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Dental treatment/hygienist after TKR

Posted , 10 users are following.

chris00938
chris00938

After reading that at one time it was recommended that anyone who had a TKR should be covered on antibiotics for life when having hygienist work on their mouths or more invasive dental work, but then this wasn't recommended anymore because the overuse of antibiotics became such a problem, and then someone recommended antibiotics for the first three months after knee replacement because there was more blood flow to the knee in that period, it got me wondering.  Firstly, we're not really told the importance of dental hygiene especially if we have  TKR.  Having said that, it seems that it's not the bugs found in the mouth that seem to cause most knee infections!    So why were antibiotics being used at all?  IF someone was inclined to get bleeding when going to the dentist, then I wondered if it was worth them using something like the stronger corsodyl for a few days before going to the dentist to reduce any risk. 

It's one of these things with conflicting advice over the years, just like everything else!

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  • marilyn10235
    marilyn10235 chris00938

    Posted

    The NICE guidance on this changed some years back.

    Prophylactic AB coverage was always given to patients with heart problems before the scale & polish or any invasive procedure. The only people now given prophylactic ABs are those with heart valve failure. In our case we haven't had to give them since the guidance changed (why it's called guidance I don't know as we HAVE to follow it).

    I recently saw my GP as I have a chest infection & he said not to worry about infection on the prosthetic as it is very rare! You are more likely to get int trouble from developing sepsis from an infection rather than infecting the prosthesis.

    ABs have been handed out like sweets in the past which is why we have the very real problem of resistantance. The medical profession as real culprits as us consumers!!

    • chris00938
      chris00938 marilyn10235

      Posted

      Absolutely!  My own GP has given me antibiotics in the past when I didn't ask for them and didn't think I needed them but she did (this is the one who overdosed me with estrogen too!) and she never did any testing to see if there was an infection!  But that bit about being more likely to develop sepsis than infecting the knee says everything and gets it all into perspective!!!!!!  Thanks Marilyn!  I might just use the strong mouthwash stuff a few days before, because there's nothing to lose on that - I actually used it before the TKR op as one of my 'precautions' LOL!  Wonder about a sheepdip????:-)))))))

    • marilyn10235
      marilyn10235 chris00938

      Posted

      Perhaps medical science is lacking in not producing a 'human dip'!!

      Lol

      XX

    • chris00938
      chris00938 marilyn10235

      Posted

      Yes LOL!  When we used to breed kittens I was SO neurotic (me? NEVER! LOL!) that I really wanted a sheep dip outside the front door so visitors couldn't bring any bugs in that might affect unvaccinated kittens.  I used to tell them to come in clothing that hadn't been worn since washing so it hadn't been in contact with other cats and made them wash their hands when they got here.  If I went anywhere with other cats then I'd change and wash my hands before contact with my cats.  I just wanted to breed the healthiest happiest cats possible!  So now my thoughts are on the 'healthiest happiest knees possible' LOL! 

      One of the things that did worry me a little in hospital was that the ward bring newspapers for the patients but tell you to share them and I was worried about infections being passed on like that.  Is that OCD or not?  Feel free to say!

    • marilyn10235
      marilyn10235 chris00938

      Posted

      Maybe a little OCD Chris!

      I think sometimes we now go a little overboard when it comes to everything being so aseptic! I'm not advocating leaving dirty, bacterium infected things hanging around but we do tend to use anti bacterial wipes & all sorts of things our mothers never had! All I remember is Dettol! I am just the same I have anti bac wipes & Dettol laundry sanitiser in my kitchen but I do wonder if our overuse of antibiotics & anti bac wipes every where is anything to do with the rise of resistant bacteria/infection!

      Maybe I've got it all wrong?

      I know you only wanted the best for your kitties! I love cats!

      XX

    • chris00938
      chris00938 marilyn10235

      Posted

      I think we DO overuse antibacterial stuff Marilyn!  I stopped using antibacterial handwash soap a while back and my husband loves to use an antibacterial spray on the kitchen worktops but I don't think it's good for us!  I tend to use washing up liquid on worktops with boiling water.   And I use a steamer a lot.   So far so good:-))))  It is difficult though - we so often have products aimed at us 'to protect us and our family' and feel duty bound - it's our responsibility to keep everything hygienic , but it's not always the best thing to do.  We live and learn:-)))))  Gradually information on these things is coming out.  Like the lemon grass used in polishes being bad for us.  Just read something about statins not providing any benefit to over 65's at risk of heart disease.

      Out of interest, there is an article on hip replacements in the mail online today under the health column.  'From sleepless nights to searing pain and constipation: What they NEVER tell you about hip operations!' That sounds a bundle of fun!

      Yes, I had to do the very best I could for the kittens:-))))  And it was so worth it:-)))))

  • sue37592
    sue37592 chris00938

    Posted

    Hi all, I spoke to my GP about this yesterday and she said replacement should be ok. My problem is i am allergic to penecillin and a lot of other antibiotics. I developed an abscess in my mouth last weekend and was put on an antibiotic which i have never had before but yet again..severe reaction...I am now covered in rash, swollen all over and miserable. When was at GP she saidkeep an eye on knee but should be fine. S
    • chris00938
      chris00938 sue37592

      Posted

      Oh sorry to hear about the abscess Sue!  And the rash - that sounds like my reaction to penicillin.  I hope you're better soon!  Thanks for the info though.  I saw my gynie yesterday and he said that you'd have to develop sepsis before an infection went to the knee and there was an article in the mail today (online) about what causes sepsis - pneumonia (I've had vaccination for this anyway)

      abdominal infection

      kidney infection

      bloodstream infection

      But I think if you've got sepsis, the knee would be way down in your list of worries!  So where I read that infection is possible for the life of the knee, I THINK (????) that the biggest risk of infection by far is hospital acquired and would come out in the early days unless you're unfortunate enough to be like Oldfatguy and have a problem with having low resitstance to some infections.

    • marilyn10235
      marilyn10235 sue37592

      Posted

      Oh dear Sue I'm sorry to hear about the abscess! Especially as you are allergic to the antibiotics! What did they give you, was it metronidazole? It's often given for dental infections where the person can't have amoxicillin (which is penicillin!). What are they doing for the abscess? Keep a close eye on it.

      I hope the each dies away soon.

      Marilyn

      XX

    • sue37592
      sue37592 marilyn10235

      Posted

      Hi Marilyn, it was metronidazole. The dentist has drained the abscess, cleaned the whole area out and i have to go back tomorrow and get it done again. Apparently cant take another antibiotic while having a reaction to one. Thank you x
    • marilyn10235
      marilyn10235 sue37592

      Posted

      Sorry you've had all this.

      I hope all goes well at the dentist.

      XX

    • sue37592
      sue37592 chris00938

      Posted

      HI Chris, Yes i had the same rash  with penicillin and 2 other antibiotics, i also was violently sick with one other one too, none of which are related....now down to being very limited with anitibiotics if i ever need them. My Gp said we stopped it in time as the antiobiotic was starting to attcck my insides too.Hopefully on mend now and hopefully get tooth sorted. Thank you x
    • chris00938
      chris00938 sue37592

      Posted

      That sounds very serious Sue!  Thank goodness it was picked up in time!  Yes, hopefully you'll be better on both counts very soon!

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