Heart murmer, dental work, and antibiotics

Heart murmer, dental work, and antibiotics (Full Version)

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CynthiaWVirginia -> Heart murmer, dental work, and antibiotics (1/29/2011 1:30:34 AM)
I need advice and links, please. Hopefully something easy to read and "official", so I can give it to my ex-husband. He phoned me up and told me that his wife has been having a root canal done, but he's not sure the dentist got it all out because she is still in a lot of pain. The doc has had her on amoxycillin for about two months. Not sure if this is off and on or has been steady...and even if steady, I am not sure the wife would have been faithful about taking it all this time. The dentist won't do more work to finish this until the pain and infection is down, or something. What I know about root canals could fit on the end of a needle...I am 46 and only have two cavities, lol. What the dentist was not told is that the wife has a heart murmer. I had a neighbor with a heart murmer over ten years ago and she said the dentist has to know about it, that she had to go on antibiotics before even a teeth cleaning, or it could cause an infection in her heart. Am I remembering this wrong? My ex's wife didn't want to tell the dentist about her heart murmer because she was afraid he wouldn't take care of her dental work. Since yesterday, she has been complaining that her heart hurts...chest pain. She doesn't want to go to the hospital though. They lost insurance when they lost their jobs, and have new jobs without coverage and pay for medical dental themselves, and have run up over $2000 with this dentist on their credit card already. I tend to be almost paranoid when it comes to medical stuff, and told him to get her to a doctor. Am I being paranoid? Chest pains can be common with stress. Is there a link somewhere on the web that would tell about complications and what to look for? All I can think of are fever and if the pain increases. She's in her thirties and has four young kids. Any help is welcome. I already explained to him that dentists take care of people all the time with heart murmors and artificial joints, and that they ask for a reason.

hlen5 -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 1:37:26 AM)
Get her to the Dr. ASAP. Even if it's just stress, it needs to be taken care of.

DeviantlyD -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 2:19:12 AM)
All you have to do is type "dental work heart murmur" into Google and you'll find plenty of information. WebMD is a reputable site (I work in healthcare, so I have a bit of a clue) and one of the sites listed on the first page of the aforementioned Google search. http://www.webmd.com/oral-health/endocarditis-prevention **Edited to correct typo.

DeviantlyD -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 2:26:28 AM)
P.S. If she is not taking the antibiotic her dentist described consistently and at the same time(s) every day, she is doing more harm than good. She needs a constant level of the antibiotic in her bloodstream in order for it to work effectively. Once she delays taking her medication, the antibiotic levels will drop and when she starts taking it again it is, in a sense starting over. However, what is even worse is that during the down time, bacteria that hasn't been killed off by the antibiotic will have an opportunity to flourish - AND - gain resistance to the antibiotic. The worst case scenario? The antibiotic will become useless, her body will harbour a resistant organism that will be all the more difficult to treat and if this resistant bacteria is able to set up residence inside of her bloodstream, she will likely develop septicemia and septicemia can kill very quickly. Edited to add: From the Centers for Disease Control web site: http://www.cdc.gov/getsmart/antibiotic-use/anitbiotic-resistance-faqs.html And no you aren't being paranoid, and yes you are remembering correctly about your neighbour. I agree with hlen5.

DarkSteven -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 4:49:36 AM)
quote: ORIGINAL: CynthiaWVirginia I am 46 and only have two cavities, lol. I hate you. With that out of the way, what the hell is her problem? With two recent layoffs and two new jobs and no health care, as well as four young children and an ex-husband (presumably) to fit into the picture, the last thing the marriage needs is more drama. And she's adding drama wholesale - refusing to take her meds properly, not telling a dentist what's up, and making her husband crazy. He's even bringing you into this. Is she feeling neglected at home?

angelikaJ -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 6:25:14 AM)
Cynthia, Regardless of whether the 2 might be connected or not (and no, you are not being overly worried) she does need to go get checked out. Women don't present with the same symptoms as far as cardiac stuff goes. I had a similar thing happen to me in May and decided it would be much better to go and feel foolish later than not go and not be able to feel foolish at all. They never made me feel foolish. Obviously your ex is concerned or he wouldn't be asking you. The hospital will work out reasonable payment arrangements with them. Tell them not to put it on their credit card. She should have told the dentist: he might have added a different antibiotic or it might not have made a difference, but if she isn't feeling well she should go get seen. They prescribe antibiotics less now as a matter of course, preferring it to be specific to the issue (as determined by an echocardiogram...where they can look at the heart and see if the patient has an issue with their valves. Of course, she could not afford to have had that done either. See if you can talk him into getting her to go, just to be safe. Her chest pain might not have anything to do with the dental work, but it still could be serious. Better to be safe than sorry.

