teeth extractions - pre meds?

[Louise]

I have 3 teeth that have broken off and they were part of a bridge. The oral surgeon says I will have general anesthesia. If you have had extractions or major dental work, were you given any meds before the procedure. I was told I would be given an IV with antibiotics during procedure. Has anyone had experience with dental procedures and MS exacerbation or increase in symptoms?

[agate]

Hi Louise,
I've had quite a lot of dental work since MS came along--several extractions, several root canals, a couple of abscesses, and a bridge installed.

Some of the work did cause MS symptoms to get worse, probably because a dental procedure can be a trauma you have to get over. But no permanent harm seems to have been done, and you might consider that you'd probably get far worse symptoms if you let necessary dental work go undone, and a bad infection sets in.

A couple of times I was given antibiotics ahead of time, but that was many years ago, and more recently I understand that this isn't being done nearly as much as it was.

It sounds as if they're shooting some antibiotics into you during the procedure as a precaution against an infection.

Are you saying that you're about to have the 3 teeth extracted?

Whatever it is that you're in for, I hope it goes well for you. If you stay as rested as you can and try to keep eating well, you'll probably have an easier time of it. At least that's been my experience.

[Kimba22]

Hi Louise,

Oh no! So sorry to hear this.

I had one tooth extracted not too long ago and pre-medicated with a dose of oral antibiotics, but mainly because I have a history with endocarditis. Afterwards, I continued on oral antibiotics for a few days. Like agate said, it's not something they prescribe that often for dental work anymore. I used to be premedicated even before cleanings because of a mitral valve prolapse. Other than some swelling and bruising, I was fine after the extraction, and had no big issues with my MS. (I'm hoping things go just as well when I get the dental implant.)

Since it is surgery, there's always a possibility the stress of it on your body will trigger a flare. (I did have relapses after two major surgeries, but I've also had other surgeries where that didn't happen.) It sounds like you will be in very good hands with your oral surgeon. I hope it all goes well for you with minimal discomfort afterwards.

Best wishes,

[Kimba22]

ADA premedication protocol

Hi again Louise,

The World Health Organization came out today with a 232 page report in regards to antimicrobial resistance http://www.who.int/drugresistance/do...ancereport/en/, which reminded me of your thread. I hope this information from the American Dental Association will be helpful to you in understanding when premedicating is recommended.

"Who is at risk? Antibiotic prophylaxis is recommended for a small number of people who have specific heart conditions. The American Heart Association has guidelines identifying people who should take antibiotics prior to dental care.

According to these guidelines, antibiotic prophylaxis should be considered for people with:

Artificial heart valves.

A history of an infection of the lining of the heart or heart valves known as infective endocarditis.

A heart transplant in which a problem develops with one of the valves inside the heart.

Heart conditions that are present from birth, such as:

Unrepaired cyanotic congenital heart disease, including people with palliative shunts and conduit.
Defects repaired with a prosthetic material or device—whether placed by surgery or catheter intervention—during the first six months after repair.
Cases in which a heart defect has been repaired, but a residual defect remains at the site or adjacent to the site of the prosthetic patch or prosthetic device used for the repair.

Antibiotic prophylaxis guidelines also have been developed for people who have orthopedic implants such as artificial joints. In 2012, the ADA and American Association of Orthopedic Surgeons updated the recommendations and no longer recommend antibiotics for everyone with artificial joints. As a result, your healthcare provider may rely more on your personal medical history to determine when antibiotics are appropriate for people with orthopedic implants. For example, antibiotic prophylaxis might be useful for patients who also have compromised immune systems (due to, for instance, diabetes, rheumatoid arthritis, cancer, chemotherapy, and chronic steroid use), which increases the risk of orthopedic implant infection. If you have a heart condition or an orthopedic implant, talk with your dentist or physician about whether antibiotic prophylaxis before dental treatment is right for you."

http://www.mouthhealthy.org/en/az-to...or-Antibiotics

Good luck with the procedure!