Re: Antibiotic Prophylaxis

[Guest guest]

Thanks ! That is an interesting bit of information. I was

thinking about those guidelines today.

I have a question. I understand we are to take antibiotics to prevent

bacteria from causing problems when we have our teeth cleaned. What

about when we floss (particularly when we are still on blood thinning

meds or the aspirin)? It makes our gums bleed. Should I be concerned

about that?

Dr Gross 6/12/03

RHR C2K

> I'm not sure how to send a message to Surface Hippy on a new

subject but here goes....

>

> There's an interesting " Advisory Statement " in this month's JADA,

The Journal of the American Dental Association on " Antibiotic

Prophylaxis for Dental Patients With Total Joint Replacements " . The

advisory statement was worked out by the ADA and the AAOS to provide

guidance to dentists who treat total joint patients.

>

> It appears to present a new standard of treatment for these

patients and undoubtably will become standard of care in most dental

offices and in most courts of law. I will try to summarize the new

reccomendations here.

>

> The most striking new reccomendation is that patients with total

joint replacements who are generally healthy do NOT need antibiotic

prophylaxis after two years, post surgery. There are some patients

who do require prophylaxis indefinitely, which include:

>

> Immunocompromized / immunosuppressed patients

> This includes patients with " Imflammatory arthropathies such as

rheumatoid arthritis, systemic lupus erythematosis " and " Drug- or

radiation induced immunosuppresion "

>

> Patients with co-morbidities

> This includes patients with " Previous prosthetic joint

infections, Malnourishment, Hemophilia, HIV infection, Insulin-

dependent (type I) diabetes, and Malignancy "

>

> Other total joint patients who are over two years out of surgery

and who do not have additional risk factors are not included in the

guidelines.

>

> NOTE: This is an " Advisory Statement " . Included in the article is

the disclaimer, " Practitioners must exercise their own clinical

judgment in determining whether ot not antibiotic prophylaxis is

appropriate. "

>

> This means that your surgeon and your dentist should confer and

make the correct decision in your case, but in the absence of the

OS's preference or other mitigating factors, most dentists will

follow these guidelines.

>

> Here is the ADA's URL on this advisary statement. I do not know if

this is available for the public or not.

>

> http://www.ada.org/prof/pubs/jada/reports/prophy/index.html

>

> I hope this information is useful to the group.

>

> MLTDMD

>

>

[Guest guest]

At 08:49 PM 7/22/2003 -0500, you wrote:

>There are some patients who do require prophylaxis indefinitely, which

>include:

>

>Immunocompromized / immunosuppressed patients

> This includes patients with " Imflammatory arthropathies such as

> rheumatoid arthritis, systemic lupus erythematosis " and " Drug- or

> radiation induced immunosuppresion "

>

>Patients with co-morbidities

> This includes patients with " Previous prosthetic joint infections,

> Malnourishment, Hemophilia, HIV infection, Insulin-dependent (type I)

> diabetes, and Malignancy "

>

>Other total joint patients who are over two years out of surgery and who

>do not have additional risk factors are not included in the guidelines.

And don't forget one of the most common reasons-heart murmurs.

C+ 5/25/01 and 6/28/01

[Guest guest]

The advice I had from Mr Treacy was to request antibiotics from a

dentist if I required major treatment i.e. an abscess or the like.

However, I also get a bit jumpy about flossing. My dentist gave me an

antibacterial spray called Eulidril for 'hard to floss' areas.

Kathy

Left BHR & bone grafts - Mr Treacy June 02

> > I'm not sure how to send a message to Surface Hippy on a new

> subject but here goes....

> >

> > There's an interesting " Advisory Statement " in this month's JADA,

> The Journal of the American Dental Association on " Antibiotic

> Prophylaxis for Dental Patients With Total Joint Replacements " . The

> advisory statement was worked out by the ADA and the AAOS to

provide

> guidance to dentists who treat total joint patients.

> >

> > It appears to present a new standard of treatment for these

> patients and undoubtably will become standard of care in most

dental

> offices and in most courts of law. I will try to summarize the new

> reccomendations here.

> >

> > The most striking new reccomendation is that patients with total

> joint replacements who are generally healthy do NOT need antibiotic

> prophylaxis after two years, post surgery. There are some patients

> who do require prophylaxis indefinitely, which include:

> >

> > Immunocompromized / immunosuppressed patients

> > This includes patients with " Imflammatory arthropathies such

as

> rheumatoid arthritis, systemic lupus erythematosis " and " Drug- or

> radiation induced immunosuppresion "

> >

> > Patients with co-morbidities

> > This includes patients with " Previous prosthetic joint

> infections, Malnourishment, Hemophilia, HIV infection, Insulin-

> dependent (type I) diabetes, and Malignancy "

> >

> > Other total joint patients who are over two years out of surgery

> and who do not have additional risk factors are not included in the

> guidelines.

> >

> > NOTE: This is an " Advisory Statement " . Included in the article is

> the disclaimer, " Practitioners must exercise their own clinical

> judgment in determining whether ot not antibiotic prophylaxis is

> appropriate. "

> >

> > This means that your surgeon and your dentist should confer and

> make the correct decision in your case, but in the absence of the

> OS's preference or other mitigating factors, most dentists will

> follow these guidelines.

> >

> > Here is the ADA's URL on this advisary statement. I do not know

if

> this is available for the public or not.

