A Warm Hello to All,

One of my friends is going through treatment for periodontal disease.
She has been having intermittent sessions of "scaling and root planing," as I understand her at this time. The dental hygienist is completing this work in 4 different appointments, each session 2-3 weeks apart.

My friend reports she is made very comfortable during the sessions, thankfully.

The concern:

After the first session, she became very ill for 4-5 days. It took a full week for her to totally recover. She had severe fatigue/ lethargy, whole body severe aches/pain, headaches, generalized GI upset with nausea, vomiting and ongoing diarrhea. She reports the weakest areas of her body, areas where there have been prior injuries, were the areas with the most ongoing pain after the dental session.

We know bacteria gets stirred up in this process/procedure.

Is this type of a reaction expected?

Is this type of a reaction all due to the bacteria stirred up, or might some of it be due to the meds injected for analgesia for gums/teeth during the procedure?

I had asked her if she was offered antibiotics and/or if she could later call and request antibiotics if she was too ill from the systemic effects of the procedure?

She had told me the dental hygienist had told her they only offer antibiotics to someone if they have a heart issue, a joint replacement, an immune deficiency and/or if they have an autoimmune disease. My friend does not have any of the listed conditions.

My friend is not one to ask for antibiotics quickly or easily. She likes "natural approaches" whenever possible. She had kept herself very hydrated and kept wishing for the best; however, she was so ill she was a bit frightened by the severity of illness that struck her within a couple of hours of finishing her first session with "scaling and root planing." She was in touch often, due to the severity of her symptoms. I know her well and have never known her to be so ill as she was then. I was also concerned about her welfare, as she lives alone in a rural area.

The worst of her symptoms were over a weekend, as the procedure was done on a Friday, and the dental clinic was not open over the weekend for calls.

She is having another session later on today, again a Friday.

What's the usual "standard of care" for use of antibiotics when "scaling and root planing?"

I have suggested she let the dental hygienist know ALL of her symptoms from the last session. I have also suggested she consider a course of antibiotics IF she is offered a choice, since she had such a truly difficult time after the last session.

What is the usual standard or care for this procedure?
Should she press for antibiotics if not offered that option?
Should she request different options?
What else may help to support her body in fighting the bacteria and/or in recovering from any/all effects of the procedure?

Thanks so much for any insights/knowledge/experience shared.

I hope she does not suffer like she did for several days after the last procedure.

I hope everyone has a fun weekend.

With Sincere Gratitude,
DejaVu

I hope Bryanna will see your post and respond.

Just my opinion, but I think in your friend's case, she does need antibiotic support during these procedures.

Not everyone may, but it sounds like your friend does even if it is not "standard" except in particular circumstances.

I believe in using antibiotics sparingly but it sound like this patient will benefit from them.

Hi Hope,

Thanks so much for your response.
I saw your response very shortly after you had posted. I wasn't able to respond to thank you just then.

I seems like she may well be a candidate for antibiotics if this was all related to the dental procedure. She feels it was related, which counts for something.

I hope this next session goes more smoothly for her.

With Gratitude,
DejaVu

Hi DejaVu,

Antibiotics should only be prescribed on a case by case basis. Taking them when it is not warranted can actually cause an adverse immune response because the medication destroys healthy bacteria in the digestive tract which is where 75% of our immune system resides. We need that healthy bacteria to kill off the bacteria that is stirred up during rp procedure. So it is not "best" to take an antibiotic as a preventive, in most cases.

Her reaction to the procedure, if that is what it actually was, is definitely extreme. I am leaning towards a couple of other possibilities.

One) Her intestinal health may not be as stable as she may have thought it was to begin with. Does she have frequent GI issues like IBS or other? Does she have candida? Does she eat a whole foods diet or one that contains processed foods and sugar? Does she take a probiotic as a nutritional supplement every day?

Two) She may have been getting ill (unknowingly) prior to the procedure and the stirring up the bacteria in her mouth just exacerbated the illness.

Three) Did she have her period at the time of the procedure? With some women there immune system is not functioning optimally the week of their period or just prior to the onset of it.

