March 30th, 2012

Our Obsession with Dental Antibiotic Prophylaxis and an E-mail from Mom

I have a regular, highly efficient email correspondence with my mother — who never really liked talking on the phone to begin with (neither do I), so email is perfect for us.

The topics we cover are mostly family stuff, and food — she’s a food writer, after all, so it might be a recipe worth trying or a recent restaurant find.

But yesterday it was this:

I went to have my teeth cleaned today and they wouldn’t do it unless I took an antibiotic because of the plate in my ankle. They gave it to me, I waited 25 minutes, and then had my teeth cleaned. Was that necessary?


Where do I begin? I considered responding with a terse, “Nope” — but what’s the fun in that? Plus, even though she never went to medical school, she seems to get medical concepts better than most MDs.

It’s broadly misconceived by dentists and orthopedists alike that the risk of antibiotics is lower than the risk of “seeding” an artificial joint or plate by the dental work.
Clearly wrong.
But that doesn’t stop them. And it’s because surgeons are much more worried about passive errors (not doing something) than they are about harming someone with an active error (medication side effect).
They’re surgeons, after all.  Maddening.

For her added reading pleasure, I sent her this reference, and this editorial.

I’m sure she’s read every word.

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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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