Community Chat

[ivey]

On 9/11/2014 ivey said:

I feel exactly the same way. I have a new dentist (after my old one retired after seeing him at least 20 years), and they find something every single time I go in. I'm getting ready to change.

Just this week, I had an interesting thing happen. This new dentist had said I needed a dental implant on a troublesome tooth, gave me a quote, breakdown, etc. He is in general dentistry and has only done 15 implants.

So I went to an oral surgeon who had worked on that tooth before. He took several Xrays, including a 3D imaging, and he said that he saw absolutely nothing that would require an implant. I'm finding a new general dentist.

[gazelle77]

On 9/17/2014 Madisson said:

On 9/11/2014 sylviahomeatlast said: Mr Sylvia has a knee replacement and he needs to take antibiotics before the dentist ---even for cleaning--

Especially for cleaning! My sister is a hygienist. I am a nurse. You take the prophylactic antibiotics when there is likely to be bleeding during a procedure. There is more bleeding during a cleaning than during the placement of a filling.

This is outdated information... The medical association is just behind the times on the issue of using prophylactic antibiotics. The newer dentists and clinics know this and my dentist who is about 30-- young and bright and up to date on everything even mentioned it to me before I brought it up!

IF you have a compromised immune system( RA etc...) IF you have had infections in the joint before... than yes it MAY help to take them prior to a procedure. But, if you are healthy and have never had any infections in the joint, the new guidelines (that are already used in the UK and Canada) are NO prophylactic antibiotics necessary. Why take them if not necessary? It is not healthy to do so.

Joint Surgeons in the US have to wait for the AMA to give them the OK( clearance) to go by the newer guidelines on use( or not use) of antibiotics for their healthy joint replacement patients. So, It is the Patient who needs to decide for themselves at this point- on what they personally want to do.

I myself- decided to wait a full year after my double knee replacement to have my cleaning done, a crown and a root canal WITHOUT ANTIBIOTICS. I read all the information and made my decision. I will do the same with my hip replacement. Wait a full year.

Here is a PDF on this issue if you want to read more on it:

http://www.aaos.org/Research/guidelines/PUDP/dentaleditorial.pdf

[Madisson]

Gazelle, physicians and dentists do keep up on the latest research and guidelines for prophylactic antibiotics. The new physicians and dentists actually don't know anymore than practicing physicians and dentists. The research and guidelines are splattered all over in the journals and in continuing education courses. They are widely discussed at association meetings and staff meetings. It's very complicated. The guidelines really have not changed since I practiced as a nurse practitioner until three years ago. The guidelines are also just suggestions and are up to the individual physician or dentist based on the patient's total health history. The American Medication Association does not make the guidelines by themselves. The AAOS, the Am. Dental Association, pharmacy associations, epidemiologists, and infectious disease specialists all throw their two cents in based upon the latest research. Thank you for the link that you posted. It was actually from a 2013 article, so the research was from 2011 and 2012. Again, in dentistry, dental cleanings and extractions remain some of the main procedures where bleeding occurs, so prophylactic antibiotics are recommended. These guidelines are also followed for certain heart problems, e.g. valve replacement. Compromised immune systems are addressed in these guidelines, as are knees that have been infected previously. Unfortunately, many dentists and orthopedic surgeons are still recommending prophylactic antibiotics prior to procedures on healthy knee and hip replacement patients out of possible concern that an infection would occur...thus, litigation. (Sad.) Many dentists actually defer to the orthopedic surgeon to make the decision about whether or not his patients need the antibiotics. These are the up-to-date 2014 guidelines. They are continually being reviewed and revised based upon new research:

http://www.uptodate.com/contents/antibiotics-before-procedures-beyond-the-basics

[SahmIam]

Yes. I just say "is insurance covering this?" If not, then my answer is always a firm "NO".

[violann]

Is this a script that new dentists are being taught in dental school? It's word for word the same thing that my dentist says.