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dentists, and taking antibiotics

Here’s a letter I got recently from a wonderful dentist who reads this blog/site. I won’t give my own response until I hear some of yours. What are your thoughts?

Dear GreenSmoothieGirl:

I think you are pretty conservative and avoid antibiotics, but I had an interesting experience recently in my dental practice that I want to share with you.   You influence a lot of people to make better choices for their health, and if you agree with me and my position as a health care provider and trying to do what is in the best interest of my patients, maybe you can pass this on to your readers.   The AAOS (american academy of orthopaedic surgeons) currently recommends that persons who have had total joint replacements should take one dose of antibiotics one hour prior to high risk dental procedures (not a whole week of antibiotics, just one dose) to avoid bacteremias forming in the artificial joint and causing a systemic infection and possibly failure of the artificial joint.   I had a patient recently who refused to take an antibiotic before a procedure because she avoids taking antibiotics in general.

I contacted her orthopaedic surgeon, and the nurse from his office recommended the same protocol for her, and she still refused.   She walked out of my office informing me there was no way she was going to take the antibiotics and she would find another dentist who would do the work without making her take the antibiotics.   I worry about her health and the risks she is taking.   I also worry about the dentist she finds to treat her without following the standards of care, as his license may be in jeopardy for treating her this way if complications were to arise anytime down the road.

I try to avoid antibiotics whenever I can for myself, but there are times when it may be worth the major complications which could arise.   I am not willing to put my license and my career on the line to treat someone who refuses to follow the written protocols and standards of care for surgeries which they have had done in the past, which now place them in a higher risk category.   I don’t know if you understand what I am saying here, but let me know if you agree or disagree with me.

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