Dental work before DS?

Hey everyone - you're going to get tired of all the questions I'm asking, but a new one comes to mind approximately ever 23 seconds! I'm scheduled to get my FIRST cavity filled (and beyond being scared to death at the thought of a drill in my mouth) at the end of the first week in September. This should be about two weeks before my surgery, and a few days AFTER I'm scheduled to go back to NYC to get some pre-op testing at the hospital. Is this a mistake? I know there's always the potential for dental work to cause systemic infections. I can possibly get it rescheduled for next week while we're on vacation, but I had been hoping to not have anything that interfered with day trips. If I have to, I have to - I know what's more important, after all! Thanks, all you advice gurus! Beth

I would suggest getting it done asap, and the cleaning first,lack of dental care can be a root cause of infection , periodontics should be in order before any surgery,

Had the cleaning done a couple of weeks ago, Walter. The dentist said we finally have to do something about the tooth that was on her "watch" list. There goes my perfect teeth claim to fame.

I have to have my wisdom teeth taken out, and I asked Dr M about it. I can do it after surgery, so it's not critical, and he suggested waiting a month after surgery to do it. I didn't ask him about doing it before though.

Sometimes antibiotics are given prophylactically with your impending surgery. Check with both your surgeon and dentist about the efficacy of doing so, given the close proximity in times in your procedures. I'm not sure at all if any of the foregoing has applicability here, but Medscape just posted an article a day or two ago that you may want to inquire about with your treating practitioners as well. In reads in part, as follows: "Preoperative Oral Nonabsorbable Antibiotics May Raise Risk of C. difficile Infection CME News Author: Paula Moyer CME Author: Charles Vega, MD, FAAFP The use of oral nonabsorbable antibiotics in the preoperative bowel preparation for colorectal surgery increases the risk of Clostridium difficile infection and should therefore be omitted from the regimen, according to investigators who published their findings in the August 2005 issue of the Archives of Surgery. This infection is a fairly common occurrence and efforts to minimize it should be explored," Sherry M. Wren, MD, and colleagues wrote. "The entire role of bowel preparation and its components is currently being redefined. We would suggest that prospective trials in the future not only track the development of C difficile infections but also question the role of oral antibiotics." Although the rate of C. difficile infection (4.2%) was lower than expected, three of the 13 infected patients required treatment in the intensive care unit, the investigators noted. Dr. Wren and coinvestigators are affiliated with the department of surgery at Stanford University School of Medicine, Stanford, California, and the Palo Alto Veterans Affairs Health Care System, Palo Alto, California... .... Although the investigators cautioned that the findings would need to be replicated in a prospective study, for now, they recommend that oral nonabsorbable antibiotics be avoided in this setting because of the additional morbidity, length of stay, and hospital costs associated with C. difficile infections. " Rock

You amaze me with the stuff you come up with...did the article give examples of these antibiotics, ie...names of meds in particular?

Not to scare you, but I personally put off having fillings done until after surgery due to the risk of infection. I was not about to take any chances of having my surgery postponed. You will probably be ok because it is a couple weeks before surgery. Just make sure you let your dentist know if you show ANY signs of infection afterwards so that they can get you on antibiotics ASAP. Hope all goes well! Hugs, Katie P.S. Thanks for the congrats on the upcoming wedding!!

Hi Beth, Your first cavity EVER? Wow. I was raised on a farm, with well water, no floride. I had 6 cavities the first time I went to the dentist at age 5 !!! So anyway, I would ask both the Surgeon and the Dentist the best thing to do, and best time to do it. They are use to these kinds of questions and will know exactly the best time to have this done. I just had my teeth cleaned and have 2 cavities, and have an appointment in September to get them filled, surgery is 10/17. My dentist said I definately needed it taken care of before surgery. I have a slight mitral valve prolapse so take a prophilactic antibiotic anyway. Keep us FILLED it !! Brenda S

Hi Brenda, Yup - first cavity ever.... at 45. Guess it's all downhill from here! I was raised in the country too, with well water and no flouride, so I guess it's just good genes - in this one area, anyway. I could do without some of the other stuff my family passed down! Guess I'm calling the surgeon's office to find out what he recommends. Beth

According to the PA at my surgeon's office, it's OK to have dental work done before surgery. She sounded more concerned about the use of general anesthesia (which I won't have), rather than possibility of infection. I rescheduled my appointment for next Thursday, 9/1 - so it's 20 days before surgery. Hopefully that's long enough that anything that might crop up could be handled. I think I may call the surgeon's office again before then and ask for another opinion. My dentist, on the other hand, knows I want to back out of this filling - and I'm sure she figures this is just another excuse....! Thanks again, everybody. Beth, the Dentaphobe!