There are many reasons dental appointments need to be delayed. Some are obvious: you’re sick, your hygienist is sick, the dentist is sick. Some aren’t so obvious. At our office, we would rather delay elective treatment and cleanings and reduce the risk of problems to you, to our other patients, and to our office staff. As a general rule, the approach “your teeth will be there when you’re feeling better” is often the most prudent.
We encounter the following scenarios in our dental office all the time. While we love when patients stay on schedule with regular maintenance and restorative work, sometimes it’s better to delay a few days or even a few weeks.
“I had surgery 3 weeks ago; I feel fine. Can I still come in?”
It depends. Different surgeries carry different risks post-operatively.
Heart surgery, Brain surgery, Organ replacement surgery
Usually heart, brain, or organ replacement surgeries are a pretty big deal! Most surgeons recommend a waiting period after the surgery before having dental work (including cleanings) done. The waiting period depends on the type of surgery, the extent of the surgery, and any complications after the surgery.
A medical clearance form from your surgeon is usually needed prior to dental work, both to let us know you’re healthy enough for dental work and to let us know if any additional precautions are necessary for your procedure. Sometimes a medical clearance advises waiting a few more weeks, sometimes it’s a few months. Occasionally, surgeons will request we use different anesthetic or will recommend certain procedures be performed in a surgical or hospital setting. Sometimes, they’ll recommend antibiotics taken before dental procedures. In any event, it’s always better to speak up ahead of time so that everyone can be on the same page.
*Due to the increased risk of infection, most patients who undergo organ replacement surgery will need antibiotic prophylaxis (one dose of antibiotics) prior to all dental procedures for life.
Knee, Hip, Joint Replacement Surgery
Many joint replacement surgeries are done in outpatient settings where patients can return to the comfort of their own homes that evening. Often patients recover rapidly, pain is often greatly relieved, and normal function seems to return very quickly. While you may feel better, the new joint takes some time to stabilize with regards to your body. Thus, many surgeons want patients to wait 6 weeks -to- 6 months after surgery for dental care (including cleanings). This allows a more comprehensive recovery with less risk of any complications from dental procedures.
Antibiotic Prophylaxis
Many orthopedic surgeons recommend patients have a course of antibiotics prior to dental procedures. Some surgeons require antibiotics before dental procedures for two years following surgery, others require antibiotics for life. Usually this is a course of one dose of amoxicillin or clindamycin taken orally 1 hour before dental procedures. The theory is that the antibiotics will neutralize any harmful bacteria from the mouth as it enters the blood stream, preventing an infection from establishing a foothold at the new joint. More research is needed to further our understanding of the effectiveness of this practice. As a dental office, we defer to the orthopedic surgeon on whether you need the antibiotics or not. We highly encourage patients to discuss their individual need for antibiotic prophylaxis with their orthopedic surgeons.
Heart Attack/Stroke
Heart attacks and strokes are very serious situations. Unfortunately, the risk of having either a second heart attack or a second stroke are the highest in the first six months following the initial episode. Any dental procedure that can be delayed, will be pushed back to six months after the initial episode and a medical clearance is needed from your doctor. Dental treatment under an emergency basis is possible, but often needs special precautions to ensure your safety.
Herpes Simplex / Cold Sores
Cold sores are a bane of everyone’s existence. They’re painful, they ooze, and they pop up at the WORST times. They’re also highly contagious, especially at the cracked-oozy stages. Cold sores are a manifestation of the herpes simplex virus. There is no cure, though many people find different anti-virals work well to expedite their recovery.
Cold sores pose a unique risk to everyone in the dental office. To the patient, pulling on the side of your mouth may cause tearing and more oozing of a cold sore. The virus particles can spread to other parts of your mouth or other parts of your face. Herpes simplex can be particularly problematic if it enters a person’s eyes.
Cold sores also put your dental team at risk. Though Universal Precautions are always taken to keep your dental team safe, dental procedures inherently create aerosols, thus making fluids (including virus particles) airborne. Though goggles are worn, they do not block 100% of fluids from splattering around the eyes of dental professionals. While rare, it is unnerving to feel a drop of “something” hit your protected eyelids while working on a patient.
Needless to say, in order to keep everyone safe, if patients present with an active cold sore, we will kindly reschedule their appointment. When in doubt, just call and ask and we’d be happy to answer any questions!
The Flu
If you’re feeling terrible and run-down, have a fever and chills, and the idea of coming in and somehow getting through your appointment sounds extra horrendous, you should reschedule your appointment. Fever, chills, general fatigue, muscle aches, etc., are all signs of the flu. Key points with the flu: 1) dental visits are only so fun , coming with the flu can be unbearable; 2) we don’t want you to get anyone in the waiting room sick; and 3) none of your dental team wants to get sick either! Take a few days to feel better, see your medical doctor if necessary, drink plenty of fluids, and we’ll be happy to see you when you’re on the mend!
Common Cold
So, it’s not quite the flu and it’s not bad enough to stay home? Still don’t feel great? Please use your best judgment. We wash our hands very frequently, we employ Universal Precautions, and we do our very best to not get sick. The chances of your dental team getting sick from a cold are actually pretty low. If you can’t recline without coughing, if you absolutely can’t breathe through your nose, or if you’re worried you’re actually getting the flu, it’s probably best if you stay home. If you’re just a little run-down and just know you need to drink more fluids, it’s probably okay for you to come in. Again, use your best judgment. Your teeth will be there when you’re feeling better!
Your long-term health, safety, and happiness mean the world to us. As always, when in doubt, give our office a call and we’d be happy to answer any questions.
