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Antibiotics after tooth extraction - advice please


RickG16

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6 minutes ago, retiree said:

Gosh, it's almost as though you knew the American Heart Association evidence-based guidelines on the recommended use of antibiotic prophylaxis ???? 

 

We continue to recommend VGS IE prophylaxis only for categories of patients at highest risk for adverse outcome while emphasizing the critical role of good oral health and regular  access to dental care for all.  Randomized controlled studies to determine whether antibiotic
prophylaxis is effective against VGS IE are needed to further refine recommendations.

https://www.ahajournals.org/doi/10.1161/CIR.0000000000000969 

 

Fwiw, when I first read this thread I agreed with the "take the antibiotics" group -- it's what I've always gotten over the years. 

 

However, it turns out that thinking has changed in light of evidence, e.g. this Cochrane review from 2021.  After raising some concerns about the quality of evidence, it says: 

 

We concluded that antibiotics given to healthy people when they are having teeth extracted may help prevent infection, but the decision to use an antibiotic should be judged on an individual patient basis based on their state of health and possible complications of getting an infection.  ... On average, treating 19 healthy patients with prophylactic antibiotics may stop one person from getting an infection. 

https://www.cochrane.org/CD003811/ORAL_are-antibiotics-effective-way-prevent-infection-following-tooth-removal 

 

Interesting topic, 

-- Retiree 

I think that the thinking has changed over the years, however in this particular person's case he was having four wisdom teeth removed, and that can be quite a dreadful procedure, which I have first-hand knowledge of because the dental specialist actually broke my jaw in trying to extract my wisdom tooth!

It is an interesting topic and in my case, I strongly advocate antibiotics for the removal of four wisdom teeth, which can be very complicated and "messy"!

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56 minutes ago, xylophone said:

The quotes I used were from carefully controlled studies and not just any old "quotes from Google", and furthermore there is more information available on it, the deeper you wish to look; and I have been doing this research for decades now, and I have enough information and links in this research to prove my point.

I don't follow the media and "shallow social media blogs" when doing my research on prostatitis, but I do follow published papers and peer reviewed studies.

 

I'm not doubting your qualifications, however I am saying that you are mistaken on this particular point and my next point below further backs this up.

 

Again, further research will show that streptococcus sanguinis has been found in the prostate and in my case it was found in the urinary tract, which was verified by culture tests done at Bangkok Phuket Hospital.

 

The article below will explain this and hopefully put paid to any doubts you may have about this particular bacteria...........

 

According to the classification criteria established by the U.S. National Institutes of Health (NIH), prostatitis is divided into the following four categories: acute bacterial prostatitis, chronic bacterial prostatitis, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and asymptomatic prostatitis. CP/CPPS reportedly has a significant negative impact on the quality of life.1, 2 CP/CPPS accounts for 80% to 90% of prostatitis cases,3 but its etiology and pathogenesis remain poorly understood.


The pathogens isolated from global cases of acute and CP primarily include Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella, Proteus spp., Enterococcus spp., Pseudomonas aeruginosa, and Corynebacterium.4, 5 Chronic bacterial prostatitis may also be caused by anaerobic bacteria, the most common of which are Streptococcus sanguis and Bacteroides. Studies have also shown that sexually transmitted microorganisms, such as mycoplasma, Chlamydia trachomatis, Neisseria gonorrhoeae, human papillomavirus, and Trichomonas vaginalis, are among the most common pathogens of CP.3, 6


https://onlinelibrary.wiley.com/doi/full/10.1002/pros.23971
 

AND from another publtshed article:  Blood and urine cultures resulted positive for S. sanguinis. In this case, we report S. sanguinis causing urinary sepsis as a primary inciting event. Although S. sanguinis is an unusual cause of urinary tract pathology, treatment should be considered if the clinical picture is consistent with infection. Given the concern of dissemination, we recommend at least two weeks of antibiotics against S. sanguinis with repeated negative blood cultures prior to ureteral procedures.

 

For the record, my son is a medical professional in London and specialises in infectious diseases, and has published many papers. Perhaps the need to gain knowledge in this area is genetic!!!!!!!

The glaring mistake I perceive is that these articles and/or you, fail to address the main and salient point, which is that these bacteria only cause problems with compromised heart valves. The correct protocol here can almost be a life or death situation. As an aside, if you'd like me to explain why antibiotics are useless after extractions, you only have to ask.

