New and Confused

[debrap]

Hello, I am new to this site. I am so glad I found it, it has been very comforting to know I am not alone in this, or losing my mind with worry. I have a BAV and am pre-op but at this point I don't know when. My consult with the surgeon is in 2 weeks. My cardio says my aortic root is at 52mm(?) and will have to be replaced along with the stenotic valve. My question is at this point, I need some dental work done, (a couple of extractions and a cap) and each of these Dr's offices, tell me to ask the other one if it is ok to proceed with the work. I am losing time waiting for them to let me know something, one way or the other. Either I go ahead and get it done, and risk delaying the surgery, or I delay the dental work and risk the surgery being delayed again (because I didn't have it done). I am worring myself sick at this point and just don't know what to do anymore. Each time I phone them, it is a day or two before they call me back, and they ack like they never heard me ask about it the time before? anyone have any suggestions? Thanks

[kfay]

Hi and welcome. I actually grew up in Nashville. Are you having your surgery at Vandy? I am 4 months post op from having my surgery at the Mayo clinic. I was told to take care of any dental work before I had surgery and then when I was given my discharge instructions, I was told not to have ANY dental work done for 6 months. (My dentist also told me he wouldn't touch me for 6 months even though I had a crown come off and break what tooth I had remaining with it. He just stuck it back on and told me to come back when my 6 months are up.) Not everyone has been given those same instructions, but if at all possible, I would get it taken care of now. I'm sure that others will be along to chime in.

Good luck,

Kim

[dick0236]

Welcome, I am more of an IRL fan than NASCAR.

I would think that either your cardio or dentist is in the best position to give you this advice. Unless your surgery is imminent I would guess I would get the dental work done before surgery. I have had several crowns and extractions after my surgery with no problems.

[ottawagal]

Hello and welcome to this site. Although I do not have a surgery date, I was informed by the cardio that OHS will be imminent (upcoming months to years), (biscuspid - severe aortic stenosis, but apparently asymptomatic). He did emphasize at my last follow up that my dental hygiene must be excellent and that all dental work should be completed prior to consideration for valve replacement surgery. I hope this helps. I do echo Dick's comment that it is ultimately up to your cardio and dentist to dialogue on this.
fyi...there are new guidelines (2007) from the AHA regarding antibiotic prophylaxis for the prevention of bacterial endocarditis.
Hope this helps and all the best!

[Jkm7]

Welcome. Happy you found us.

First thing my surgeon's office told me when I was setting up appointment to meet with him was to have letter from my dentist saying I had no major work needed and no infection in my mouth.

I also was told to not have any dental work for six months post op.
I have been very careful to not eat anything that could crack a tooth or pull out a filling. I am now past 5 months post op so am starting to feel relief that if I need dental work, it will be okay.

I would advise you stay on top of the dentist and have the work done ASAP. Sounds like he may be dragging his feet in hopes you'll go to another dentist. If you aren't totally attached to him, might not be a bad idea to find a new one.

Hope we can help you with questions/support.
The wait truly is the worst part.

[ruthienc1]

Welcome! I had my surgery put on the schedule this past March for mid-May and was told I would need a dental clearance before the surgery could take place. Then the fun began! Two root canals and two crowns later (neither one of which was causing discomfort, but which turned out to be needed) I got my clearance. What a relief- and unexpected expense! Good luck to you........

[ponygirlmom]

Each time I phone them, it is a day or two before they call me back, and they ack like they never heard me ask about it the time before? anyone have any suggestions? Thanks

It sounds like both of your doctors have a case of Bad Office Staff. It's time to turn into the Annoying Patient from Hell.

Has anyone told you WHY you need the extractions? If you have an infection, then there is absolutely no question that your surgeon will require them. In that case, if your dentist has any questions, HE should be talking to your surgeon.

If your dentist wants to take out your teeth because they are making your smile all crooked-y, then TOO BAD! it will have to wait.

Find out who hasn't yet talked to whom, and the hound them, hound them, hound them. Show up in person if you have to.

[Freddie]

Hi there debrap and welcome to this amazing family.
Can't add much more that has already been said. I just wanted to say "hi"

[aussigal]

It will be easier if you can get this dental work over and done with. I too had to visit my Dentist pre-op and luckily for me I was all clear and good to go.

[khawkk]

My surgeon said I should do any needed dental work at once.

Note: The word is NEEDED.

[WayneGM]

Welcome to the VR community. Glad you found us. I echo what's been about getting needed dental work done prior to your OHS. Best wishes and good luck.

[Cooker]

Welcome to the zoo ....take off your coat and stay a while:D

[ALCapshaw2]

Welcome Debra,

I concur with the advice others have already posted, i.e. press the Doc's to confer on a plan to deal with your dental issues. I expect most surgeons would want your dental issues to be resolved before surgery.

Since you have BAV, I also encourage you to read through the Bicuspid Aorta Valve and Connective Tissue Disorder Forum for LOTS of information on those issues. Hopefully, one of your Doc's will order a Chest CT or MRI to check for aneurism(s) of the aorta. Note that an ordinary Echocardiogram does not give good images of the entire aorta.

