Dental work

[mamagemini]

What are some of your experiences getting dental work done while in ESRD?

[Traveller1947]

Tell your nephrologist about your plans for dental work, even cleaning.  He'll prescribe an antibiotic that you'll take beforehand.  This is a very important precaution.  All the best to you, mamagemini.

[AnnieB]

Why do you need an antibiotic before dental work?

[monrein]

I've never had an antibiotic prior to dental work.  Not on dialysis and not with transplant.  The exception would be implant surgery but I never took them even with gum grafts.

If you have heart issues that is another story but many nephs and dentists do not automatically require them for dental work.

[cattlekid]

Dentist #1 would barely touch me after renal failure.

Dentist #2, who I switched to after firing dentist #1, said dentist #1 was an idiot. I have no problems getting basic cleanings and fillings.

[mamagemini]

The antibiotics are any infection that might set in during the surgery. Considering the ESRD is in full force the immune system is down. On top of that the steroid inhaler I use is anther factor. Better safe than sorry.

[MommyChick]

I guess each nephrologist could be different but I was always told I needed antibiotics. When I had my transplant & even being on dialysis now, always antibiotics. It might be a pain at times but its better to be safe then sorry!

[jbeany]

When I got on the list, I was told that my hospital's requirements were antibiotics for even a simple cleaning and checkup.  One year after my transplant, the hospital sent out a letter with the new policy - no antibiotics needed for simple care like cleanings, cavities, and caps, according to recent studies.  So, the real answer to the antibiotic question is - do whatever your hospital tells you so you can stay on the list. 

I haven't had any problems with care either before or after - except for hating to get near a dentist!

[mcclane]

When I got on the list, I was told that my hospital's requirements were antibiotics for even a simple cleaning and checkup.  One year after my transplant, the hospital sent out a letter with the new policy - no antibiotics needed for simple care like cleanings, cavities, and caps, according to recent studies.  So, the real answer to the antibiotic question is - do whatever your hospital tells you so you can stay on the list. 

I haven't had any problems with care either before or after - except for hating to get near a dentist!

x 2 on that.  I recently had my teeth cleaned and I had to take amoxilin before the the dental hygienist will even start cleaning. 

[Deanne]

I hate the dentist, but I get there twice a year. Blech. I've never had to take antibiotics before a routine cleaning or crowns/cavities. I had to take them before I had a root canal, but it sounds like they have everyone do that. My dentist knows I'm on the transplant list. The transplant center had him fill out a dental clearance form before they listed me. It's never been an issue.

[sullidog]

I was only required to take one before I had my wisdom teeth out but for cleanings, no.

[let.us.try]

I am not aware of any issues but if you are very sensitive to the thought of bleeding you can ask?

You could tell your nurse or doctor if you are on blood thinners like Coumadin or Plavix. Baby aspirin is a none issue and I don't think heparin is so bad. Ask is you can hold for a day before.

[RichardMEL]

A couple of comments here:

pre-D  it was highly recommended I get big dental work (basically wisdom teeth out) done before that. First it was considered a really good idea to get that done before any transplant came near(due to infection risks). And also so recovery could be done sort of independant of dealing with D. As it was my surgery went pretty OK and I was back at work the next day it was easy enough.

I never used antibiotics for dental checks while on D. Dentist was aware of my renal issues and being on D. It was treated as normal.

post-tx though oral health is considered extra important because the mouth is one of the areas most pront to getting bacteria in and chance of infection - which makes a lot of sense - so they like you to keep dental checks up. I talked o the crew about antibiotics - both the tx neph and also the dentist himself - there was some disagreement but in the end *I* went with the "safer than sorry" approach and took some and there were no issues - tha was for my first check and clean which I put off till 6 months post-tx (as recommended). I've been going every 4 months since and not bothered with the AB's and no issue. I did discuss this choice again with the docs and dentist and they all agreed that it was probably OK given my meds were coming down to a more stable level and the risk was not quite so high, but if I had a tooth out or other work like that then yes a good idea. So far, no issues.

I do understand and appreciate doing it under the "better to be safe than sorry" mantra - specially post-tx, but while on D TBH I am not sure it is such a big deal - but everyone's situations are different.... like.. a steroid inhaler? Never heard of that one - I thought that would be the sort of thing the beefcakes down at the gym might be nto....