Pacemakers and dentistry
I have read that I must inform my dentist about my pacemaker and wondered why. Obviously I will tell her because I usually do as I am told, but would there be a problem with ordinary procedures, scaling, fillings etc? What is this all about?
17 Comments
Used to be
by Theknotguy - 2018-08-18 08:04:32
Used to be they were worried that working on the teeth would cause bacteria from the gums to get into the blood stream and cause an infection. However they've found that not to be the case. Used to be they wanted you to go on antibiotics to lessen the risk. But they don't do that any more. You run into the occasional post about a dentist who is very conservative and wants to do all sorts of precautions but most don't necessarily do anything. Mine just takes normal precautions.
Other than inform your dentist you have a pacemaker and give them the list of all medications you are taking, nothing further needs to be done.
New to this
by LIssH - 2018-08-18 08:42:49
I’ve only had my pacemaker for two weeks and in that time have needed some dental work. My dentist said she prefers to put me on antibiotics before any work such as fillings in the first 12 months post implant.
I don’t normally like to take antibiotics unless I really need them (increased antibiotic restistance and all :)) but also prefer to be on the safe side when it comes to my heart. If there is any risk of infection I’d prefer to take the antibiotics.
LissH
by IAN MC - 2018-08-18 08:52:59
Your dentist is not up to date on current thinking and recommendations. I would love to ask her to justify the nonsense view that she prefers to use antibiotics in the first 12 months.
Why should dentistry be more of a risk in the first 12 months ? There is absolutely no logical justification for that !
But if it makes you feel happier so be it .....
Ian
Dentists
by MissFitts - 2018-08-18 09:05:52
Thank you everyone for your replies. I had not thought of the infection angle, I imagined it would have something to do with vibrations from the drill, or taking special care not to drop a lump of equipment onto my PM site.
Dentists
by AgentX86 - 2018-08-18 11:09:14
Anyone doing a medical procedure on you should know everything about your condition that has a remote possibility of affecting your treatment so they're allert for unusual reactions.
The other possible issue is the X-Ray machine causing interference with the pacemaker. The dentist should know if his equipment is PM friendly (newer) and again, be aware of the possibility.
The main reason to tel them...
by donr - 2018-08-18 13:21:48
...is so they won't lean on the device while workig on you.. Can you imagine getting the dental assistant's elbow on your PM?
Yes, the mouth is a swamp of bacteria - some of it bad stuff. A priori it is prudent to be concerned, but about ten yrs ago, studies showed that it was NOT the problem.everyone expected.
Extractios are a different situation & leave a gaping maw for a period.
Some ideas die a slow, agonizing deatth.
Donr
Keep your dentist informed
by Jimmy Dinfla - 2018-08-18 21:52:42
The preceding comments about telling your dentist are so important. I asked my cardiologist about antibiotics before routine dental cleanings and he said that is no longer needed. In the past, I was prescribed an antibiotic.
dentists
by Tracey_E - 2018-08-19 12:48:28
I would be wary of any dentist that still prescribes antibiotics. Both ADA and AMA stopped that recommendation more than 10 years ago, any one who doesn't know that is not very up to date. Valve replacement, sometimes yes. Pacer and other electrical issues, no.
Cleanings and other normal office procedures are fine. If they use the ultrasonic thingy (cavitron?), they need to keep the cable away from our chest but it's ok to use it.
Nothing about xrays will hurt a pacer. Magnets are the potential issue, nothing about an xray uses a magnet.
My dentist is not comfortable doing sedation in the office because of my heart history, not necessarily the pacer. I've never needed/wanted it so I don't know what he'd do if it came up.
XRays
by AgentX86 - 2018-08-19 18:27:45
An XRay machine may not use a magnet but they do operate on very high voltages and will create EMI, not because of the XRays but because of the circuitry that is used to make them and it's very close to your body.
But that's not the point. The dentist needs to have all the information about you that might be important. If you're that sure that nothing can happen that you're willing to hide information from your medical team, that's up to you but it's not a good idea to tell others it's harmless to do so.
agentx, please don't put words in my mouth
by Tracey_E - 2018-08-19 19:31:10
Who said anything about withholding information from a medical team?? I said xrays are safe and I am 100% sure that is a fact. Regular film xrays, digital, dental (old film and new digital and the fancy ones that go 360 degrees around you), CT scans, 3D scanners at the airport... all safe. Call your manufacturer if you are in doubt, but EMI from xrays is not an issue.
Really
by ROBO Pop - 2018-08-20 18:36:14
OMG now we're saying Xrays affect you...You best make sure your malpractice insurance is paid up. Where do you get this nonsense?
Here we go another nonsense claim that will begin making the rounds. Some people do more harm than good with their advice.
Dentist
by tammyjk1021 - 2018-08-21 13:12:15
Everyone including the dentist will err on the side of caution. In my case, I have bradycardia and sometimes tachycardia so it makes for interesting treatment. I sought out a very knowledgable dentist who does not use the numbing agent before giving me a shot. It contains Epinephrine. He does not use regular novicane either. Sounds terrible not being nummbed up but a really good dentist can do it without pain. And he's good. Then of course there is the blood thinner issue and many more. So it's not just one thing to consider but many.
Oh no!
by MissFitts - 2018-08-23 11:48:54
I can cope with the info about antibiotics - the pros and cons - ditto X-rays. But please can someone tell me that pre-numbing for injections will be OK? And injections themselves?
intersting
by dwelch - 2018-08-28 02:15:46
So thats why they stoped pushing the pre-medication. The dentits do hone in on this, and I tell them to call my doc but they seem to want me to be the middole man.
The last go around was with the I dont remember what they call it maybe the scaler you are talking about it is basically an industrial level water pik. They refused to use it until hearing from the cardiologists office. What they were told is dont have the cable/bundle over the pacer.
So we have gone from bacteria in the gums to the blood stream and a handful of pills an hour before the visit with the dentist. To now the dental tech wraps the thing around them to keep it from having stray signals too close to your pacer. This is along the lines of can I shave with an electric shaver or use an electric tooth brush.
I defintely agree with the dont lean on it, and they are going to err on the side of caution, so no meds but if your doc's office doesnt want the stuff near the pacer then keep it away from the pacer they can manage that I know first hand. Scaler, drill, etc.
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Scaling
by Shaun - 2018-08-18 08:01:56
My dentist wouldn’t use the scaler until she had received a letter from my cardiologist confirming that it would not cause problems for my pacemaker.