Post transplant dentist checkup and antibiotics

[RichardMEL]

So I'm 7 months post tx, and I have my first dental checkup next weeksince the transplant, since I was advised t wait six months before seeing the dentist due to infection risks with the initial high doses of the immunosupressants and all that. So I mentioned that I was going to the dentist at clinic and they gave me a script for antibiotics to take which i filled (5 day course of treatment).

All this I expected.

However in the rush I forgot to ask when I'm supposed to take the antibiotics! I'm presuming I should start the course before the dentist or after I see them, but I'm not sure. It would make sense I guess to start the course the morning of the appt then continue after the appt so if I do get any kind of infection, bacteria in there from the cleaning and whatever else they do, that the antibiotics will jump right on it there and then.

Anyone have any experience with this? I can email the tx co-ordinator to confirm what they want, but thought I'd ask here what others have benen advised, or done.

[Chris]

When I was allowed to take antibiotics, I took them before the dental appointment. However I forgot if it was 5 days prior to visit or to start 1 or 2 days prior to visit thus allowing it to be effective after procedure.
 
Call them up when you can.

[cariad]

I was only given a single dose, and told to take it 1-2 hours before the appointment. It worked and I came through it with no infections. A five day course seems excessive, but I guess that's how they do it these days.

[rsudock]

When I went to the dentist 2 500mg amoxicillian an hour before and after the dentist appointment. This was when I was on dialysis though. I actually just stopped going to the dentist for a bit with the first transplant b/c I didn't want to risk harming my kidney...when it started rejecting 10 years later I started going to the dentist to get my dental work updated for a new transplant. The transplant center did not give me anything since I was 10 years out...



good luck!

xo,

R

[Chris]

Zythromax is what I was usually given prior to dental appointments that was a 5 day packet., and then other types before I had problems with antibiotics and detal procedures. Now the doctors  do not have me take anything. One pill would be great though

[RichardMEL]

cool. thanks all I have emailed the TC just to be safe with what they want. It does make sense to start the morning of any procedure and go from there, but our guys might have their own preferred schedule. Better to ask a dumb question than just guess


incidently when I was on D and going to the dentist I never took anything and had no issues. Obviously post-tx we all know how important oral health is so I want to be extra careful.

[Jie]

I had also one dose taken one hour before the appointment. I had my teeth cleaning 2.5 months post transplant.

[Chris]

RM this is not a dumb question, it is an important question.

[okarol]

I was only given a single dose, and told to take it 1-2 hours before the appointment. It worked and I came through it with no infections. A five day course seems excessive, but I guess that's how they do it these days.

Same for Jenna - one dose of 2000 mg of Amoxil one hour before treatment.

[Jelena]

Goran was given amoxicillin (don't know how it's spelled) 4 pills 1 hour before the dentist appt. He had his dentist appt. scheduled from before and it falls a little less than two months post-transplant. He asked his transplant doctor if this is too soon, and he said it won't be a problem, gave him prescription and told him to go to his appt. Now I am thinking reading your posts, is it too soon anyway?

[Marina]

I  was  told  the  magic  number  to  start  going  back to  the  dentist  was  3  (3 months  out).
I  was  instructed to  take  2000mg amoxicillin   (4-500mg caps)   1 hour  prior  to  appt.
I  wasn't told  about  taking  it  post  appt.  but   then again, it  was  just  a simple  cleaning.

By  the  way  on  PD  I  was  given the  same prescription.
The  reason  for the  antibiotics  is  because    we  carry  the  MOST  bacteria  in our  mouths   
It's  so  very  easy   for  bacteria  to  enter  our  blood  stream  when  teeth  are  cleaned  due  to  bleeding  of the  gums.

[RichardMEL]

Well if this threadproves anything it's yet again how different tx units/doctors/whatever have different standards about this kind of thing.

Anyway I got an email back from my TC, and she initially said it if's just a check up and clean then don't bother taking anything (!) only if there was an extraction or some other more invasive proedure. I mentioned that often when I have a cleaning there can be blood because I do have a small bit of gum disease that has been treated for the past X years, and given how much  they harp on about oral health I asked if it would be best to just take the course of antibiotics under the idea that it's better to be safe than sorry (I mean I don't see what harm it could do - unless I'm allergic or something - but I don't think I am). Anyway so she basically said well sure if it makes you felel better to take it then take it. I got the impression she thought I was worrying too much.