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My impressions are that a) infection is usually an issue for the lower wisdom tooth extraction, but b) delayed infection is far more common for these, and c) prophylactic antibiotics immediately following extraction aren't much help for delayed infection (it's more about patient's dental anatomy predisposing development of a problem).  So, the proper course of action (like watchful waiting, maybe?) would rely on the dentist's judgment.   

 

Can crouchpeter (or any other lurking dentists) shed some light on this?  

 

-- Retiree 

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On 9/11/2022 at 8:34 PM, RickG16 said:

It's amoxicillin 

Amoxicillin supposedly stops bacteria getting to the heart, where it 'could' cause problems.

 

Why have four out in one sitting? Too traumatic! If you had pulled them yourself one at a time - with a gap of two weeks between - it would have been much kinder to the mouth and your body in general.

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22 minutes ago, crouchpeter said:

The glaring mistake I perceive is that these articles and/or you, fail to address the main and salient point, which is that these bacteria only cause problems with compromised heart valves.

With respect you seem to be missing the salient point in a couple of the links/research I have posted, whereby streptococcus sanguinis has been found in the prostate, and can be the cause of prostatitis – – and for anyone who has had this condition, that would indeed be a "salient point". So these bacteria DO NOT ONLY CAUSE PROBLEMS WITH COMPROMISED HEART VALVES!!!!!

 

It's all there, out in the open in published and peer-reviewed papers/research if you care to look

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5 minutes ago, owl sees all said:

Amoxicillin supposedly stops bacteria getting to the heart, where it 'could' cause problems.

 

Why have four out in one sitting? Too traumatic! If you had pulled them yourself one at a time - with a gap of two weeks between - it would have been much kinder to the mouth and your body in general.

Tbh Owl it's a week later and I feel fine. 

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6 minutes ago, owl sees all said:

Amoxicillin supposedly stops bacteria getting to the heart, where it 'could' cause problems.

 

Why have four out in one sitting? Too traumatic! If you had pulled them yourself one at a time - with a gap of two weeks between - it would have been much kinder to the mouth and your body in general.

I totally agree with your comment about having four wisdom teeth out in one sitting as being "too traumatic".

 

The one I had removed, lower jaw, took an age to remove (well over an hour as I recall) and was very bloody and messy and eventuated in me having a broken jaw!

 

God only knows what having four out at one time would entail!

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4 minutes ago, RickG16 said:

Tbh Owl it's a week later and I feel fine. 

Really pleased to hear that Rick, as after my experience, I wouldn't wish it on anybody, however you have come through with flying colours and all's well that ends well.

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11 minutes ago, retiree said:

My impressions are that a) infection is usually an issue for the lower wisdom tooth extraction, but b) delayed infection is far more common for these, and c) prophylactic antibiotics immediately following extraction aren't much help for delayed infection (it's more about patient's dental anatomy predisposing development of a problem).  So, the proper course of action (like watchful waiting, maybe?) would rely on the dentist's judgment.   

 

Can crouchpeter (or any other lurking dentists) shed some light on this?  

 

-- Retiree 

OK. I've just offered my expertise to "Xylophone", and as I'm being driven to Bangkok to have check up and x-rays after a hip replacement 2 and a half weeks ago, this stops me being bored! Firstly I've done thousands of lower wisdom teeth removals, usually impacted, and probably at least 100,000 other extractions. Post op any extracted tooth socket can get infected, and the stats are approximately 20%. However, for lower 8's the percentage is closer to 100%, especially if they are impacted and a flap is raised and bone removed. So when you see your wisdom tooth patient a few days to a week later,they look like a squirrel that has stored his nuts in his cheek pouches! They can't open their mouth, can't sleep, they stink and they hate you. The only treatment is hot and cold packs, NSAIDS and gentle rinsing. Now to the nitty-gritty. These infections are called,"dry sockets", because the blood clot breaks down and bleeds out 48 hours after the extraction, leaving bare bone,. Always painful. The treatment is to gently clean out the socket, try to make it bleed, and pack it with Alvogyl. This works in 20 minutes, but not as well for lower 8s. The point is, antibiotics cannot get to the source of the infection. They do not work! Sometimes you'll extract a tooth and the pus will pour out. Again, no Ab necessary. Of course if afterwards the submandibular gland is swollen, then give Amoxicillin for 7 days. But that's rare.

.