IF you have an aneurism or signs of Connective Tissue Disorder, it would be wise to find a Surgeon who specializes in surgery of the Aorta which is often beyond the 'comfort zone' of most Heart surgeons, especially those who treat mostly Coronary Artery Disease and an occasional first time Valve Replacement.

The GOOD NEWS is that your conditions are FIXABLE with high rates of Success.

Out of curiosity, what surgeon / hospital were you referred to?

'AL Capshaw'

[debrap]

Thanks for all of your advice and well wishes. I feel I need to apologize for my first post, I was very agitated. It was the communication (or lack thereof) from the cardio staff and the surgeon's staff that was getting to me. I now finally have the ok to get the dental work done this week. The dental work is an extraction in leu of a molar root canal and another 2 crowns to repair some large lost fillings. I have had a number of tests done since jan 08, including several echo's, a CT an MRI, a nuclear stress test, a Tee and finally just had a cardiac cath done. I was referred to Dr John Lea at St Thomas here in Nashville. It is really good to know I am not alone in this. Thanks again.

[Dawn-Marie]

Hi Debra and welcome to this site. I know my heart surgeon insisted that i get any needed dental work done before he would perform surgery. He said that after valve replacement he doesn't like a person to have dental work done for at least 6 months thereafter, so anything that needs doing should be done. He said dental work done within the six month period carried high risk of infecting the new valve and making it useless. So, i'd go ahead and get it done if i were you...then you don't have to worry about it after surgery. Just make sure to take a course of antibiotics beforehand.

Good luck!!

[Phyllis]

Welcome, Debra. Be sure to let us know when you have a surgery date so we can add you to the calendar. I'm glad you have resolved the dental work issue.

[marie]

Good luck and I'm happy to hear you can resolve your dental issues prior to surgery. No matter how well you plan however sometimes things just happen. I had a complete dental work up prior to surgery and then about three months after surgery I broke a bridge and with it a tooth.

The tooth wasn't hurting and both my cardio and dentist had me wait six months before having anything done.

So it's good to get it done first IMHO.:D

[ALCapshaw2]

It sounds like your pre-op testing / dental treatments are progressing well.

Was there any sign of aneurism(s) from your CT or MRI?

If so, be sure to ask your surgeon about his experience with surgery of the aorta, especially if your have any issues up to the aortic arch. That can be especially 'challenging'.

I'm not familiar with your surgeon but know that St. Thomas does a lot of Heart Surgeries.

'AL Capshaw'

[CCRN]

Thanks for all of your advice and well wishes. I feel I need to apologize for my first post, I was very agitated. It was the communication (or lack thereof) from the cardio staff and the surgeon's staff that was getting to me. I now finally have the ok to get the dental work done this week. The dental work is an extraction in leu of a molar root canal and another 2 crowns to repair some large lost fillings. I have had a number of tests done since jan 08, including several echo's, a CT an MRI, a nuclear stress test, a Tee and finally just had a cardiac cath done. I was referred to Dr John Lea at St Thomas here in Nashville. It is really good to know I am not alone in this. Thanks again.

HI!

You have a great Surgeon and hospital. I know because I work there and had the exact same surgery......(I guess I am a little biased) :) I hope everything goes well for you. It looks like you're on track and the right things are being done. Wish I had checked in on the site earlier last month. Nice to know of another valve replacement member in Nashville.

[hensylee]

welcome to VR. Hope you will be able to quickly resolve this dental issue. It's important.

Glad to have you with us. Blessins...........

[Illinois Al]

I have a BAV and am pre-op but at this point I don't know when. My consult with the surgeon is in 2 weeks. My cardio says my aortic root is at 52mm(?) and will have to be replaced along with the stenotic valve. My question is at this point, I need some dental work done, (a couple of extractions and a cap) and each of these Dr's offices, tell me to ask the other one if it is ok to proceed with the work.

I was in a similiar situation; after my initial diagnosis (on July 17) I was in the hospital, and it was determined I needed an Aortic Conduit replacement (valve + aorta, I assume that is the same as "aortic root") and one bypass.

However when they found out I had a cavity that had been discovered at a dental checkup that hadn't been filled yet (an appointment was pending) they released me to have the dental work done first, then readmitted me for the operation which was on August 8. For the dental work I had to be "pre-medicated" which was just taking an antibotic one hour before the procedure.

I'm not sure why the doctors are avoiding making a decision, I would think the best thing to do is get the dental work done (get "pre-medicated") ASAP and then have the OHS.

But I'm obvioiusly not a medical expert, I can just telll you my experience.

[Laura R]

Hi Debra and welcome. I'm pre-surgery myself, but I have read that you should get your dental work done before surgery, if possible.
Are you sure you need extractions? I was told that I should get my wisdom teeth extracted, but I objected and went to another dentist for work on those teeth instead of letting them be extracted.
Try not to stress too much about it. You have enough to stress about already!
Laura