Duration for dental antibiotics

[Simon]

There has been some discussions on for how long should you use antibiotics before dental work. I asked my OS about this as in the preop classes they said forever and my dentist goes for a year based on current guidelines.

The OS said it really is an issue of risk management. The thinking of just a year or 2 of antibiotics is to avoid the possibility of developing a major drug allergy to the "cillins" which are a pretty common group of antibiotics. They are also thinking a bit about drug resistance. My OS said that since you are talking about 1 dose the possiblity of these events is extremely low. You then have to weight this against the 1 in 1000 possibility of an infection in the joint. Though those are low odds, the outcome of a joint infection is much more severe than a drug allergy.

He said that for him and his patients life time use of antibiotics before dental surgery or any other invasive procedure is the better choice.

Simon

 

[beachcomber]

I think my OS is of the super conservative philosophy too. When the dentist saw the antibiotic dose I had been given she said it was 3x the latest recommendation. I figure better safe than sorry!

 

[mvo]

Hi Simon,

Is that 1/1000 the risk for a joint infection, or risk for a joint infection for dental work? I have yet to find any occurances or stats for the latter in my (minimal) seaching so far.

Monica

 

[JudyS]

My doc said antibiotics for life. I sure don't want to take a chance of a joint infection. I don't do well with statistics anyway. I had 3 miscarrages in a row. I forgot what the odds of that were.
I have hypopituitarism , which is not too common either. My endocrinologist sent me out of state for a rare test only done in 2 hospitals in the US. Well the morning of the procedure they called and told me I had to reschedule. I said you do know that I am from out of state. She told me she was very sorry, but the drug had failed. (It is flown in that morning and goes through a series of tests to see if it is safe to inject) Later in the day when my mental breakdown was over I called to ask how often the drug fails. I was told that this was the first time in the 20 years they have been performing this test!!!

So , I do not play the odds game!!!!

I'll be faithfully taking the amoxicillin!!
Judy

 

[Sandy R]

My OS said I must take antibiotics for 2 years after my surgery.
Sandy

 

[mvo]

Gee Judy, does your luck with the odds game work the other way - like with lottery tickets perhaps?

I will take the antibiotics as well, my surgeon says not to bother but I am sure my dentist wouldn't look at me without them!
Monica

 

[JudyS]

Hey Monica
I wish it worked the other way, but so far no. I had a therapist a few years back who said I would be the last person he would ask for lottery ticket #'s
Judy

 

[Josephine]

It does seem to vary and I would suggest that the reason there aren't any stats on this is because it would be next to impossible to prove - or disprove - that an infection in the joint was actually caused by the dental work.

What we DO know is that bugs that are in an infected THR/TKR are very often of the same type as the human body commensals - staph areus and streptococcus - or varients thereof. They are perfectly safe when in their proper 'home' but when the circumstances change such as an infection in the urinary tract or gut or the mouth, and is then compounded by surgery or dentistry, it can cause huge amounts of the bacteria to be dumped into the circulatory system which then go looking for some nice, quiet, hidden place to lie in wait for the next set of ideal circumstances. This is when the bug can adhere to the metal of the prosthesis and lie dormant for a long time before it starts making itself known. Another member is describing how her prosthesis had a kind of slime on it then it was removed (can't find it now and am too tired to try). This is typical of the kind of thing that happens.Sneeky, those little critters!

I'd go with others on here - I'd sooner be safe than sorry.

For what it's worth, when I was a new student nurse, 18-19 years old, I was forever getting bad throats with tonsillitis. I was a regular resident in the nurses' sick bay! So the consultant who's privilege it was to see to the nurses health, decided to put me on oral pencicillin for a YEAR!! Well, the script was lodged in the hospital pharmacy and I was supposed to go every month with my bottle and get it filled up. Only I wasn't too strict with myself about taking them so I would often find at the end of the month I had 10 or more tablets left over! so I would chuck the rest in the toilet and cut along to the pharmacy for my refill!

But you know what? That crazy regimen actually WORKED! I never had another bad throat again during my training and for many years after. And I still can take penicillin ok.

 

[Simon]

Monica

That was 1/1000 of infection from dental work but that is his opinion. I did a search of medline and like Josephine stated there is no hard evidence out there. In fact, no real studies have been done. The one thing that the literature does show is that if you have something like diabetes, cardiovascular disease, weakened immune system than antibiotics are needed.

Simon

 

[DaleMc]

When you talk about dental work are you talking about the fillings or extractions or are you including the normal checkup where they just clean your teeth and take x-rays? I have a dentist appt in Dec and will need to contact my OS if i need it for just a checkup. 5 months and counting and so far it is working out great. No problems to date and am now back to walking and climbing stairs like a normal person with no pain.

Dale

 

[edk]

Actually I think its almost anything. When the hygenist is pick-axing your gumline it frequently causes bleeding.

 

[Linda2]

Tell your dentist you have had joint replacement surgery. I know mine has a list for all the local surgeon's and knows what they want their patients to have--he then calls in the prescription.

 

[Sandy R]

Antibiotics for any dental work, especially teeth cleaning. I can't take penicillin so the OS gave me Clindamycin.
Sandy