So anyway yeah start the 5 day course (1 tab, twiace  aday) the day before the appt, and go till finished. So that's what I'll do

[rsudock]

I had an inclinging that they were going to tell you don't worry about it....glad they did give you something though. I think you are not out long enough from the transplant to not take anything, but hey what do I know with my honorary nephrology degree!?!   

xo,
R

[Chris]

but hey what do I know with my honorary nephrology degree!?!   

xo,
R

Just remember this rsudock, Your a legend in your own mind! 

[rsudock]

but hey what do I know with my honorary nephrology degree!?!   

xo,
R

Just remember this rsudock, Your a legend in your own mind! 

so true, so true!! I had a boss say this to me once as well!!

[RichardMEL]

Yeah but Rachel you're much hotter than 90% of the renal staff I deal with, so I'll take your advice anyway!!!    

I agree that *I* feel it is still too soon - so I'd rather have the antibiotics there just in case to be safe rather than sorry. It might be overkill, but I don't think it will hurt me to take them, so if all it does is make me feel more confident then it's worth it.

I'd hate to somehow get an infection because I didn't take something when I could have.

[rsudock]

Yeah but Rachel you're much hotter than 90% of the renal staff I deal with, so I'll take your advice anyway!!!    

I agree that *I* feel it is still too soon - so I'd rather have the antibiotics there just in case to be safe rather than sorry. It might be overkill, but I don't think it will hurt me to take them, so if all it does is make me feel more confident then it's worth it.

I'd hate to somehow get an infection because I didn't take something when I could have.

well yes besides being hot, I do have my life experience....double threat gal!!!   

xo,
R

[Chris]

Probably a bad joke, but I'll say it anyway.
I thought I read that as a double treatgal, but either way is good.

[RichardMEL]

Just to update this one post the dentist.

I went to see him and first of all my teeth are doing OK. Not awesome, but not too bad since it's been 8 months since I went.

Anyway the dentist basically thought it was a waste of time being on the antibiotics (he agreed with the TC) but he then mentioned what most of you guys said - that if you're going to do it take a large dose an hour or so prior to treatment, then another one say 6 or so hours later, rather than a 5 day course which is what I was doing. I got the impression he was saying that the "normal" dose wouldn't be enough to kill anything happening during the dental work, but a big one would help with that. As I said though he seemed to think it was all not really needed for just a check up and clean.

At any rate it's been a couple of days since and I don't think I have an infection or anything, so that's good - if it's due to me taking the antibiotics or not. I'm happy to be safe than sorry, but for next visit (November) I'll maybe ask the neph if they think a big dose is the way to go, or maybe just forget it, as that will be around 1 year post tx (well just a little before) - omg time flies!! - so perhaps I'd be OK to go without.

So anyway all's well that ends well, for now anyway

(although I did note in the information that came with the antibiotics that it says if you're having blood tests it may affect some results and to let docs know - well I am having regular blood tests tomorrow!! lol. Still at least if some of the results are fishy there will hopefulkly be a reason).

[C904]

In my post transplant book it had a message about making sure you let your doc know about going to the dentist and you will be prescribed a antibiotic.  I had my transplant December 2010 and I went to the dentist May 2011, I asked my transplant doc about what I needed for antibiotic and he said you don't need anything unless you have heart problems.  I went and everything worked out good.

[monrein]

I also raised this with my dentist since in all my years of being transplanted I was never advised to take antibiotics.  He said the same thing about only taking them if there were heart problems present.

[Savemeimdtba]

Richard!  I haven't been here in forever and just found out you got a transplant - that is AWESOME! I am so happy for you Maybe I can take it out for a spin sometime

[RightSide]

Just this past Wednesday, my transplant team informed me that my hospital (Massachusetts General) no longer requires renal transplant patients to take prophylactic antibiotics when receiving dental work.  She said there's some new research that it really doesn't have much of an effect anyway, as long as the immunosuppressants haven't totally smashed your immune system.

However, my oral surgeon prescribes prophylactic antibiotics for all patients receiving surgical procedures (tooth extractions, sinus lifts, etc.)--so I still take antibiotics for those purposes.