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2 hours ago, owl sees all said:

Amoxicillin supposedly stops bacteria getting to the heart, where it 'could' cause problems.

 

Why have four out in one sitting? Too traumatic! If you had pulled them yourself one at a time - with a gap of two weeks between - it would have been much kinder to the mouth and your body in general.

Because you only suffer once!

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2 hours ago, crouchpeter said:

OK. I've just offered my expertise to "Xylophone", and as I'm being driven to Bangkok to have check up and x-rays after a hip replacement 2 and a half weeks ago, this stops me being bored! Firstly I've done thousands of lower wisdom teeth removals, usually impacted, and probably at least 100,000 other extractions. Post op any extracted tooth socket can get infected, and the stats are approximately 20%. However, for lower 8's the percentage is closer to 100%, especially if they are impacted and a flap is raised and bone removed. So when you see your wisdom tooth patient a few days to a week later,they look like a squirrel that has stored his nuts in his cheek pouches! They can't open their mouth, can't sleep, they stink and they hate you. The only treatment is hot and cold packs, NSAIDS and gentle rinsing. Now to the nitty-gritty. These infections are called,"dry sockets", because the blood clot breaks down and bleeds out 48 hours after the extraction, leaving bare bone,. Always painful. The treatment is to gently clean out the socket, try to make it bleed, and pack it with Alvogyl. This works in 20 minutes, but not as well for lower 8s. The point is, antibiotics cannot get to the source of the infection. They do not work! Sometimes you'll extract a tooth and the pus will pour out. Again, no Ab necessary. Of course if afterwards the submandibular gland is swollen, then give Amoxicillin for 7 days. But that's rare.

.

Yes, and I have offered my expertise and research on streptococcus sanguinis, which has been found in the prostate, and indeed in my UTI.

 

We may differ on this, but I've been through this actual experience and there are medical journals which backup my research.

 

No doubt about it you are the expert on dentistry, and although your posts would suggest that antibiotics are not necessary, again there are many, many medical articles which are in favour of issuing antibiotics, and many which warn of the problems with streptococcus sanguinis finding its way into the bloodstream and colonising the heart valves (which you scoffed at in one of my earlier posts) especially in cases of difficult extractions (wisdom teeth?). 

 

So I guess we will have to agree to differ. However if you are unfortunate enough to get that particular bacteria in your urinary system/prostate, then you may be in for many years or even decades of prostatitis, which is extremely unpleasant.
 

PS. I hope the checkup and x-rays on your hip replacement show that everything is well.

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2 hours ago, xylophone said:

With respect you seem to be missing the salient point in a couple of the links/research I have posted, whereby streptococcus sanguinis has been found in the prostate, and can be the cause of prostatitis – – and for anyone who has had this condition, that would indeed be a "salient point". So these bacteria DO NOT ONLY CAUSE PROBLEMS WITH COMPROMISED HEART VALVES!!!!!

 

It's all there, out in the open in published and peer-reviewed papers/research if you care to look

The oral bacteria have nothing to do with the bacteria at the other end of the body under normal circumstances. If you've got inflammation of the prostate, (not infection), or UTI this is due to being stressed or run down or immuno-compromised or bad luck. And we're talking about oral prophylaxis; nothing to do with infections in other parts of the body. It's very frustrating arguing with people who weren't on the Oxford or Cambridge debating team! They can never stick to the point so as to try and prove they weren't wrong. As an aside, if your dentist took an hour to extract your lower 8, and fractured the mandible, I don't think he's an oral surgeon. Just another operator biting off more than he can chew; like we all do sometimes.

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7 minutes ago, xylophone said:

Yes, and I have offered my expertise and research on streptococcus sanguinis, which has been found in the prostate, and indeed in my UTI.

 

We may differ on this, but I've been through this actual experience and there are medical journals which backup my research.

 

No doubt about it you are the expert on dentistry, and although your posts would suggest that antibiotics are not necessary, again there are many, many medical articles which are in favour of issuing antibiotics, and many which warn of the problems with streptococcus sanguinis finding its way into the bloodstream and colonising the heart valves (which you scoffed at in one of my earlier posts) especially in cases of difficult extractions (wisdom teeth?). 

 

So I guess we will have to agree to differ. However if you are unfortunate enough to get that particular bacteria in your urinary system/prostate, then you may be in for many years or even decades of prostatitis, which is extremely unpleasant.
 

