The NY Times book review yesterday was a review of a book by Norris Church Mailer, Morman Mailer’s last wife that mentions that his life started to go downhill after his surgeons insisted that he get all his teeth pulled before they perform a coronary bypass operation. He did, but the implants they attempted failed, his false teeth didn’t fit right and it generally led to loss of quality of life.
Now, I have known a number of people who had coronary bypass operations and, while they have sometimes led to loss of life quality (usually cognitive) but I have never heard of pulling all the teeth. Wouldn’t a prophylactic use of antibiotics have accomplished the same thing? Is this common or does anyone know if there was something special about Mailer’s teeth?
Bacterial endocarditis is a bitch, a lady in my rehab class has 2 replaced valves thanks to an infection on her shin :eek: so I would imagine if you are weakened from a cardiac procedure, any gumline infection could travel and set up shop somewhere nasty.
I personally would refuse and tell them to load me with antibiotics - I have all my teeth, and they are in good condition and unless you can tell me 100 percent I will die if they are not yanked, you can sod off with that little suggestion.
There is a pretty solid correlation between oral bacteria and cardiac issues. A lot of research has been focused on this area in the last few years. Not knowing specifics, I would assume that he had advanced periodontal disease.
From: Periodontal bacteremia and various vascular diseases.
Iwai T.
Journal of Periodontal Research. 44(6):689-94, 2009 Dec.
Other Cites:
Periodontal disease and systemic health: current status. [Review] [76 refs]
Cullinan MP. Ford PJ. Seymour GJ.
Australian Dental Journal. 54 Suppl 1:S62-9, 2009 Sep.
[Journal Article. Review]
Editor’s consensus report: periodontitis and atherosclerotic cardiovascular disease.
Pickett F.
American Journal of Cardiology. 105(3):424-5; author reply 425-8, 2010 Feb 1.
[Comment. Letter]
Periodontal status and Prevotella intermedia antibody in acute coronary syndrome.
Soejima H. Oe Y. Nakayama H. Matsuo K. Fukunaga T. Sugamura K. Kawano H. Sugiyama S. Shinohara M. Izumi Y. Ogawa H.
International Journal of Cardiology. 137(3):304-6, 2009 Nov 12.
[Letter. Research Support, Non-U.S. Gov’t]
Destructive periodontal diseases, systemic inflammation, and atherosclerotic complications: the emerging role of the dental profession.
Craig RG.
Journal of the California Dental Association. 37(11):773-7, 2009 Nov.
[Journal Article]
We had a senator who was running for re-election and he had heart surgery due to a dental problem. That was the first I had heard of it. He lost a close race and it’s possible the time he spent off the trail may have cost him his seat.
Well, they didn’t tell my mom to get her teeth pulled before her first triple bypass - she’d already lost almost all of them to gum disease before then.
Never heard of pulling teeth as a prerequisite for heart surgery. However, it’s my understanding that people with artificial body parts (heart valves, joints, etc.) are generally advised to take prophylactic antibiotics prior to any dental procedures, including routine cleaning, due to the risk of oral bacteria traveling from the mouth to the implant. Certainly, it’s the case for my father (joint replacement) and father-in-law (heart valve replacement).
As others have said: If the teeth are in poor shape anyway, pulling them so the gums can heal will make it less likely to get serious complications with the heart later.
A friend had a kidney transplant about 5 years ago. During a conversation with his doctor, before the surgery, this came up. One option was to have all his teeth pulled to reduce the chanced of complications due to later dental work.
He chose to have a complete teeth cleaning, and have some potential cavities filled, before the transplant. Any post transplant dental work is accompanied with antibiotics and keeping an eye out for any complications.
That sounds kind of crazy to me, given the complications that can arise from not having teeth! Unless there was some sort of ongoing problem, but it seems like one of those situations where the side of effects of prevention can be as bad as the complication you’re trying to avoid.
That’s a little different because the anti-rejection meds are going to reduce the effectiveness of his immune system (that’s their purpose). Mailer’s wife claimed he started going downhill as a result of the teeth being lost.
My dad have valve replacement/repair surgery about 7 years ago. His cardiologist recommended that he get all of his teeth pulled. He’s done pretty well with dentures.
So…if one does have all their teeth pulled prior to a major surgery, who does the pulling: doctors or dentists? And for insurance purposes, is it a dental expense (and not covered) or a medical expense (and covered)?