Mx of unrestorable tooth - heart valve

Question 1

What are tx options for unrestorable tooth w/ chronic PAP?

Answer 1

1. XLA
2. Leave and monitor

Question 2

What are the risks of XLA of upper second molar?

Answer 2

OAF requiring surgical repair, displacement of roots into sinus

Question 3

What is risk in pt w/ heart valve of XLA

Answer 3

Small risk IE - 1 in 10,000
Increased risk w/ previous IE

Question 4

What factors might see on RAD that make more favourable xla

Answer 4

PA lesion reducing bone support, generalised bone loss

Question 5

What features see RAD that suggest more complex xla?

Answer 5

Divergent and curved roots, heavily restored crown

Question 6

There is a 65-year old pt w/ prosthetic heart valve, ischeamic heart disease and type II diabetes. What are key points about his MH?

Answer 6

Previous IE
Bleeding disorders - any anticoagulant medication?

Question 7

What is IE?

Answer 7

Introduction of bacteria into the bloodstream which then colonises the heart lining, most often the valves

Question 8

Who is at more risk of IE?

Answer 8

Pt w/ prosthetic valves
Previous IE
CHD

Question 9

How to mx pt is higher risk of IE group?

Answer 9

If invasive dental procedure what to lease w/ pt cardiologist to see if ab prophylaxis is required

Question 10

Is ab cover routinely provided?

Answer 10

Dental procedures are no longer thought to be main cause IE and therefore ab not routinely prescribed

Question 11

What guidelines should be followed?

Answer 11

SDCEP

Question 12

What is first line ab used for IE prophylaxis?

Answer 12

Amoxicillin 3g sachet

Question 13

What is second line durg/ drug used if penicillin allergy?

Answer 13

clindamycin - 60mg capsule

Question 14

What drug to give if pt allergic to penicillin and unable to swollen?

Answer 14

Azithromycin - 500mg in oral suspension

Question 15

What are common side effects with ab?

Answer 15

GI symptoms, ab related colitis, allergic reaction