PS. I hope the checkup and x-rays on your hip replacement show that everything is well.

Like you, I've done oodles of research on hip replacement surgery. The best implant, the best approach, the best anaesthetic, the surgeon's expertise etc. etc. There's nothing I don't know about revision, failure rates and causes, rehabilitation etc. And guess what, even with my oral surgery experience,..... I still couldn't do one! And that's the bottom line.

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15 minutes ago, xylophone said:

Yes, and I have offered my expertise and research on streptococcus sanguinis, which has been found in the prostate, and indeed in my UTI.

 

We may differ on this, but I've been through this actual experience and there are medical journals which backup my research.

 

No doubt about it you are the expert on dentistry, and although your posts would suggest that antibiotics are not necessary, again there are many, many medical articles which are in favour of issuing antibiotics, and many which warn of the problems with streptococcus sanguinis finding its way into the bloodstream and colonising the heart valves (which you scoffed at in one of my earlier posts) especially in cases of difficult extractions (wisdom teeth?). 

 

So I guess we will have to agree to differ. However if you are unfortunate enough to get that particular bacteria in your urinary system/prostate, then you may be in for many years or even decades of prostatitis, which is extremely unpleasant.
 

PS. I hope the checkup and x-rays on your hip replacement show that everything is well.

Any invasive dental procedure forces bacteria into the bloodstream, even a scaling. So you're advocating Ab cover for all dental patients?

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6 minutes ago, crouchpeter said:

The oral bacteria have nothing to do with the bacteria at the other end of the body under normal circumstances. If you've got inflammation of the prostate, (not infection), or UTI this is due to being stressed or run down or immuno-compromised or bad luck. And we're talking about oral prophylaxis; nothing to do with infections in other parts of the body. It's very frustrating arguing with people who weren't on the Oxford or Cambridge debating team! They can never stick to the point so as to try and prove they weren't wrong. As an aside, if your dentist took an hour to extract your lower 8, and fractured the mandible, I don't think he's an oral surgeon. Just another operator biting off more than he can chew; like we all do sometimes.

Jesus, if you were on the Oxford or Cambridge debating team, then it must have been a pretty poor bunch!

 

First of all I stated that I had Streptococcus sanguinius in my urinary system and that was confirmed by a culture test, yet you dismissed that as not being the case???

 

I also presented case histories/medical publications of the same and also regarding this particular bacteria being found in the prostate, again you dismissed it, obviously because you didn't read them, and my point about this particular bacteria was that if it gets into the bloodstream it can be dangerous, which you have now stated can be the case.

 

And as for your assertion that the dentist I had which fractured my lower jaw was a "poor operator" then that's another own goal for you, because my normal and highly regarded dentist in New Zealand recommended a well-known oral surgeon to do the extraction because the root of the tooth was somewhat crooked in the jaw, and it was he who fractured my jaw.

 

And just for the record no, I wasn't stressed or run down or immunocompromised when the Streptococcus sanguinis found its way into my urinary system.

 

As for your last question regarding advocating antibiotics for all dental patients, that is not something I've advocated, and I will go with what the experts know (not you of course) and what is widely recommended by these experts.
 

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50 minutes ago, xylophone said:

Jesus, if you were on the Oxford or Cambridge debating team, then it must have been a pretty poor bunch!

 

First of all I stated that I had Streptococcus sanguinius in my urinary system and that was confirmed by a culture test, yet you dismissed that as not being the case???

 

I also presented case histories/medical publications of the same and also regarding this particular bacteria being found in the prostate, again you dismissed it, obviously because you didn't read them, and my point about this particular bacteria was that if it gets into the bloodstream it can be dangerous, which you have now stated can be the case.

 

And as for your assertion that the dentist I had which fractured my lower jaw was a "poor operator" then that's another own goal for you, because my normal and highly regarded dentist in New Zealand recommended a well-known oral surgeon to do the extraction because the root of the tooth was somewhat crooked in the jaw, and it was he who fractured my jaw.

 

And just for the record no, I wasn't stressed or run down or immunocompromised when the Streptococcus sanguinis found its way into my urinary system.

 

As for your last question regarding advocating antibiotics for all dental patients, that is not something I've advocated, and I will go with what the experts know (not you of course) and what is widely recommended by these experts.
 