Four) If she has had periodontal disease for a long time and/or she has moderate to severe perio disease where she is oozing pus from her gums, or she has infected or abscessed teeth, then her intestinal bacteria is already compromised due the chronic swallowing of the infection. Depending on the person, the stimulation of that infectious bacteria in the mouth can, in basic terms, systemically stimulate the bacteria residing in the intestines and a person can become quite ill.

Five) If she was very anxious prior to and/or during the rp procedure this could result in a systemic reaction where she could have a multitude of symptoms post operatively.

The things she can do to help reduce the reaction would depend on the longevity and degree of her perio disease, the status of her overall oral health as well as her overall systemic health.

There is no standard protocol to prescribe antibiotics for root planing procedures. It is based on a case by case basis and can be detrimental if prescribed unnecessarily.

Bryanna





TE=DejaVu;1215142]A Warm Hello to All,

One of my friends is going through treatment for periodontal disease.
She has been having intermittent sessions of "scaling and root planing," as I understand her at this time. The dental hygienist is completing this work in 4 different appointments, each session 2-3 weeks apart.

My friend reports she is made very comfortable during the sessions, thankfully.

The concern:

After the first session, she became very ill for 4-5 days. It took a full week for her to totally recover. She had severe fatigue/ lethargy, whole body severe aches/pain, headaches, generalized GI upset with nausea, vomiting and ongoing diarrhea. She reports the weakest areas of her body, areas where there have been prior injuries, were the areas with the most ongoing pain after the dental session.

We know bacteria gets stirred up in this process/procedure.

Is this type of a reaction expected?

Is this type of a reaction all due to the bacteria stirred up, or might some of it be due to the meds injected for analgesia for gums/teeth during the procedure?

I had asked her if she was offered antibiotics and/or if she could later call and request antibiotics if she was too ill from the systemic effects of the procedure?

She had told me the dental hygienist had told her they only offer antibiotics to someone if they have a heart issue, a joint replacement, an immune deficiency and/or if they have an autoimmune disease. My friend does not have any of the listed conditions.

My friend is not one to ask for antibiotics quickly or easily. She likes "natural approaches" whenever possible. She had kept herself very hydrated and kept wishing for the best; however, she was so ill she was a bit frightened by the severity of illness that struck her within a couple of hours of finishing her first session with "scaling and root planing." She was in touch often, due to the severity of her symptoms. I know her well and have never known her to be so ill as she was then. I was also concerned about her welfare, as she lives alone in a rural area.

The worst of her symptoms were over a weekend, as the procedure was done on a Friday, and the dental clinic was not open over the weekend for calls.

She is having another session later on today, again a Friday.

What's the usual "standard of care" for use of antibiotics when "scaling and root planing?"

I have suggested she let the dental hygienist know ALL of her symptoms from the last session. I have also suggested she consider a course of antibiotics IF she is offered a choice, since she had such a truly difficult time after the last session.

What is the usual standard or care for this procedure?
Should she press for antibiotics if not offered that option?
Should she request different options?
What else may help to support her body in fighting the bacteria and/or in recovering from any/all effects of the procedure?

Thanks so much for any insights/knowledge/experience shared.

I hope she does not suffer like she did for several days after the last procedure.

I hope everyone has a fun weekend.

With Sincere Gratitude,
DejaVu[/QUOTE]

Hi Bryanna,

Thank you for a very comprehensive answer to the questions posed.
I deeply appreciate your time, your dedication, your compassion.

I agree with you on any unneeded use of antibiotics, as does my friend.

While she has taken probiotics daily for years, she was not taking them at the time of the dental procedures.

She eats whole foods and is one of the healthiest people I know re: eating a healthy diet, restricting unnecessary meds, etc.

No menstruation at the time of dental procedure.

Candida can always be an issue. She had lost the last of any excess weight over the past 9 months and has likely starved out any of the last of candida; yet, how can anyone know for sure?

She has had intermittent intestinal issues which have not been figured out to date.
These are relevantly recent, within the past 3 months and she has been looking at the well water, etc, to find a cause.
The reaction immediately after her dental work, was severe in nature.

She has taken probiotics daily for years. However, she was not taking probiotics at the time of the dental procedure.

I cannot be sure of the duration or severity of her periodontal issues. I believe she was told this was all caught just in time, whatever that may mean?
She has been held up from dental work due to other medical issues and financial constraints and is just now having an opportunity to address these dental issues.

