in one of my 5 stents within 2 months.

Thanks for the information. Can I ask you how you felt, or what were your symptoms of endocarditis? I have felt terrible for what seems like months.

Thanks again :)

Mayo Clinic on dental procedures and risk:

The skinny on preventive antibiotics and certain dental and medical procedures that may allow bacteria to enter your bloodstream. Antibiotics taken before these procedures can help destroy or control the harmful bacteria that may lead to endocarditis.

However, new guidelines released in 2007 reserve preventive antibiotic treatment only for those people who would have the worst outcomes if they get infective endocarditis. As a result, the list of procedures for which antibiotics are recommended has grown shorter. Antibiotics are no longer recommended before all dental procedures or for procedures of the urinary tract or gastrointestinal system.

As with Meleena always follow your doctor's advice, but it may be wise to inquire if your doctor is aware of the new AHA guidelines as antibiotics have caused serious medical problems and death. Understandingly, if one took peventive antibiotics in the past before your dental exams, one may be concerned about these changes. In the past, one may have been told to take antibiotics because of a concern that common dental procedures increased the risk of endocarditis. "But as doctors have learned more about endocarditis prevention, they've realized that endocarditis is much more likely to occur from exposure to random germs than from a typical dental exam or surgery".

As a result of this new knowledge, doctors now know few people would benefit from receiving preventive antibiotics before a dental exam in an effort to prevent endocarditis. Part of the reason for the change is that although the risk of receiving antibiotic treatment is small, adverse reactions and even life-threatening reactions can occur.

Still, if you have been told to take antibiotics before any procedures in the past, check with your doctor to see how these recommendations apply to you. Most vulnerable sites for germs that enter the blood stream that travel to the heart will attach to abnormal valves or damaged heart tissue. Organisms that cause infection tend to adhere to and multiply only on malformed, damaged or surgically implanted heart valves.

Frankly, I wasn't aware fully of the potential harmful effects of antibiotics with immunology and the development of other very serious medical conditions. Latent or otherwise

Antibiotics are essential. I am allergic to penicillin, so after years of suffering 3g of erythromycin before and after dental treatment, I now just take 500mg of Klaricid before and after. No gastric problems/sickness or any side effect. It took my daughter's paediatrician to find that out for me. Its good to know there are newer antib's out there that can be effectively taken in much lower doses, but still give great and safe cover. I also had rheumatic fever as a child, so cover is vital.

Best wishes

Julie.