Now What?!?!? Dental work....

[malaka]

Went to dentist for routine exam/cleaning.  First time since I started dialysis.  Dentist announces that she can't/won't even authorize a cleaning without clearance and pre-treatment antibiotics from nephrologist.  Who knew this? 

I did get xrays and a cursory exam without the usual pick routine at the gumline.  So now I have to see my nephrologist and take some antibiotics (maybe) before routine dental work.  She said she knew the dialysis center uses heparin (not for me since I'm on coumadin, but I couldn't convince her that I wouldn't bleed to death) so my dental appointment has to be on a dialysis "off" day, too.

What other complications am I going to be looking forward to that I didn't know about and nobody told me about?!?!?!?!?

[cdwbrooklyn]

Please go get your meds before having work done on your mouth.  This is one thing I did not do and suffered with a baterica in my blood.  I had to go in center (I do it at home) for six weeks to get IV antobics for one hour.  If I did not do so, I would have died because the baterica travels to your heart.  The next visit to the dentist, I will get some antobics  first.   

[noahvale]

*

[wbdoug]

This is interesting. I have had my teeth cleaned two times since starting dialysis and there was no mention of taking antibiotics prior to the appointment.

Bill

[smcd23]

I've never heard this either - We were told that if you needed dental work done (more than just a cleaning) then yes, antibiotics are needed. When SO had his wisdom teeth removed (they were impacted and got infected) he just had to be on antibiotics to clear up the infection prior to the extraction. Even the cheapo dentist he goes to for cleanings will still clean his teeth and everything without antibiotics. If he needed any more work, or it appeared he had broken teeth or an active oral infection, then he'd have to get antibiotics.

But maybe every dentist/nephrologist is different and some take more precautions...

[amanda100wilson]

Always advised to take an antibiotic one hour prior to appt. for cleaning or anything.  Risk of endocarditis from mouth bacteria.

[paris]

From the beginning of kidney diagnosis, I was told to always have antibiotics before going to dentist for anything, even cleaning.  Better safe than sorry.

[smcd23]

That's so strange that we were told only if he needed actual work or had an active infection. I am going to ask our new coordinator about it next time I speak with her. Wish I had her email, I'd email her now...

[KarenInWA]

In all my years of being a CKD patient, I never had to take antibiotics before a dental appointment. And that included getting a crown done. I was going to go in for a cleaning with my chest cath, but ended up postponing it unit a few weeks after it was removed. No antibiotics then, either. Now that I am a transplant patient, I take antibiotics before every dental appointment. They won't work on me without it!

KarenInWA

[Joe]

Neither my Neph nor my dentist have said anything about taking antibiotics before a cleaning. Now, I may be going in for a couple of extractions and implants, don't know what the process is going to be for that.

[Chris]

Could it depend on what they find on intial visit? That is if you haven't seen a dentist n a long time. Maybe if you have had the same dentist for years or is not knowledgeable about CKD have an impact? When I started seeing a dentist again due to request of transplant, the first visit was to look at my teeth and xrays, then on second appointment I had to take antibiotics. Now with transplant I do not take antibiotics due to troubles I had with them with dental visits.

[amanda100wilson]

Joe, I was advised against implants.  I take it your dentist is aware of your medical history.  Suggest you run it ,past your neph. First.

[Darthvadar]

My mum, who's in Renal Failure and on PD had to take antibiotics before every visit for a recent course of treatment...

What was this treatment???... New dentures!... Yep... The new mouthful of delph meant a large dose of antibiotics prior to every visit....

Mum was treated at a Dental University Hospital, and they took no chances... They were wary of causing a little nick inside her mouth, and were covering all bases....

I've a replacement knee, and due to disability, I've also a dodgy heart valve... I have to take antibiotics and have an injection of steroid even before exams and cleaning... As others have said, better safe than sorry... You've enough to be dealing with without taking the risk...

Ask your doc to prescribe enough doses for several visits...

Good luck with your treatment...

Darth...

[Cordelia]

I was prescribed amoxicillan, having to take one hour prior to dental visit. I had to pop 4 pills before going.       

[malaka]

I just got off the phone with the doctor's office and the gal at the desk said "Oh, you need a script for amoxicillin.  I'll let the doctor know.  We'll mail it to you unless you need it right away".  (Thanks, Cordelia, you are right as usual).  So, apparently, this is Standard Operating Procedure. 

The only disappointment is that she told me I was TOO OLD for the pediatric, bubblegum flavored version of amox.   

[Cordelia]

I just got off the phone with the doctor's office and the gal at the desk said "Oh, you need a script for amoxicillin.  I'll let the doctor know.  We'll mail it to you unless you need it right away".  (Thanks, Cordelia, you are right as usual).  So, apparently, this is Standard Operating Procedure. 

The only disappointment is that she told me I was TOO OLD for the pediatric, bubblegum flavored version of amox.   

Hi Malaka,

I had some cavities needing filling a few months ago. I went for an initial consult where my dentist took X-rays and looked inside my mouth and did some picking around with a pick only.

He then consulted my nephrologist who said I needed what's called a "pre-med" 

I had suspected having to take something only because one of my friends who had a transplant years ago told me she had to take a pre med prior to any dental visit. I inquired with my dentist asking if I needed to have the same thing even though my kidneys are damaged, I thought whatever, the kidneys are damaged, who needs to take something anyways if the kidneys are screwed, it didn't make any sense to me.....However, my dentist said I had to take a premed because of my central line.  That's what I was told.  He told me since it goes into the heart, I had to take the premed to protect in case I get infection......

The stuff I didn't realize....geesh, I thought.  I couldn't get over the thought of having to take 4 of these huge horse pills prior to having a cavity filled.           
The stuff I took for granted before, I can't anymore.....

But I guess its better to be safe than sorry I always say!