I have passed your responses on to her, Bryanna.

This is what has transpired:

My friend went to the dental office for her next session. She had explained what had happened following her last session. She asked about the use of antibiotics in her case. She had a dentist and a hygienist assigned to her case. Her dentist became upset and quit as her dentist, stating she could not care for a patient who did not trust her. A colleague (dentist) signed on as her dentist and she kept the same hygienist, both of whom were not the least bit upset with her voicing her concerns and questions.

It was quickly decided they would postpone today's procedure and would move the procedure to a Wednesday, when they will have time to provide follow-up care, should she have an extreme reaction once again. This seems like a very reasonable plan, being available for any follow-up care, should follow-up be needed. (With this plan, she is not left ill over the weekend, without additional care, should she have a reaction, should she need assistance or should she need an antibiotic, after the next session.) Brilliant "common sense plan" put forth by my friend and agreed upon by her dental care team.

Thanks so much Hope and Bryanna for your rapid responses and very helpful input!

With Sincere Gratitude,
DejaVu

[/QUOTE]

DejaVu,

Okay, thank you for the update and additional information about your friend.

I am going to re post some of your thread and address some of those issues that you shared here as I think they are pertinent to her situation. I will re post and then reply in bold type.

<<While she has taken probiotics daily for years, she was not taking them at the time of the dental procedures.>>

ACTUAL PROBIOTIC SUPPLEMENTS, NOT IN THE FORM OF YOGURT OR ANY OTHER STORE BOUGHT FOOD SOURCE, ACT ALMOST LIKE A MEDICINE IN THE INTESTINAL TRACT. THEY ARE GOOD BACTERIA'S THAT SUPPLY AND CONTINUALLY REPLENISH THE HEALTHY BACTERIA'S THAT ARE DESTROYED FROM DAILY LIFE, POOR DIET, STRESS, MEDICAL CONDITIONS, METHYLATION DISORDERS, ETC.
IF SOMEONE IS SUPPLEMENTING WITH A DAILY PROBIOTIC FOR AN EXTENDED PERIOD OF TIME AND THEN COMPLETELY STOP, THEIR INTESTINAL BACTERIA MAY BECOME UNSTABLE OR IMBALANCED.

AN IMPORTANT SIDE NOTE ... PROBIOTICS ARE NOT A ONE SIZE FITS ALL MEDICAMENT. SINGLE STRAINS LIKE LACTOBACILLUS GG OR LACTOBACILLUS-PLANTARUM ARE IS GENERALLY TOLERATED WELL BY MOST PEOPLE. HOWEVER, CERTAIN PEOPLE WITH CERTAIN CONDITIONS REQUIRE SPECIFIC STRAINS OF BACTERIA EITHER AS A TEMPORARY MEASURE TO GET THROUGH A CERTAIN CHRONIC CONDITION OR FOR A LIFETIME. TAKING A PROBIOTIC THAT IS NOT CONDUCIVE TO THE INDIVIDUALS NEEDS CAN CAUSE FURTHER DIGESTIVE PROBLEMS WHICH FREQUENTLY SHOW THEMSELVES AFTER THE PERSON IS SUBJECTED TO ANY TYPE OF PHYSICAL TRAUMA SUCH AS DENTAL PROCEDURES LIKE ROOT PLANINGS. HER DENTIST, IF HE IS CONVENTIONAL, IN ALL PROBABILITY IS NOT GOING TO BE EDUCATED ON PROBIOTICS, ETC. IT'S NOT A PART OF THEIR DENTAL TRAINING. SO SHE WILL NOT GET ANY GUIDANCE FROM THAT PERSPECTIVE.

<<She eats whole foods and is one of the healthiest people I know re: eating a healthy diet, restricting unnecessary meds, etc.>>

A HEALTHY DIET IN THE TRUE SENSE IS FEW OR NO PROCESSED FOODS OR DRINKS .. REFINED SUGAR .. ARTIFICIAL SUGARS LIKE SPLENDA .. NO SODA OR OTHER SOFT DRINKS, DIET OR OTHERWISE. IT DOES CONTAIN FOOD IN THEIR WHOLE FORM LIKE VEGETABLES, FRUIT, MEAT, WILD CAUGHT LOW MERCURY FISH (BAKED, BROILED OR STIR FRIED), HEALTHY OILS LIKE VIRGIN OLIVE OIL, ORGANIC UNREFINED COCONUT OIL, ETC., NUTS, SEEDS AND WATER. EVERYONE IS A BIT DIFFERENT SO ONE DIET IS NOT MEANT FOR EVERY PERSON. BUT THAT LIST GIVES A BASIC FOUNDATION FOR A HEALTHY DIET TO BE DRAWN UPON.

