Dental work before surgery

Hello @deedth64 Before heading into surgery, most clinics prefer to have all dental work done before the procedure. Depending on the protocol of the surgical team they may suggest a prophylactic dosage of antibiotics in conjunction with the dental procedure, especially since you’re having an implant. That’s quite invasive into the bone. Definitely talk to your cardiologist to see what they have to say.

There was a recent discussion in Connect with someone else having similar surgery for an aneurysm so I thought you may want to meet @partyon, who did have their dental treatment before undergoing their procedure.

Dental work before surgery
https://connect.mayoclinic.org/discussion/dental-work-before-surgery/
If you’re having a dental implant with a bridge, this takes months and many steps to complete. Not sure it’s the best scenario for your heart surgery to wait that long. So you may have the implanted portion of the dental work done first…which takes a few months for the implant to build new bone around before work can be completed. Then after the surgery you’ll be able to have the new prosthetic placed on top of the implant.

Wishing you all the best on both ventures! Will you let me know how it all plays out?

I don't have any surgery planned this is just dental work. My aorta is mildly dilated. My concern is the dental procedure itself I don't want the stress and anxiety of the procedure to have an adverse effect and cause the dilation to grow. In the end we decided that I need to have clearance from the Cardio doctor so the DDS knows how to sedate me during this procedure and is aware of the BP though out. Honestly I really don't want the implants insurance costs I am good with a removable bridge but we'll see what happens.

Hi @deedth64. Oop, I guess I misunderstood. I thought you had surgery coming up relatively soon. Then you do have some time to work through your dental decisions. I can understand the hesitancy with the implants relative to cost, length of procedures and stress. There are other options to replace your current bridge besides the implant…with pros and cons to each of them, including the implants. So if you need a sounding board to help make an informed decision just let me know. I’ve had 30+ years in the dental field.

It will be good to get your Cardiologist’s take on this. ☺️

I need dentures because my C PAP machine along with poor dental care has resulted in “ weak “ teeth.
Some are broken , some are rotted black and some are loose and a few were extracted . I’m pretty sure I have some kind of infection too.

My dentist obviously knows how bad my teeth are and is itching to get me in due to the possibility have a dangerous infection which can spread to the rest of my body. Especially my heart since I have a mechanical aortic valve replacement.

All they want me to do is take 10.000 dose of antibiotics. Don’t need a cardiovascular surgeon.
An hour before the extraction. Nothing else needed. I bleed a lot because I’m on Coumadin to manage my blood management due to the mechanical aortic torn aneurysm.
Last time I had dental work I woke up the next morning with a lot of blood so I had to have an ER visit to stop it.
Now she stitches the hole up. Scary. Just local anesthesia by needles. Last time I needed 6 shots of local anesthesia. I want sedation but most dentist also have to have a 4 year extra training and insurance doesn’t cover the anesthesia. Just the extraction and stitches.

Hi @andytheman. Your dentist is looking out for your health in trying to schedule your extractions and dental work soon because there is strong evidence to support the link between poor oral health and heart disease/stroke. Preventing any type of infection around your valve replacement from dental extractions necessitates the need for a prophylactic dose of antibiotics. It helps prevent infections of the heart valves-a condition called infective endocarditis.

Tossing in a few articles for you to read.
https://www.heart.org/en/news/2021/03/19/how-oral-health-may-affect-your-heart-brain-and-risk-of-death
~
Why the antibiotics are important.
https://www.uptodate.com/contents/antibiotics-to-prevent-heart-valve-infections-beyond-the-basics
Usually there’s no need to have general anesthesia for extractions. The exceptions frequently being having all 4 wisdom teeth removed in one sitting. So in a case like yours it’s pretty customary to only use local injections of anesthetic. With local anesthetic there’s typically no restriction on driving afterwards and the local keeps the area numb for a couple hours. Having the extraction site sutured can help with the healing process by closing the open socket a little better. It can also help with keeping the bleeding under control. No vigorous swishing of water, no sucking through a straw and no smoking for 48 hours after extractions. You want to protect the blood clots that form in the tooth sockets.
After the extractions, remember to bite firmly on the gauze provided by the dentist. If you’re on Coumadin it may take longer for the bleeding to stop. So you may have to use fresh placements of gauze throughout the day. It’s normal to have blood tinged saliva after extractions for 24 hours. But if you have a more prolonged bleeding let your dentist know. Another good trick to stop bleeding is to boil water, soak a tea bag. Then, let the tea bag cool, gently squeeze out the excess water and bite on the tea bag for 20-30 minutes. The tannins in the black tea help to stem the bleeding.
Good luck with your extractions. What type of replacment teeth is your dentist recommending?

Thanks for the reads. I never knew how important it is to get broken, cracked, loose teeth and cavities. Much is written about a non mechanical valve but I think it doesn’t hurt to use antibiotics. Although antibiotics have their own issues but it outweighs the risk of infection of my heart and brain bleeds. As it is I’m sure you know about NRI levels that can cause brain bleeds resulting in strokes or clots blocking your arteries which is dangerous.
If my blood level of Coumadin is too thin I would be prone to brain bleeds. I heard of a dentist that accepts Medicaid ( I’m disabled and 71 years old)
People who are residents in my Assisted Living Facility have gone to this dentist that they say they don’t get hurt by him. His specialty is geriatric extractions. No pain extractions are what he’s good at. I’m going to try to get in which I should because his hygienist comes every 6 months to clean our teeth. She recommended her boss who happens to be the house dentist. I’m anxious to start because I have so many things in my heart, esophagus, right vocal cord paralysis and an aortic artery with a tear in it. That and blood thinners makes me concerned because if I bleed because my blood level is thin and an abdominal aortic tear could kill me if it burst. I also had an esophagus “stretch “ because my food was baking up so the possibility of aspiration into my lungs could cause pneumonia. Plus I am being monitored for a spot on my right lung.
It’s probably time I start taking care of myself as I’m not getting any younger. My birthday is in 3 days and I want to live into the 80’s. Thanks for encouraging me.