Major dental extraction

Extraction

by Lavender - 2023-06-06 18:34:50

In the USA, we number teeth 1-32. When I first started in dentistry, we used the 1-8 system in each quadrant of the mouth. If I understood you correctly, you had a "wisdom" tooth, or third molar removed. 
 

In the dental offices here, we used to prescribe premed antibiotics but several decades ago, we had all patients get their personal primary care doc to do the prescription-it was safer. We found that less and less patients actually needed the premed due to the guidelines being changed. So many people are getting antibiotic-resistant that they don't want to overprescribe. 
 

Sorry you went through a time of discomfort but glad the end result is successful!  

You were most definitely at risk and the rigors/high temperature confirmed this

by Gemita - 2023-06-06 21:24:30

Oh crustyg, we had some Flucloxacillin in stock.  I am sorry you had to struggle to get the cover you clearly needed.  We always keep antibiotics in the store cupboard now for a variety of infections so that we can start treatment without delay.  We would indeed be in trouble without them.  If we need them we need them and that should be the end to it whatever the NICE guidelines state.

I still carry a card from an old cardiologist about infective endocarditis and leaky valves and recommending antibiotic cover prior to any extraction. 

Four large roots, my goodness that must have been painful.  Hopefully you had good pain relief?  How long did the extraction take and did you suffer any heart rhythm disturbances with the local anaesthetics?  I always do.  I think I would probably have required a GA and hospitalisation for what you have been through.  I developed a dry socket probably due to my anticoagulant after my last major extraction and that took ages to heal I recall.

Thank you for the explanation on bacteraemia versus septicaemia and why it is vital to catch bacteraemia early before the bugs attach themselves to foreign bodies like pacing wires, making it more difficult at that point to treat effectively.  The rigors and high temperature you experienced clearly indicated the dangers you were exposed to and I am so glad the outcome was a good one.  Hope you are healing well 

Thanks - dental hygienist appt yesterday

by crustyg - 2023-06-07 04:49:40

By sheer good luck I had a routine hygienist appt yesterday, they noted my tale of woe for the day of the extraction.  Socket healing well (but a nightmare for food trapping at present).  Apparently it will heal over eventually.

Extraction: very good anaesthesia, they use really small needles for the local and infuse slowly so very little pain and nothing during the extraction although the adjacent tooth was a little sore.  A bit tender once the local had worn off, but nothing that required any treatment (no sense => no feeling, as we say!).  Happily I'm still not anticoagulated (although I now have a score of 1) so no complications there.

This was intended as a Success Story, but with a cautionary note.

Good dental care!

by Lavender - 2023-06-07 08:08:42

I'm smiling about you taking such good care of your dentition! Good you had your prophy and exam appointment and they could take a look-see at your socket. It truly is a success story 😁

Extraction

by AgentX86 - 2023-06-07 20:15:57

I had to have my fist molar pulled a few weeks ago.  I had a crown on the tooth in 2019, I think.  A few weeks ago I was flossing and pulled the crown off, along with the post  and piece of the tooth.  The crown was iffy the first time and there wasn't much left this time.

The dentist prescribed an antibiotic (sorry, don't remember which one) for a week after (none before). I think she grafted the bone and sutured it closed.  There was no socket (I had that problem with wisdom teeth).  She didn't have me stop Eliquis and I bled quite a bit (for two days).  Waking up with a mouth full of sliva and blood isn't pleasant.  A lot of blood but very little pain.  My dentist manages pain really well. She makes up for it with extractions from my wallet.

Agent

by IAN MC - 2023-06-08 05:49:04

I was interested  to read of your bloody experience with Apixaban as I also had a molar extracted a couple of weeks ago and I take Eliquis ( apixaban )

- I asked the dentist what I should do about Apixaban. She said " Ask your G.P. "

- I asked my GP who didn't have a clue !

- The GP wrote to the local cardiology department who didn't reply.

- In total frustration, I made a unilateral decision  and stopped the Apixaban for 2 days before and 3 days after the extraction.

It was a happy ending in that I didn't have a stroke and didn't bleed too much. Fortunately in  the UK the wallet-extraction was fairly minimal  but I think I  should have billed the dentist !

Ian