Close encounters of the dental kind

It has been a busy week! Things don’t stop when you go out of town… I’m just now getting really caught up from my trip to Durham! I haven’t even unpacked my laptop bag; I need to get everything out and start charging batteries!

But Monday afternoon I had to stop for a while and go see my dentist, to write the final chapter of The Tooth Chronicles*. As usual, I took my antibiotics: The American Heart Association recommends that people with certain Congenital Heart Defects (press release with basic information) take antibiotics an hour before the dental appointment.  (Here’s the full report)

We do this in an effort to avoid Endocarditis. Endocarditis is an inflammation of the lining of the heart, and it usually attacks the heart valves. And since I have had it, I am a firm believer in taking my pills! Endocarditis put me in the hospital for seven weeks, getting IV antibiotics every minute of it. Well, except for a couple of hours…

I was slurring my speech, forgetting things that just happened, and dragging a foot when I walked – and I didn’t realize it. My parents became alarmed, naturally, and mentioned it to the doctor, who looked me over and decided that I needed to have the Neurologist drop by. The Neurologist decided pretty quickly that I needed an MRI.

So I was bundled up, shipped to a different hospital – this was the late 1980’s, there wasn’t an MRI machine on every corner back then – and they ran a scan of my head. Sure enough, there it was: a silver dollar sized cyst inside my brain.

My next stop was the Operating Room. Thankfully it was not very deep and pretty straightforward – the operation started about 3:00 PM and the surgeon made it home in time for dinner. I did come out of the OR looking like Kojak, though.

After that, there was two more weeks of IV antibiotics before I was able to go home. And as often happens with Endocarditis, there was really no way for sure to tell how I had gotten the bacteria. But it can occur when a CHD survivor has dental work, so I am careful to “dose up” before I see the dentist. And it was only later that I found out that Endocarditis can lead to heart valve damage – enough to need surgery to replace the valve – and can even kill you! So if you have to see the dentist, call your cardiologist first, and get a prescription for antibiotics if you need them.

* I have an overbite; over time, my lower teeth have worn down the back of that tooth and finally exposed the root. I got the root canal and went back to my local dentist for the follow-up. He felt that it would be better to bond it rather than insert a crown.

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8 Responses to “Close encounters of the dental kind”

  1. CHD-UK Says:

    In the UK, they have stopped prescribing antibiotics to people with congenital heart defects/disease because they say the person is more at risk from being allergic to amoxycillin!!!.

    This has scared a lot of parents in the UK. You are so lucky to still be able to take antibiotics for dental treatment.

  2. CHD-UK Says:

    I forgot to say that they also say you can get it from bleeding gums just from brushing you teeth!!!! But it would be nice if I had the option of taking amoxycillin when having dental treatment.

  3. Joye Says:

    Hey Steve!

    Thanks for posting this. My son’s (Ethan) discharge paperwork mentioned that antibiotics should be taken before dental appointments, but I wasn’t sure why. Since he’s all gums right now, we have a little bit of time before we really have to look into that!! 🙂 And just out of curiosity… did you have your pacemaker at the time of your MRI??? I’m concerned about Ethan not being able to have an MRI, if need be, because of his.

    • Steve Says:

      No, that was pre-pacemaker. Pacemakers and MRIs do NOT play well together! If you have a pacer, the main option is Ultrasound. Medtronic is working on a MRI-resisteant pacemaker, but it is still in development.

  4. Nicole Wardell Says:

    My nine-year-old daughter used to take antibiotics before dental appointments. However, last year her pediatrician supplied us with some information that the American Medical Association has now decided that people with CHD’s don’t need to take the antibiotics any longer. She has gone to three appointments since that time with no pre-medication. Having a heart child seems like a little puzzle at times doesn’t it?

  5. Nicole Wardell Says:

    Thanks for the link….I could have just gone there first. My daughter isn’t in the category right now…however, after her mechanical valve is implanted next summer it looks like she’ll be back on the meds!:)

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