Question about dental cleanings and mesh

Hi guys, Those of you who have had mesh placed during a hernia repair -- did they tell you needed antibiotics for dental work and cleanings? This is something that's been traditionally done for people with heart murmurs and valve and joint replacements. But I'm getting conflicting information about whether we, as meshies, need it. My dentist says "no", my plastics doc says "no" but I have a nagging feeling like I need it. I'm concerned because I have an appt for a cleaning later this week and my hernia doc was, and still is, out of town and unreachable; his secretary, though, says that he recommends we not have any dental work done for several months after the mesh is placed. (OTOH this guy is notoriously medically conservative). What have your experiences been, if any? Thoughts? Thanks, Vickie

YAY!  A question I know the answer to..........I am a dentist.

No, you do not need premed. 

There is also no reason to delay dental treatment after mesh hernia repair. 

Have fun at the dentist!!  :)

Thanks for checking in with this! I was just talking to my husband about it (he's a dental assistant with 25 years experience) and he agrees. I just wanted to be sure since the hernia doc usually doesn't want his mesh patients having any dental work for three months. My dentist, who my husband works for, thinks it's fine, too. It's just the hernia doc who's balking. I wonder who trumps in these cases? The dentist? Or the doc who placed the me****'s really frustrating getting different, conflicting "orders" from my docs. I wonder why the hernia doc would suggest I wait. Maybe he just doesn't know the new dental regulations? I'd love to ask him but he's out of town until after my appointment. At the very least I'm going in for an exam tomorrow, and am inclined to go for my cleaning the next day. It's just that this whole mesh ordeal has been, well, an ordeal and I don't want to mess it up at all. Thanks again for checking in, Vickie

Ah the trump card - this is quite the subject on the dental forums I read. In my opinion - if your surgeon wanted you to wait for dental he/she should have given you WRITTEN instructions to wait.  If he/she wanted you to be premedicated for dental - he/she should write a script for you to take. As a dentist, we have guidelines from the American Dental Association, the American Heart Association, and the American Association of Orthopedic surgeons.  They are specific and clear.  If a dentist writes a script beyond the guidelines and heaven forbid the patient has an adverse or allergic reaction to the premed or premed effects - the dentist's *ss would be in a sling. In my opinion many surgeons - mostly orthopedic - just throw antibiotics around like candy - not a medicine with possible side effects.  And in my opinion, they do NOT understand about dental procedures and the infection issues associated with dental. Many of the patients out there have a daily risk higher than any dental procedure risk just because they do not take care of themselves (brush twice, floss daily).  Many patients introduce bacteria to their bloodstream every time they EAT just from their gingivitis or perio. I am sure you have perfect oral hygiene - with hubby being in the biz.   Hope this helps!

Thanks, Dr. Laila, Oh yeah, I'm big time surrounded by dentists and dental folk. My father in law is a dentist, my husband is an assistant, we own a dental assisting school, my brother in law is a dental lab guy. Um.. yeah. Plus, since our school is a tiny one with just the two of us, I'm often called on to be the "dummy" for demonstrating procedures on. So I get lots of people looking in my mouth on a daily basis. And yet... how often do I get to an actual dentist? Yeah, don't ask. But my oral hygiene is darn good, and while I have really bad TMD I have excellent dental health (only four tiny composite fillings and minimal pockets -- about what you'd see for the typical healthy 43 year old woman with TMD). And man, I know what you mean about what people do to themselves. I hear stories of gums hemorrhaging when you look at them, unable to keep up with the bleeding with suction and cotton rolls. I can't believe that people just live with routine gum bleeding like it's normal. They cut down on flossing -- yeah that's a good idea. NOT. In my own case, I have no bleeding when I floss and I don't anticipate anything really deep needing to be done. So you understand the whole "who's the boss -- doc or dentist" thing. I was never told not to have any dental work done by my doctor; OTOH he might never have thought I'd do that, since I'm around doctors so much (open wound and thyroid cancer -- unrelated, thank goodness, my thyroid wound has healed nicely). But I figured since I'm off work anyway, why not get 'er done. My husband read the guidelines, talked to his dentist, and both agree with you. So you guys will end up "trumping" my doc. I was going to ask my dentist for a scrip "just in case" but if he could get in trouble, I may not do that. Fortunately, I'll see him Wednesday so he can assess what kind of shape I'm in in terms of what I'll need for a cleaning and if he thinks it'd be too much we can reschedule that. I just need to get in because my TMD has gotten so bad that I have wicked wear on my anterior incisors (lower and upper, lateral and medial), my cuspids (flat), and even my first bicuspids; it's THAT bad. I have deep cracks on those lower anteriors, lots of dentin exposed and I'm looking at veneers, if not crowns. Oy. So I need to get the whole bite study and treatment thing done.  It's a shame because I have beautiful strong, healthy teeth but my jaw muscles are like ROCKS. I know, more than you wanted to know but I figured I'd do a little "dental talk".  Thanks again for such a great response. I very much appreciate it. BTW, dental forums? Do you mind PM'ing them to me? I bet my husband would love to be involved if they will allow assistants to participate. He's truly a dental geek. Thanks again, Vickie The Dental Wuss

Thanks ladies for the very enlightening conversation.  I don't have these issues, but it's interesting to hear about.  Cool! Mary

I hate to appear stupid, but what on earth does having mesh have to do with dental care?

Vickie, what does a dental cleaning have to do with a mesh? I do not see the relation.......

Some prosthetic devices - like knees and hips - have the potential to become infected with dental procedures.  Many dental procedures cause bleeding - which introduces bacteria into the bloodstream.  This bacteria can attack a prosthetic device - causing massive infection, possibly causing the prosthetic device to fail. Vickie and I were discussing if her mesh would require premed because it is new and not a natural part of her.  Mesh is not in the list of qualifying prosthetics that need premed (antibiotic prior to dental). Hope this helps!