A lot of misquoting here. Most prostatitis infections are E. Coli for obvious reasons. All bacteremias are potentially dangerous, but usually the body deals with it. But sometimes with diabetics, old people, generally unhealthy, fat, smokers etc. it can't. And then we have acute prostatitis, cellulitis, fasciitis. But you're becoming blinkered in your one man battle against Streptococci. Perhaps listen to the doctors instead of rubbish talking about your "in depth research". You've diverted the subject from antibiotics after extraction, incidentally telling me I don't know what I'm talking about, to your prostatitis involving flora that is found in the oral cavity as well as in every other orifice in the body. And after all this pseudo intellectualism, you've probably never even examined a patient in your life!

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2 hours ago, crouchpeter said:

A lot of misquoting here. Most prostatitis infections are E. Coli for obvious reasons. All bacteremias are potentially dangerous, but usually the body deals with it. But sometimes with diabetics, old people, generally unhealthy, fat, smokers etc. it can't. And then we have acute prostatitis, cellulitis, fasciitis. But you're becoming blinkered in your one man battle against Streptococci. Perhaps listen to the doctors instead of rubbish talking about your "in depth research". You've diverted the subject from antibiotics after extraction, incidentally telling me I don't know what I'm talking about, to your prostatitis involving flora that is found in the oral cavity as well as in every other orifice in the body. And after all this pseudo intellectualism, you've probably never even examined a patient in your life!

Again you are incorrect in your assumption with regards to prostatitis, this especially as two professors with whom I have liaised, one in Harley Street and one in Melbourne, readily agree that prostatitis is extremely difficult to treat and not as simple as just being an E. coli infection which the body can deal with, otherwise there wouldn't be millions of men worldwide suffering from ongoing prostatitis which doesn't respond to various antibiotics, and which has been called "a medical wasteland for treatment" by prominent a urologist in the USA.

 

Furthermore it is not only "diabetics, old people, generally unhealthy, fat, smokers etc" who are continually suffering with prostatitis, despite your assertion that is the case. I am none of the above and other men I know are not either

 

Now back to how this started:-

 

I posted: Unfortunately there are quite a few bacteria that live in the mouth and one which is usually protective of teeth and environs, Streptococcus sanguinus, can be dangerous if it gets into the bloodstream, causing problems with heart valves. (Which is correct).

 

To which you replied: The mind boggles reading these fairytales! (ridiculing my post)

 

I replied: S. sanguinis may gain entrance to the bloodstream when opportunity presents (dental cleanings and surgeries) and colonize the heart valves, particularly the mitral and aortic valves, where it is the most common cause of subacute bacterial endocarditis. For this reason, oral surgeons often prescribe a short course of antibiotics to be taken a few days before to a few days after oral surgery. (Which is correct)

 

You replied: It's strep. viridans found in the mouth, and it can compromise damaged or artificial heart valves only!  (Which is not correct because it was Streptococcus Sanguinis I was referring to).

 

You then suggested that I was "like everybody, using quotes from Google without having any in-depth understanding". Thereby disparaging not only my comments but the results of carefully controlled studies in the medical field, and by medical experts in that particular field.

 

I stated that you were mistaken on this particular point and again published peer-reviewed medical research regarding this bacteria, which you also disparaged by saying "so it's unlikely oral bacteria would infect the urinary track", but as other research I quoted has shown you, it does, along with many other bacteria, which I also detailed.

 

I also included links to online medical libraries for your perusal. This after you again refuted my point that this bacteria could infect/colonise the prostate.

 

You see this goes on and on and it results from your ridiculing of my original post and your assertion that Streptococcus sanguinis cannot be found in the urinary track or prostate – – and you are wrong.

 

No point in arguing with you when you will not admit what you actually posted, or even admit that you could have been wrong. 
 

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On 9/9/2022 at 11:20 PM, JackGats said:

4 wisdom teeth extracted at one go is not trivial. I'd take the antibiotics.

 

I was once given Clindamycin after some procedure, an implant I think. I got catastrophic diarrhoea. That was about the only time in my life an antibiotic gave me diarrhoea.

I would avoid clindamycin at all costs, it has some very nasty side effects including C-diff  stick to amoxy or fluco   There is another one to avoid called metronidazole  or something like that    avoid it too especially if you intend to drink  wasn't very effective either

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3 hours ago, Bday Prang said:

I would avoid clindamycin at all costs, it has some very nasty side effects including C-diff  stick to amoxy or fluco   There is another one to avoid called metronidazole  or something like that    avoid it too especially if you intend to drink  wasn't very effective either

Don't know what you mean by "fluco". If you mean fluconazole, that's not an antibiotic (it's an antifungal).