<<No menstruation at the time of dental procedure.>>

NONE... JUST BEFORE, DURING OR JUST AFTER?

<<Candida can always be an issue. She had lost the last of any excess weight over the past 9 months and has likely starved out any of the last of candida; yet, how can anyone know for sure?>>

JUST CURIOUS, WAS SHE OBESE, MEANS HAVING A BMI (BODY MASS INDEX) OF 35 OR MORE? HOW MUCH WEIGHT DID SHE LOSE ALTOGETHER AND HOW DID SHE DO IT? BY THE WAY... KUDOS TO HER FOR LOSING IT!!!

CANDIDA IS A COMMON PROBLEM FOR MANY PEOPLE, OVERWEIGHT OR OTHER. HOWEVER ONCE THE WEIGHT IS LOST, THE INTESTINAL TRACT MOST LIKELY WOULD BENEFIT FROM SUPPLEMENTATION OF PROBIOTICS.

<<She has had intermittent intestinal issues which have not been figured out to date. These are relevantly recent, within the past 3 months and she has been looking at the well water, etc, to find a cause.>>

SHE COULD HAVE FOOD INTOLERANCE'S, AND/OR DYSBIOSIS (MICROBIAL IMBALANCE IN THE DIGESTIVE TRACT), AND/OR ANOTHER INTESTINAL DISORDER, AND/OR A METHYLATION OR MAST CELL DISORDER. ALL OF THESE ISSUES ARE QUITE COMMON AMONG THE GENERAL POPULATION.

AS A SIDE NOTE .... CONVENTIONAL MEDICINE RARELY EXPLORES, IN ANY DEPTH, THE ROOT CAUSE OF INTESTINAL DISORDERS. THEY ARE REAL QUICK TO MEDICATE THE SYMPTOMS.
PRACTITIONERS IN FUNCTIONAL MEDICINE, NATUROPATHY, HOMEOPATHY AND INTEGRATIVE MEDICINE USE VARIOUS TESTING METHODS, EVEN GENETIC TESTING, TO LOOK FOR THE ROOT CAUSE OF THE PROBLEM. THIS IS REFERRED TO AS "PEELING THE ONION" UNTIL THE CAUSE IS KNOWN.

<<The reaction immediately after her dental work, was severe in nature.>>
YES YOU MENTIONED THAT. AGAIN, THE PROCEDURE COULD HAVE IGNITED A PROBLEM THAT WAS PREVIOUSLY "SILENT" OR HAD "INTERMITTENT" SYMPTOMS. IT'S IMPORTANT TO KNOW THAT THE BACTERIA'S, BOTH GOOD AND BAD, THAT RESIDE IN OUR MOUTH, BELOW OUR GUMS, ETC ALSO LIVE IN OUR DIGESTIVE TRACT.

<<She has taken probiotics daily for years. However, she was not taking probiotics at the time of the dental procedure.>>

YEA, HER INTESTINAL FLORA IS LIKELY OUT OF WHACK. WHY DID SHE STOP TAKING THEM?
IF THE PROBIOTICS THAT SHE WAS TAKING PREVIOUSLY WERE WORKING FOR HER... IN OTHER WORDS NOT CAUSING HER ANY INTESTINAL DISTRESS, THEN IT WOULD BE WISE TO START TAKING THEM AGAIN ASAP.