DesFIP -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 8:40:47 AM)
My memory of my root canal, where I was not given an antibiotic to begin with, is that when it becomes infected it is then an anaerobic bacteria and amoxicillin is not designed for that. I took Flagyl for the infection that developed. I'm not sure her endodontist is giving her the right antibiotic but since she has a heart murmur and now has heart pain, she needs to go to the ER.

hausboy -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 8:58:12 AM)
You have CMail.

mummyman321 -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 9:40:42 AM)
Cynthia, Regarless of insurance, this is a case where he needs to see a doctor. An infection of the heart can occur due to dental work if the person has a heart murmur. Only a doctor is going to know by examination and blood work. Hopefully its only something simple like heartburn but not worth risk someone's life over.

calamitysandra -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 12:07:26 PM)
ER now!

sirsholly -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 1:45:48 PM)
quote: What the dentist was not told is that the wife has a heart murmer. I had a neighbor with a heart murmer over ten years ago and she said the dentist has to know about it, that she had to go on antibiotics before even a teeth cleaning, or it could cause an infection in her heart. Am I remembering this wrong? you are remembering correctly, but the tides of antibiotic use are changing. They are given in certain cases (a patient who has a history of Rheumatic fever, i believe) but as a general rule a heart murmur is not a cause for pretreatment antibiotics. That said, if this woman has been in pain and on antibiotics for groan two months, i would have seriously advised her to go to an oral surgeon immediately.However...with the chest pain, she needs to get herself to an ER asap. Antibiotics used long term can cause a yeast infection in the blood which proves fatal in many cases, and a bacteria can cause damage to the heart (bacterial endocarditis, i believe)

CynthiaWVirginia -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 3:59:06 PM)
Thank you, DeviantlyD, for the webmd site. At one time, I had that on my desktop...I couldn*t remember the name of it to find it on my own. I am horrible at Gooble, but will go there later tonight to get more info. I just got off the phone with him, so I will have to email this or tell him when he uses his computer to phone tomorrow. Thanks again.

bemyslut -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 5:05:41 PM)
the use of antibiotics depends on the type of murmur (regurgitation vs stenosis) and which valve is affected. Depending on those factors, antibiotics SHOULD be given even for the mildest invasive procedures (sorry to burst your bubble SirsHolly and no, long term antibiotic use will not cause a fatal fungicemia). 2 months of antibiotics seems excessive; if the infection does not clear up in a week or 2, the physician/dentist/surgeon should reevaluate the situation (a culture and sensitivity would be ideal). Patients who develop infective vegetations become acutely and intensely ill. When I was an intern, we had an I drug abuser who got infective vegetations on a newly placed porcine valve--he had to be taken to the OR immediately and have the valve replaced--he was literally on death's door. A new onset of murmur after having dental work is very worrisome; so is having an exacerbation of symptoms (angina, fever, chills, dyspnea, generalized malaise)...my advice---seek immediate medical care---don't even bother going back to the dentist---head straight to the nearest ER

sirsholly -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 5:40:55 PM)
quote: antibiotics SHOULD be given even for the mildest invasive procedures (sorry to burst your bubble SirsHolly and no, long term antibiotic use will not cause a fatal fungicemia) My bubble is intact, thanks. But long term antibiotics can cause a yeast infection in the blood. I have a heart murmur. I thought antibiotics were given as a rule to persons with this condition prior to a procedure but have been told by several doctors that they are getting away from doing so, as it has proven ineffective. Post procedure is another story, but that was not the question I'm not an expert...this is just my experience.

