Mayo Clinic Connect
I was just diagnosed wit probable MAC ( ct scan). My dentist wants to wait to finish my crown until definitive diagnosis. Is this normal?
@crepassNever heard of that, and I am the queen of dental work- crowns, bridges, implants etc.. With MAC you are only infectious to yourself. Many have suggested it is the water in dentist offices that is a “way in” for mycobacterium especially with invasive types of dental work. I would be interested in knowing why your dentist wants to wait. That is odd to me. (Irene5)
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@crepass, Hello. Like Irene said, I had never heard of a dentist putting off dental work over mac. But then again; dentists, like drs are sometimes in uncharted waters when it comes to mac. You may want to ask 'why' he doesn't want to do the work. Are you on antibiotics at the present?
Just a guess here but I suspect your dentist, like many other health professionals, don’t understand the nature of MAC and what it actually means contagion-wise. I’ve had the same reaction from my dermatologist,
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I just told him I might have an infection(after ct scan). He said to wait and get definitive diagnosis before finishing crown. I’ll call him and try again now that the pulmonologist has said MAC. I’m not on antibiotics yet. He is still trying to get a “deep?” Sputum sample. By hydration , doxycycline, and bronchodilators for next 2 weeks. Hope it works . The pulmonologist also said it’s a “light” case of MAC. Is that a thing? Sorry so many questions. I appreciate your replies.
My hygienist now uses an ultrasonic scaler instead of the older hand held scraper kind of tools when she cleans our teeth, and she really thinks it’s better for your teeth. It means I’m breathing in the mist the whole time she’s working. It’s cool rather than steamy, but I’m wondering if I’m being exposed to a big dose of mycobacteria anyway. I’m (hopefully) just about to finish my course of the big three and don’t want to have to start over! Anyone have any thoughts or experience that might help?
The last time I went to the dentist I asked the hygienist not to use the ultrasonic scaler because of the mist in my face the whole time. I don't know if it's a issue but I figure I'd rather be safe then sorry.
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My dentist went back to the old way because his patients prefer it.
I spoke to my hygienist before she began cleaning my teeth. She knew about NTMs and said they use purified water for the de-scaling. That way there wouldn’t be any biofilm in the lines. I’m hoping that is correct because I also worry about breathing in the mist.
@marthachs I am afraid I cannot offer anything helpful. I just had my teeth cleaned at the dentists and I just held my breath a lot for as long as I could to avoid breathing in the mist.
@crepass Hello –
Sorry I missed this post. Do you have any more information on your infection from your pulmonologist? There are varying ways to get a sputum sample. When first diagnosed, I was coughing 24/7 and they just used what I coughed up in the AM for 3 days in a row, delivered to their lab. Later when I had trouble coughing up sufficient sputum for a culture, my doc had me neb with 10% saline in the office – I coughed like crazy & they got enough to sample. My daughter's doc was doing a bronchoscopy on her for another reason, and got a sample during the test (hers was negative, thankfully.)
Maybe the pulmonologist meant that there is some evidence of MAC infection on the CT, but not a lot – as MAC progresses, if not treated, some people begin to show more evidence of infection – pockets or shadows, I've had docs describe them various ways.
The sputum sample, cultured for 6-8 weeks, tells the doc exactly what strain(s) you have. The "bugs" are then subjected to sensitivity testing to see which antibiotics they respond to. This is very important, because various strains respond to different antibiotics. I have M. avium intracellulare and M. gordonae, both of which respond to a combination known as the "Big 3" here – azithromycin, rifampin and ethambutol. I was treated for 18 months until my symptoms and the evidence of infection on the CT resolved. My sputum still tests positive, so I use 7% saline & a bronchdilator to try to keep it down. If I get symptoms again, I may need to restart those antibiotics or different ones (praying not!) Other people with different strains may be treated with other drugs, but almost all must be treated with more than one antibiotic, either in combination or alternating, because NTM (non-tubercular mycobacteria) are notorious for developing drug resistance.
If you have done much reading, here or elsewhere, you are aware that MAC is very slow-growing, needs to be treated for a long time to eradicate it, and occurs just about everywhere in the environment, so reinfection happens if you have bronchiectasis or other risk factors.
One thing you can assure your dentist is that MAC is not contagious to him, his staff, or his other patients.
Good luck with your treatment. Keep us informed & feel free to ask questions.
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