> >

> > http://www.ada.org/prof/pubs/jada/reports/prophy/index.html

> >

> > I hope this information is useful to the group.

> >

> > MLTDMD

> >

> >

[Guest guest]

Absolutely! This advisory does not affect other areas of concern and need for

antibiotic prophylaxis such as preventing bacterial endocarditis in patients

with heart murmurs, prosthetic valves, Etc. It only relates to total joint

patients.

MLTDMD

Re: Antibiotic Prophylaxis

At 08:49 PM 7/22/2003 -0500, you wrote:

>There are some patients who do require prophylaxis indefinitely, which

>include:

>

>Immunocompromized / immunosuppressed patients

> This includes patients with " Imflammatory arthropathies such as

> rheumatoid arthritis, systemic lupus erythematosis " and " Drug- or

> radiation induced immunosuppresion "

>

>Patients with co-morbidities

> This includes patients with " Previous prosthetic joint infections,

> Malnourishment, Hemophilia, HIV infection, Insulin-dependent (type I)

> diabetes, and Malignancy "

>

>Other total joint patients who are over two years out of surgery and who

>do not have additional risk factors are not included in the guidelines.

And don't forget one of the most common reasons-heart murmurs.

C+ 5/25/01 and 6/28/01

[Guest guest]

I understand your concern about flossing causing bleeding and possibly

bacteremia. But remember, it's far better to remove the bacterial plaque between

the teeth by flossing then to let that bacterial colony grow and remain as a

chronic source of infection.

If you floss regularly, the swelling and inflammation will be reduced and

eventually you will have little or no bleeding. More importantly, disrupting and

removing the bacteria will remove a dangerous source of infection from your

body.

Obviously, your dentist and / or hygienist should be consulted for the best

advice on how to clean your teeth most effectively and if there is any serious

concern about infection / bacteremia. Sorry, but it's the same old advice...

brush and floss, brush and floss... see your dentist and hygienist regularly.

It's worth the time, trouble and expense to keep healthy!

MLTDMD

Re: Antibiotic Prophylaxis

Thanks ! That is an interesting bit of information. I was

thinking about those guidelines today.

I have a question. I understand we are to take antibiotics to prevent

bacteria from causing problems when we have our teeth cleaned. What

about when we floss (particularly when we are still on blood thinning

meds or the aspirin)? It makes our gums bleed. Should I be concerned

about that?

Dr Gross 6/12/03

RHR C2K

> I'm not sure how to send a message to Surface Hippy on a new

subject but here goes....

>

> There's an interesting " Advisory Statement " in this month's JADA,

The Journal of the American Dental Association on " Antibiotic

Prophylaxis for Dental Patients With Total Joint Replacements " . The

advisory statement was worked out by the ADA and the AAOS to provide

guidance to dentists who treat total joint patients.

>

> It appears to present a new standard of treatment for these

patients and undoubtably will become standard of care in most dental

offices and in most courts of law. I will try to summarize the new

reccomendations here.

>

> The most striking new reccomendation is that patients with total

joint replacements who are generally healthy do NOT need antibiotic

prophylaxis after two years, post surgery. There are some patients

who do require prophylaxis indefinitely, which include:

>

> Immunocompromized / immunosuppressed patients

> This includes patients with " Imflammatory arthropathies such as

rheumatoid arthritis, systemic lupus erythematosis " and " Drug- or

radiation induced immunosuppresion "

>

> Patients with co-morbidities

> This includes patients with " Previous prosthetic joint

infections, Malnourishment, Hemophilia, HIV infection, Insulin-

dependent (type I) diabetes, and Malignancy "

>

> Other total joint patients who are over two years out of surgery

and who do not have additional risk factors are not included in the

guidelines.

>

> NOTE: This is an " Advisory Statement " . Included in the article is

the disclaimer, " Practitioners must exercise their own clinical

judgment in determining whether ot not antibiotic prophylaxis is

appropriate. "

>

> This means that your surgeon and your dentist should confer and

make the correct decision in your case, but in the absence of the

OS's preference or other mitigating factors, most dentists will

follow these guidelines.

>

> Here is the ADA's URL on this advisary statement. I do not know if

this is available for the public or not.

>

> http://www.ada.org/prof/pubs/jada/reports/prophy/index.html

>

> I hope this information is useful to the group.

>

> MLTDMD

>

>

[Guest guest]

Thanks for the response! My gums don't normally bleed when I floss

because I try to floss regularly. I think since I'm still at the

stage where I'm having to take the aspirin after surgery, my blood is

a little thin and my gums bleed a little more than usual. I still do

it though. Just had me a little concerned. Thanks!

Dr Gross 6/12/03

RHR C2K

> I understand your concern about flossing causing bleeding and

possibly bacteremia. But remember, it's far better to remove the

bacterial plaque between the teeth by flossing then to let that

bacterial colony grow and remain as a chronic source of infection.

>

> If you floss regularly, the swelling and inflammation will be

reduced and eventually you will have little or no bleeding. More

importantly, disrupting and removing the bacteria will remove a

dangerous source of infection from your body.

>

> Obviously, your dentist and / or hygienist should be consulted for

the best advice on how to clean your teeth most effectively and if

there is any serious concern about infection / bacteremia. Sorry, but

it's the same old advice... brush and floss, brush and floss... see

your dentist and hygienist regularly. It's worth the time, trouble

and expense to keep healthy!

>

> MLTDMD