CynthiaWVirginia -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 6:56:43 PM)
quote: ORIGINAL: DarkSteven quote: ORIGINAL: CynthiaWVirginia I am 46 and only have two cavities, lol. I hate you. With that out of the way, what the hell is her problem? With two recent layoffs and two new jobs and no health care, as well as four young children and an ex-husband (presumably) to fit into the picture, the last thing the marriage needs is more drama. And she's adding drama wholesale - refusing to take her meds properly, not telling a dentist what's up, and making her husband crazy. He's even bringing you into this. Is she feeling neglected at home? Those are just the ones I have filled. I got them done when I was 19 years old. The cement on my braces wore down and food snuck in and nailed my teeth. Will it make you feel better to know...that I have a baby cavity that has been too small to drill? We have been waiting since I was in 7th grade for it to get bigger...maybe it's big enough now, finally. This spring I plan to go to a dental college or something over another tooth...it hurts some of the time, lol. I have the best teeth in my family and am so glad everyone else is getting drilled and worse instead of me. <knocks on wood> Btw, my sister flosses every blessed day, and I don't. [:D] I know...life's not fair, lol. Neener neener... My ex is like the brother I never had, and I am honorary auntie to his household. Theirs was an arranged marriage and has been rocky ever since the kids started coming. His father chose her, and she has a filthy temper...complete with screaming out profanities and shattering glass against the wall. He is not easy to live with either because he is not a good listener and can act like something of a robot. I believe he has asperger (however you spell that). You're right about all the drama, it was good to see this from a guy's point of view. *********** Edited because I forgot to answer that last question. My ex is gentle and mild mannered, but kind of...dumb. While she was in labor with his kids, he was somwhere else...with their first baby, he left her alone at the hospital to take one of his night school college classes. He is a vanillasubbie, and needs his partner to take the lead. With their ethnicity/culture, he is supposed to wear the pants in the family. To put it mildly, she regrets having married him, and yes, if she feels neglected...it's because she is. If she just put a ring through his nose like they do with bulls and tie a rope to it...they would get along fine. When he is neglectful, it's because he doesn't know any better...he is good hearted and hard working, doesn't drink or take drugs, and hasn't cheated on her yet though he keeps thinking about it. Her education level is very low and she refuses to read books that could help her with child care or even first aid, etc. She probably genuinely thought that the dentist wouldn't help her if he knew she had a heart murmer, and if she had asked her hubby, he might have advised her to keep silent. Now they both know the truth, and I will also send them the appropriate page on that webmd site.

CynthiaWVirginia -> RE: Heart murmer, dental work, and antibiotics (1/29/2011 7:32:24 PM)
Thanks, everyone. Y'all are the best, and I appreciate the advice. Roger was wondering about her being given amoxycillin for two months. Her last dose was tonight and they cannot go back to the dentist until Monday to get another prescription. Normally I have books that would tell me what to expect, but they all took a walk when I was doing some early spring cleaning. Getting it cultured sounds ideal, to get this all over with. I cannot imagine being in as much pain for over two months...with no end in sight. I already talked with him today, and will come back here after watching two movies and will copy and paste a lot of what was said into an email and send it to him. Hopefully they will both look it over and make the right decision. This could be very serious...I have made my mother go to the emergency room for less.

SexyBossyBBW -> RE: Heart murmer, dental work, and antibiotics (1/30/2011 12:47:41 AM)
I'm thinking that if she's had to take the same antibiotic for 2 months, that one isn't working. She has a murmur, and now chest pain? That means take thee to a good cardiologist or ER immediatedly. I don't know any reputable institution that wouldn't test her appropriately for advanced valve disease, and repair need immediately, with or without insurance. M

hausboy -> RE: Heart murmer, dental work, and antibiotics (1/30/2011 12:55:27 PM)
quote: ORIGINAL: SexyBossyBBW I'm thinking that if she's had to take the same antibiotic for 2 months, that one isn't working. She has a murmur, and now chest pain? That means take thee to a good cardiologist or ER immediatedly. I don't know any reputable institution that wouldn't test her appropriately for advanced valve disease, and repair need immediately, with or without insurance. M Hey SexyBossyBBW-- just a tangent--but there are some conditions which require a 60-day regiment of antibiotics, so the length of time one is on the antibiotic does not necessarily indicate poor efficacy. In fact, the biggest risk is that people who are placed on longer treatments of antibiotics tend to stopping taking them once they feel better/symptoms resolve and don't finish the treatment, risking recurrence.

ShaharThorne -> RE: Heart murmer, dental work, and antibiotics (1/30/2011 6:59:02 PM)
when I had to have a tooth pulled last year, one dentist recommended that I take some antibiotics. I did not know that I had gum disease and the drugs took care of it. The dentist did not want to pull my tooth out, by recommending an oral surgeon, who did not have an opening until 6 weeks later. Brother M works for the postal service and he talked with the secretary of a dentist on his route. The dentist told him to tell me to get my ass in there (after taking the antibiotics). the next week, I had a bad tooth removed (back molar with a nasty cavity) and got me some pain killers. I did not take them because I was not in pain (any time I have something bad removed from me, I dance for joy). I ended up having 2 more teeth removal, using gas and tons of Novocaine. I just got dxed with having a weak heart valve a few months. I just have to be careful and alert the dentist when I have to go back soon.

dixiedumpling -> RE: Heart murmer, dental work, and antibiotics (1/30/2011 9:12:22 PM)
I have mitral valve prolapse, also known as a heart murmur. For awhile I had to take amoxicillian before every cleaning of my teeth. Then the FDA removed that requirement. However, if I have dental work that might lead to blood loss, such as a root canal, then I would have to take the antibiotic four hours before the appointment time. The danger is an infection in the sac around the heart. She was foolish for not telling the dentist beforehand. One dose of antibiotic would have been enough.

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