<<I cannot be sure of the duration or severity of her periodontal issues. I believe she was told this was all caught just in time, whatever that may mean?>>

THE PHRASE "caught just in time" COULD MEAN SHE HAS AN ADVANCED STAGE AND WITHOUT INTERVENTION, WITHIN A SHORT PERIOD OF TIME SHE WOULD BE LOSING HER TEETH TO GUM DISEASE. IF THAT IS THE CASE, THEN SHE HAS HAD AN ONGOING ORAL INFECTION BREWING FOR A VERY LONG TIME AND THAT BACTERIA HAS TRAVELED SYSTEMICALLY. PERIODONTAL DISEASE OF THE ENTIRE MOUTH DOES NOT HAPPEN OVER NIGHT. IN MOST PEOPLE IT TAKES MANY, MANY MONTHS IF NOT YEARS TO DEVELOP TO THE POINT WHERE IT'S ADVANCED. CERTAIN MEDICAL CONDITIONS, POOR DENTISTRY, POOR ORAL HYGIENE, POOR DIET, MEDICATIONS ... ARE ALL CONTRIBUTING FACTORS TO PERIODONTAL DISEASE.
THE ROOT PLANINGS ARE DONE TO REMOVE THE INFECTION THAT IS VISIBLE AND TO ENCOURAGE HEALING TO TAKE PLACE IN THOSE AREAS. BUT THE PATIENT NEEDS TO BE VERY DILIGENT WITH THEIR HOME CARE IN ORDER FOR THE DISEASE TO NOT TAKE A HOLD AGAIN. OTHER FACTORS THAT ALSO CONTRIBUTE TO PERIO DISEASE ARE STRESS AND CERTAIN LIFESTYLE HABITS.

<<She has been held up from dental work due to other medical issues and financial constraints and is just now having an opportunity to address these dental issues.>>

YES, FOR MANY REASONS DENTAL HEALTH IS OFTEN TAKEN FOR GRANTED OR PUT ON THE BACK BURNER. IT CAN BE DIFFICULT TO DEAL WITH DENTAL ISSUES WHEN YOU DON'T FEEL WELL AND IT'S ALSO OFTEN DIFFICULT TO AFFORD PROPER CARE. THE LONGER WE WAIT TO SEE A DENTIST, THE MORE PROGRESSED THE PROBLEMS BECOME. BUT WE CAN ONLY DO THE BEST WE CAN DO AT THE TIME. HOPEFULLY SHE IS ABLE TO FOLLOW THROUGH WITH HER DENTAL CARE NOW AND COMMIT TO A REGULAR MAINTENANCE.

<<My friend went to the dental office for her next session. She had explained what had happened following her last session. She asked about the use of antibiotics in her case. She had a dentist and a hygienist "assigned" to her case.>>

WHAT COUNTRY DOES SHE LIVE IN? IS SHE GOING TO A DENTAL SCHOOL OR DENTAL CLINIC?

<<Her dentist became upset and quit as her dentist, stating she could not care for a patient who did not trust her.>>

SOUNDS LIKE IT'S A 'GOOD' THING THIS DENTIST CHOSE TO NOT TREAT HER ANY FURTHER. WHO NEEDS SOMEONE WITH A POOR ATTITUDE LIKE THAT?! EVERY PATIENT HAS EVERY RIGHT TO INQUIRE OR ASK QUESTIONS. PERIOD.

<< A colleague (dentist) signed on as her dentist and she kept the same hygienist, both of whom were not the least bit upset with her voicing her concerns and questions.>>

THAT IS REASSURING

<<It was quickly decided they would postpone today's procedure and would move the procedure to a Wednesday, when they will have time to provide follow-up care, should she have an extreme reaction once again. This seems like a very reasonable plan, being available for any follow-up care, should follow-up be needed. (With this plan, she is not left ill over the weekend, without additional care, should she have a reaction, should she need assistance or should she need an antibiotic, after the next session.) Brilliant "common sense plan" put forth by my friend and agreed upon by her dental care team. >>

I AGREE WHOLEHEARTEDLY! PLEASE TELL YOUR FRIEND I AM GLAD TO HEAR THAT SHE STUCK UP FOR HERSELF ... IT IS ALWAYS BEST TO BE OUR OWN HEALTH ADVOCATE!! KUDOS TO HER!!!

<<Thanks so much Hope and Bryanna for your rapid responses and very helpful input! >>

YES, THANK YOU HOPE
AND DEJAVU YOU ARE VERY WELCOME! I AM NOT HERE AS OFTEN AS I USE TO BE. HOWEVER, I DO CHECK IN FREQUENTLY. LET ME KNOW IF YOU HAVE OTHER QUESTIONS AND PLEASE KEEP US POSTED ON HOW SHE'S DOING