{1 - 24} GreyGrey
{25 - 49} GreenGreen
{50 - 499} BlueBlue
{500 - 4999} OrangeOrange
{5000 - 24999} RedRed
{25000+} BlackBlack

Please confirm that you would like to report this for an admin to review.


Premed/ Delaying TX

I’ve been working at a practice with one dentist for about a year now. Every time I have a patient with recent heart surgery or rods/pins that I’m concerned about either delaying treatment or needing a premed, he always says no. The only thing he thinks they should premed for are total joint replacements, and never is there a need to delay treatment. Should I mention I’m not allowed to take BP! I’m in situations where I’m uncomfortable with treatment regularly and today made me think hard about looking for something else. Is anyone else in these situations? What is the protocol in your office?



Confirm that you would like to Remove Email Alerts for your question. You cant undo this and you will not be able to re-subscribe.


7 Answers

Sue, thanks! I have searched the ADA and the American heart association, but nothing conclusive about delaying tx, just about what to and what not to premed for. It looks like asking the patients physician is the most responsible way to go, but my dentist wouldn’t put up with that if it meant rescheduling and concerning the patient.

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


When in doubt always contact the patient’s physician and document that you did so. Don’t do anything you aren’t comfortable with! Here is a link to the ADA’s recommendations (you may want to print it for your doctor!): http://www.ada.org/en/member-center/oral-health-topics/antibiotic-prophylaxis

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


They have changed protocol for stemmed so many times. Your best resources would be the ADS and American Heart Association. Show him the literature if it is not in accordance with his protocols. Of course you can always check with the pts. MD too.
It is tough working with a boss that doesn’t treat you like a knowledgeable professional, if you are asked to do things you are not comfortable with, document, document, document!

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


We always ask for clearance from the patient’s physician. It’s just safer that way for everyone. Why aren’t you allowed to take BP?

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


When he’s at his office it’s either nap time or social hour, so the vast majority of the patients are his friends or family (he’s Greek, he has a lot of family). He wouldn’t want to “inconvenience” them with BP. In the same way, he doesn’t like me to tell people about their perio issues as it would inconvenience them and insult them. He usually tries to downplay or disregard perio issues entirely ( but I still tell them what they need to hear, and some people are in bad shape). What if we had to tell a pt their BP was too high! We would have to reschedule! gasp! Or they may be insulted!
He’s a dentist who doesn’t want any problems….he’s nearing retirement…..so the way he’s used to is the way it’ll stay.

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


Protocols are continuously changing. Current literature states full joint replacement, heart valve replacement, or hx of endocarditis. No longer are all heart murmurs or partial joints needing premed. Here, the cardiologists rec not procedure for 3-6 months after tx but no premed needed.

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


If he isn’t retiring tomorrow, you might need to move on. He is practicing managed neglect…

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


You must be Logged In to Answer this Question

Already a Member, Log In
Not a member yet? Sign Up

Search

Categories

Like Kara RDH on Facebook!