FAQs, Useful Tips, and Links
FAQ | Useful Tips | Links
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Why do some people have to take antibiotics before dental treatment?
People with artificial heart valves and some types of artificial joints may require antibiotics before dental work. Artificial heart valves are the highest risk; bacteria can get into the bloodstream (bacteremia) during the procedure, travel to the heart, and stick to the valves. The bacteria multiply into large colonies and destroy the valves, and/or seed throughout the rest of the body. For more information see, for example,
Not all dental work creates significant bacteremia, but for higher risk procedures, which includes dental cleanings, antibiotics are recommended, usually taken one hour prior to the dental appointment. Artificial joints can develop a similar problem, and require replacement. Until recently, even most heart murmurs (leaky valves) were also covered with antibiotics. The most recent guidelines are that heart murmurs do not require antibiotics unless the patient has had a history of bacterial endocarditis - that is, a heart infection. If you have previously taken antibiotics before all dental visits, you should ask us before your appointment if you are in one of the groups that should still take them. Currently the joint doctors require antibiotics before dental work for all recently placed artificial joints. After two years, this requirement is lifted, except for patients over age 75.
Is there any way to avoid taking these antibiotics? I don’t like taking pills ...
Unfortunately, you can't just say "I'll accept the risk of heart damage, what do you want me to sign?" To go ahead with treatment under those circumstances would be malpractice for the dentist, and his or her insurance wouldn't cover it if something went amiss. Regarding artificial joints, it's only for the first two years, so we recommend just putting up with it. It is likely that the recommendations for joints will be changed within the next several years, but what the changes will be is hard to predict.
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Toothbrush recommendations
While we don't specifically recommend any one type of electric brush, or sell them in our office, we do have some preferences.
Our hygienist, Candi, prefers the Sonicare brush.
Advertising claims aside, the sonic waves don't do anything magical to the bacteria, but the vibrating motion does a good job of removing bacterial plaque. The brush beeps every 30 seconds to pace you through the four quadrants of your mouth, and if you turn it out off before taking it out of your mouth, it doesn't splatter the mirror all to heck. The latest version, the Sonicare Elite, has a smaller brush which fits into most spaces quite well. Brush heads for the Sonicare are fairly expensive, and need replacing every 3 months.
Dr. Dave prefers the Oral B Braun electric brush.
The brush head is smaller, and the vibrating motion is slightly faster than the Sonicare. Most models don't beep every 30 seconds, but they do notify you when you've gone 2 minutes. They splatter and dribble more than the Sonicare, and can be messy unless used in the shower. The brushes are less expensive than the Sonicare, and there are some specialty shapes for cleaning orthodontic appliances and wires. Braun also makes a smaller, cheaper, spiffed-up brush for kids.
Oral B now sells the Sonic Complete, which is direct competition with the Sonicare. It is almost a carbon copy of the Sonicare Elite, and they probably budgeted more money for legal defense of the copyright infringement lawsuit than for R & D. It's a nice brush, and the brush heads are a bit cheaper than the Sonicare, but more expensive then the Braun.
All the brushes mentioned have removable heads, so that each member of the family can have their own brush and share the motor section. We don't recommend this--there's too much dribble-back effect. You wouldn't share toothbrush handles with someone, and the motor is just a glorified handle.
Oral B has just come out with a new and improved brush called the Triumph. This one slices, it dices, it walks, it talks--and does it in Spanish or Greek if you want (I think--I can't actually read Greek). If you simply must have the latest and greatest, by all means buy one. I don't think it's better than their old brush, but it is definitely cooler . . . and more expensive, of course.
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