teeth cleaning

No, but yes for extractions

by crustyg - 2022-08-27 03:23:58

You should be OK without antibiotic cover for a descale (make sure that your dentist is using a piezo-electric descaler not the old fashioned magnetic variety which can interfere with your PM).

This is an area that's been hotly debated but IMHO the evidence is quite clear.  You DO need antibiotic cover for any dental procedure that involves extraction, and you should avoid any dentist who won't provide it.

I hope it won't frighten you to know that people have been shown to have a very short-lived episode of (non-growing) bacteria in the blood stream after each normal, home-based, tooth-brushing.  This is NOT septicaemia, it's bacteraemia, and your immune system clears them up very quickly.  One of the things that causes difficulties for some people is the concept of infective dose: having a very few bacteria in your blood stream for a couple of minutes is very different to having a thousand or ten thousand present for fifteen minutes.

A dentist's descaling is not that much different to home tooth-brushing. It *is* different to a tooth extraction.

Hope that helps.

Would agree with crustyg

by Gemita - 2022-08-27 07:34:36

DMJ, I usually get my hygienist to clean my teeth using the old fashioned hand scaling method which takes a little longer.  I do not receive antibiotic cover routinely before visiting the dental hygienist, although I always do in the event of an extraction or root canal treatment.  Hand scaling can cause tooth sensitivity at times but other methods of cleaning have not worked well for me.

I think it is important that each one of us realises that certain health conditions may expose us to an increased risk for infection if these conditions are not well controlled.  I am thinking here of diabetes in particular.  If glucose levels are not controlled, the risk for an infection is obviously so much greater.  Heart failure, a chronic lung condition, or other acute illness causing a weakened immune system may also require antibiotic cover in certain circumstances, so always seek advice before any dental treatment to be safe. 

teeth cleaning

by new to pace.... - 2022-08-27 09:03:12

I agree with the other comments.  Because of my shoulder replacement I have to take antiboitics before my teeth cleaning.  Anyone with a replacement is advised to take antibiotic.  Was explained to be since my pacemaker in theory is just laying there and the other was cut into my body.

new to pace

Dental pre medication

by Lavender - 2022-08-27 10:11:14

Due to the overuse of antibiotics and folks developing resistance, guidelines changed over my 40 years working in the dental field. We used to premed anyone with anything extra in the body. In time, that was stopped. Dentists also now defer this decision to the patient's own cardiologist and should not be prescribing premeds. 
 

I was told by my cardiologist that I DO NOT NEED antibiotics for dental care. I only am to not have them use ultrasonic scalers. I have them use hand scalers and polish with the cup and paste using the electric/air powered handpiece (you might see it as a "drill".)
 

Here are the dental devices compared in a report from the American Dental Assoc:

https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/cardiac-implanted-devices-and-electronic-dental-instruments

Pacemaker recipients are to not have dental care for the first four weeks of getting their device.

ALL patients who have extractions and root canals are prescribed antibiotics in the dental offices where I worked or was a patient-regardless of implanted devices or not.

For home brushing this is the American Dental Association statement:

The guidelines note that people who are at risk for infective endocarditis are regularly exposed to oral bacteria during basic daily activities such as brushing or flossing.  The valvular disease management guidelines recommend that persons at risk of developing bacterial infective endocarditis establish and maintain the best possible oral health to reduce potential sources of bacterial seeding.  They state, “Optimal oral health is maintained through regular professional dental care and the use of appropriate dental products, such as manual, powered, and ultrasonic toothbrushes; dental floss; and other plaque-removal devices.”

From the American Dental Assoc site:

With input from the ADA, the American Heart Association (AHA) released guidelines for the prevention of infective endocarditis ...The AHA continues to recommend infective endocarditis prophylaxis “only for categories of patients at highest risk for adverse outcome while emphasizing the critical role of good oral health and regular access to dental care for all.”

These current guidelines support infective endocarditis premedication for a relatively small subset of patients. This is based on a review of scientific evidence, which showed that the risk of adverse reactions to antibiotics generally outweigh the benefits of prophylaxis for many patients who would have been considered eligible for prophylaxis in previous versions of the guidelines. Concern about the development of drug-resistant bacteria also was a factor.

The current infective endocarditis/valvular heart disease guidelines state that use of preventive antibiotics before certain dental procedures is reasonable for patients with:

prosthetic cardiac valves, including transcatheter-implanted prostheses and homografts;

prosthetic material used for cardiac valve repair, such as annuloplasty rings and chords;

a history of infective endocarditis;

a cardiac transplant with valve regurgitation due to a structurally abnormal valve;

the following congenital (present from birth) heart disease:

unrepaired cyanotic congenital heart disease, including palliative shunts and conduits

any repaired congenital heart defect with residual shunts or valvular regurgitation at the site of or adjacent to the site of a prosthetic patch or a prosthetic device

Pretty Well Covers It All, Lavender.

by Marybird - 2022-08-27 12:43:39

Thanks for this great information.  I just wanted to add that I have my teeth cleaned every 6 months. The hygenist uses a manual scaler, and a powered polisher ( as well as dental floss to get between the teeth), and I have never had to take an antibiotic beforehand. I'm vigilant about my dental care as I'm trying to make these old teeth last until I don't need them anymore. They aren't much but they're all I got.! 

Prevention!

by Lavender - 2022-08-28 10:18:43

Prevention is key. I haven't had any cavities in decades. Brushing with a sonicare toothbrush, as well as seeing a dentist every six months and using a nightly fluoride rinse is what keeps things going well. Mom is 97 and has all her teeth. She was a stickler at us having checkups. My guy gets his teeth cleaned every three months-his parents both lost their teeth early on and he is genetically predisposed to gum issues. You gotta fight back!

Yes, I Take Meds!

by MinimeJer05 - 2022-08-29 15:20:05

Hello,

I take a medication before any dental work (cleaning or cavities, etc.). I think mine is more for my heart valve though -- I had a mechanical valve put in Jan. of 2020 and ever since then I have taken 4 tablets of Cefalexin (I am allergic to Amoxycilin, otherwise I believe I would take that?).

I use to take something similiar when I was a kid (before the valve surgery) but then they randomly told me that I didn't need to (maybe for ten years) and then as soon as I got surgery, I had to start taking again and have been told I will take it for the rest of my life before appts.

Hope that helps

Jer

Antibiotic prophylaxis for dental work with pacemakers

by Rch - 2022-08-30 03:06:17

AHA does not recommend antibiotic prophylaxis for dental work in patients with pacemakers. But just IMHO I would wait for at least 4-6 weeks until the wound is healed and leads are well embedded. 

educate the dentists

by dwelch - 2022-09-03 22:21:42

I assume that most dentists do not have a lot of us as patients, we are not rare but it is not like every third person has a pacer either.  So they will ask, do you need it and, as pointed out and debated already.  No.  

Now on the scaler side they wouldnt use it because I didnt have the answer, so they did it the old fashioned way.  But the next time the cardiologists said just dont lay the cable over the device, and its fine.  As with anything, just keep it several inches away.