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  • antibiotics for dentist

    someone told me today that their daughter had scoliosis surgery and for 5 years post surgery she has to take antibiotics before she goes to the dentist for the next five years. My doctor never mentioned this to me and i was curious if anyone else has to do this and her daughter used the same dr. as mine.

    jennifer

  • #2
    Hi Jennifer...

    The use of prophylactic antibiotics after spine surgery (or other implant surgery) is fairly controversial. Here are some links to study abstracts on the topic:

    http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15040070
    http://www.ncbi.nlm.nih.gov/entrez/q..._uids=12423612
    http://www.ncbi.nlm.nih.gov/entrez/q..._uids=11805936

    If you're concerned about it, I'm fairly certain that most doctors and dentists will prescribe an antibiotic for procedures if asked. However, I've found that my dentist and doctors think that the incidence of infection is so low that it doesn't warrant medicating every implant patient before every dental procedure.

    Regards,
    Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

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    • #3
      antibiotics for dentist

      thanks linda for responding. My dr. never mentioned that to me and i'm wondering if i should call them and ask them about it. If this woman never said this to me i never would have gave it any concern and i've never heard of this before.
      jennifer

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      • #4
        Hi Jennifer,

        Rather than calling the ortho, I would call the dentist. Some dentists are quite strict on the prophylactic antibiotic thing, while others have a similar attitude as Linda's doctors/dentists. Some of the issue comes from what kind of treatment is being done. Braydon has a mild cardiac issue, so he always pre-medicates as a precaution regardless. We had no idea that implants were in this same category until I was filling out a medical form once and this question was asked. Each doc/dentist is different. Personally, I agree with Linda's docs. There are people who are at a higher risk of infection. Those people should be pre-medicated. I'm not sure a routine scoliosis surgery would qualify as a higher risk category. I'm not a doc, so please get permission from your ortho and dentist together.
        Carmell
        mom to Kara, idiopathic scoliosis, Blake 19, GERD and Braydon 14, VACTERL, GERD, DGE, VEPTR #137, thoracic insufficiency, rib anomalies, congenital scoliosis, missing coccyx, fatty filum/TC, anal stenosis, horseshoe kidney, dbl ureter in left kidney, ureterocele, kidney reflux, neurogenic bladder, bilateral hip dysplasia, right leg/foot dyplasia, tibial torsion, clubfoot with 8 toes, pes cavus, single umblilical artery, etc. http://carmellb-ivil.tripod.com/myfamily/

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        • #5
          Jennifer...

          I spoke to my daughter's dentist and he said she probably wouldn't need to be pre-medicated. The only reason I knew to ask was because my Mom has artificial knee joints and she has to be pre-medicated. However, I asked my daughter's surgeon and he said he will pre-medicate her for a year as a precautionary measure. He explained that since the back is pretty much "self-contained" infection is less likely to settle there.

          Like Carmell said, each doctor/dentist is different. My other daughter has what our cardiologist calls a "functional heart murmur" and doesn't require her to be pre-medicated. The first time I took her to her dentist, he actually called the doctor's office before he would treat her just to be sure.

          Mary Lou
          Last edited by ; 12-01-2004, 04:43 PM.

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          • #6
            antibiotics for dentist

            thanks everyone for your input i appreciate it. Now how about the orthodontist would that be the same thing?? She wears braces would the same go for that kind of work?

            jennifer

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            • #7
              Jennifer...

              I believe that the risk is in dislodging bacteria that lives in our mouths, into the bloodstream. I think that it can actually happen from simply brushing or flossing the teeth. I doubt that anyone would recommend that your daughter be medicated every time she sees the orthodontist, but you should ask the orthodontist to be sure.

              Regards,
              Linda
              Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
              ---------------------------------------------------------------------------------------------------------------------------------------------------
              Surgery 2/10/93 A/P fusion T4-L3
              Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

              Comment


              • #8
                I agree with Linda. I wouldn't worry too much about orthodontist appointments as I would question a regular dental appointment. With braces, they are usually just changing the colored bands and making adjustments to the wires. With dental cleanings, they are scraping at the teeth and gum line which do tend to cause some bleeding.

                My advice would be to contact your surgeon and ask him/her. Make sure you call well in advance of her next ortho. appointment because if they decide to medicate her, she'll probably have to take antibiotics the day before, the day of and the day following her appointment, atleast that's how my Mom has to take hers.

                Mary Lou

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                • #9
                  antibiotics for dentist

                  thanks linda and marylou for responding. I'm glad i was informed of this because i had no idea and i don't even know if i would have mentioned to the dentist that she had surgery since she wouldn't be going there for a few months. She needs to go to the ortho though as soon as she is able to get into their chair. I am wondering when she will be able to do that.

                  jennifer

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                  • #10
                    antibiotics

                    Dr. Boachie has me take just one dose of Clindamycin (allergic to penicillin)an hour before dental work. Before my colonoscopy I took a different antibiotic by mouth(Cipro) an hour before the procedure.(different organisms in the gut). My gastroenterologist really questioned the need. The trend is not using antibiotics so often because of antibiotic resistence. But Dr. Boachie was adamant because I has had an extensive revision 2 years ago.

                    The current thinking according to his office is antibiotics the first 2-3 years after revisions.

                    Karen
                    Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
                    Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

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                    • #11
                      antibiotics for dentist

                      thanks karen i wish they would have told me at boachies office. I guess i will call there and ask them about this.

                      jennifer

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                      • #12
                        Jennifer,

                        Bill was supposed to go to the orthodontist about 10 days ago but didn't because we were flooded in (so I can't tell you how it went) BUT we did contact the orthodontist ahead of time and asked about antibiotics. She said that when the work is invasive he will need antibiotics ahead of time, but he will not need them every time. So, you might want to ask when you schedule the appointment.

                        Susan

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                        • #13
                          antibiotics for dentist

                          thanks susan
                          i will call them ahead of time. Let me know when he goes to the ortho and how he makes out getting in the chair. Nicole needs to go before she goes back to school to get her rubberbands changed.
                          How did he make out going to school???
                          jennifer

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