Re: Re: replacement - now antibiotics after dental work . . .

August 27, 2010

Don't you wish the medicos would all get on the same page? Prior to hip

replacement, my dentist wouldn't work on my mouth because I hadn't taken an

antibiotic. I have a heart murmur (I suspect lots of us do!), he said he

wanted me covered.

I just had a cellulitis infection in May and my ortho again said antibiotics for

any infection. I agree, , with all the superbugs and with our rush to take

antibiotics anyway, we're probably rendering them ineffective. But then, when I

think about having to uninstall a hip or knee if an infection would hit....that

gives me the willies!

Lynn

THR 26 Oct 09

It is better to wear out than rust out - Bishop Cumberland

Here's my art blog: http://www.adreamseyeview.blogspot.com/

From: F <celtictrek@...>

Subject: Re: replacement - now antibiotics after

dental work . . .

Joint Replacement

Date: Friday, August 27, 2010, 8:23 AM

Glad to hear this! I had my TKR done at Cleveland Clinic, and was told I didn't

need antibiotics and that as a preventative, they are no longer recommending

it. There are so many " superbugs " that are supposedly developing due to

resistance from overuse, that they no longer give them unless absolutely

necessary.

f.

>

> said the following on 27/08/2010 03:43:

> > Yes I have to. In fact I just went in for my 1 year check up

> > and I asked how long I have to take the antibiotics for my teeth and

> > my doctor told me forever. I will always need to take them when I

> > get my teeth worked on.

>

> Hi all:

>

> I find it quite interesting that this thread has come up at this time.

> Just this last Monday I went for my first dental appointment since my Bi

> Hip replacement 17 months ago. I informed the dentist of my hip

> replacements, and in the event needed 1 filling and a 'clean & polish'.

> This was all done with no mention of antibiotics, so before leaving I

> queried the situation. The dentist told me that the general consensus,

> now, is that it is more problematic to give antibiotics than not to:

> problems with people's reactions to them, and the matter of giving the

> bugs too much opportunity to develop resistance to the drugs. The

> dentist went on to say that with fillings, and clean/polish, there will

> be no more bacteria (and possibly less) entering the blood stream than

> when cleaning your own teeth (sounds logical), and the automatic giving

> of antibiotics was just a precautionary measure anyway - now believed to

> be a total 'overkill'. Further, she said that they would only consider

> giving antibiotics in the case of an extraction, but even then they

> would contact the OS to see if he felt it was really necessary.

>

> It seems that they don't want to give AB at all unless they really have to.

>

> So there we are. I had a filling & Clean/Polish - with no antibiotics!

> (Sort of . . . good news, I think - you feel less 'tied' to something).

>

> Regards,

>

> Mick.

>

------------------------------------

August 27, 2010

My OS and also my dentist want me to take 5,000 mg of my antibiotic one hour

prior to any dental procedure. It's four 500 mg pills.

RTKR - 9/16/09

OS: Coon, St. Helena, CA

Re: replacement - now antibiotics after

dental work . . .

Hi,

I had bilateral TKR done 7/09.

At my dental appointment prior to surgery, I told my dentist I was scheduled

for my TKR in a couple months. When I left that day, she gave me a prescription

for antibiotics for my next appointment, since I would have my new knees by

then.

My next appointment was in November of '09, I forgot to get the prescription

filled, and my dentist wouldn't allow me to have my appointment (cleaning,

polishing, x-rays). She also wanted, in writing, how long post-surgery my

surgeon wanted me on antibiotics. Dr. K. said typically it's 2-3 years, so was

surprized my OS indicated he wanted me on prophylatic antibiotics permanently.

A topic was mentioned that is interesting to me. The concern was that joint

replacement patients develop a resistance to the " front-line " antibiotics

prescribed us for dental work (Keflex, etc.) Over the course of getting the

dental work antibiotics issue taken care of, I found out from my OS that

permanent antibiotics for any dental work for joint replacement patients is

routine. The issue of developing resistance to the antibiotics did come up in

our conversation last year. Dr. Teeny said the one dose a couple times per year

prior to dental appointments would not contribute to my building resistance to

the antibiotics. Over the year, I have talked with several local TJR (hips and

knees) patients and they all take one dose about an hour prior to their dental

appointment. Typical dose is 500 mg. All of the people I spoke to said their

OSs have them on this type of permanent antibiotics for dental work. (They all

had different surgeons than I did.)

Very few of us have antibiotics prescribed at a level where developing

resistance to them is an issue. Someone would have to be on daily antibiotics

for some time for this to be of concern. There would have to be extenuating

circumstances for antibiotics to be prescribed at such a level.

I happen to have a history of cellulitis in my left leg (five bouts in 26

years). When I develop cellulitis, I end up on " the big boys " as my infection

specialist calls them (Vankomycin or Daptomycin). They're administered by IV,

and I have a hep-lock in my arm for the duration of time I'm on it. At some

point in the future, I may have to be on routine oral antibiotics as a

preventative measure for cellulitis. I want to make the point though, that if I

eventually end up on daily antibiotics, it's part of the cellulitis prevention

protocol for me, and not a dental work issue. An underlying concern in either

case (cellulitis prevention vs. dental work) of course, is that I have two

artificial joints and need to be concerned about the potential of deveoping an

infection and getting into my bloodstream and affecting my joints.

LTKR 7/16/09

RTKR 7/20/10

Teeny, OS, Tacoma, WA