Human Petrie Dish

    As I mentioned on Facebook recently, I have been in a vicious antibiotics cycle. Ever since I got artificial knees six years ago, I had to take amoxicillin before my twice yearly dental cleanings. Because of that frequency, I developed an allergic reaction to amoxicillin. Because of that allergy, for my recent wisdom tooth extraction I was given clyndamicin. I did not have an allergic reaction to that, I got C-Dif, which is what happens when antibiotics kill off the good bacteria in your intestines and leave the thugs to proliferate. Colons are unhappy with the thugs and attempt to "eliminate" them. My colon was so bent on elimination, I could not go anywhere a bathroom wasn't handy. Because of the C-Dif, they gave me--you guessed it--antibiotics. Big gun antibiotics that aim specifically for the intestines--vancomycin. One of the potential side effects of vancomycin is hearing loss, and I know people this has happened to. It is permanent. And it's really important to finish the entire vancomycin prescription or you can wind up with the brain-eating zombie version of intestinal bacteria.
     The (probably overcautious) reason for giving dental patients antibiotics before having their teeth cleaned, is the (probably exaggerated) fear that bacteria from the gums will enter the bloodstream and infect the artificial joint. I can just picture two newly freed germs discussing this:

   First germ, "So, where do you want to go now?"
   Second germ, "I know this new joint where we can hang out."

    At a time when unnecessary (which used to be considered medically necessary) antibiotic use is being discouraged by physicians, it is encouraged in dentistry even though there is very little data to  justify it. Even in those rare occurrences of infection, it appears to be related to diabetes, bleeding disorders or poor oral hygiene, not gum disturbance by itself. In a few years, I expect they will reverse the recommendation because the danger of antibiotic resistance far outweighs the odds of artificial joint infection.
    That is what happened to my husband. He went through his entire childhood dental visits without prophylactic antibiotics. When we moved to Kalispell, he was told he had to have them because he had rheumatic fever as a child. After about 25 years of taking pre-meds, his dentist said they were not necessary. Oopsy! Antibiotics can be discontinued but the bitter pill to swallow is there is no "undo" function on a prescription bottle. So I have no intention of taking premeds before my upcoming teeth cleaning and probably for any after that. I will gladly sign a waiver but, unless they can show me hard data linking teeth cleaning to artificial joint infection in a healthy person whose surgery healed years ago, I will not waver. I have no interest in being the human petrie dish for a study on the lifecycles of bacteria.