Clindamycin is loved by mang dentists, but it does often  cause diarrhea. It rarely causes severe problems with C-diff (Clostridium difficile) in previously healthy patients.

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8 hours ago, crouchpeter said:

Like you, I've done oodles of research on hip replacement surgery. The best implant, the best approach, the best anaesthetic, the surgeon's expertise etc. etc. There's nothing I don't know about revision, failure rates and causes, rehabilitation etc. And guess what, even with my oral surgery experience,..... I still couldn't do one! And that's the bottom line.

Well said.

But you still read up on hip replacements...? Isn't that funny?

And your surgeon maybe thought " oh, another f...ing dentist who knows nothing about real medicine but thinks he knows after a bit of googling"

 

The alternative would be, just find out who is the best surgeon,  see him, let him do his thing and don't think too much. Not exactly intellectually satisfying.  I did my hip replacement that way, as I am not an orthopedic surgeon. 

(The result was not good BTW).

 

But people who suffer from chronic prostatitis like Xylo, or fibromyalgia, or CFS, or long Covid, you name it, they will invariably start reading up on their disease. And they will come across all kinds of studies,  some of which they don't fully understand.  And as they keep being dismissed by their doctors ("their is nothing", "it's all in the mind", "you must learn to live with it") they will feel that sometimes they know more than their doctors. Often, they  are right. More often, they are wrong. 

 

It's not that clear-cut.

 

 

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6 hours ago, Lorry said:

Don't know what you mean by "fluco". If you mean fluconazole, that's not an antibiotic (it's an antifungal).

Clindamycin is loved by mang dentists, but it does often  cause diarrhea. It rarely causes severe problems with C-diff (Clostridium difficile) in previously healthy patients.

I meant Flucloxacillin, which is indeed an antibiotic

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14 hours ago, crouchpeter said:

A lot of misquoting here. Most prostatitis infections are E. Coli for obvious reasons. All bacteremias are potentially dangerous, but usually the body deals with it. But sometimes with diabetics, old people, generally unhealthy, fat, smokers etc. it can't. And then we have acute prostatitis, cellulitis, fasciitis. But you're becoming blinkered in your one man battle against Streptococci. Perhaps listen to the doctors instead of rubbish talking about your "in depth research". You've diverted the subject from antibiotics after extraction, incidentally telling me I don't know what I'm talking about, to your prostatitis involving flora that is found in the oral cavity as well as in every other orifice in the body. And after all this pseudo intellectualism, you've probably never even examined a patient in your life!

I agree with a lot of what you have said, and I find a lot of the "research" quoted by your debating opponent to be focused on a niche segment that would not apply broadly to everyone.  There is some truth on both sides of this aisle--but perhaps some myths on both as well.

 

Yet, to help me see where you're coming from, I am curious if, given a choice, you would choose to extract a tooth or do a root canal on it.  (This does have an antibiotics-related impact.)

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10 hours ago, Lorry said:

But people who suffer from chronic prostatitis like Xylo, or fibromyalgia, or CFS, or long Covid, you name it, they will invariably start reading up on their disease. And they will come across all kinds of studies,  some of which they don't fully understand.  And as they keep being dismissed by their doctors ("their is nothing", "it's all in the mind", "you must learn to live with it") they will feel that sometimes they know more than their doctors. Often, they  are right. More often, they are wrong. 

 

It's not that clear-cut.

I agree with what you have said Lorry, and quite true I did start reading up on my "disease" when I'd had it for many years (decades) and no amount of antibiotics would cure it, nor many visits to different urologists. And you are quite right inasmuch as I don't fully understand some of what I read, but there are elements which are easily understandable, and much is published on the subject, which can make easy reading.

 

I have also consulted a couple of professors who are doing a lot of research on prostatitis, and both of them have said that because it is so difficult to treat, they often use multi-antibiotic regimes at once, and over a long period of time, and much has been published on the different bacteria which have been found in the prostate and can cause this situation, and it's not just E. coli.

 

I still stand by a lot of what I said and it's best summed up as follows: –

 

1). My stance was that antibiotics can be given where dental work involves dental surgery or difficult extractions and where it is possible that the bacteria Streptococcus sanguinis can enter the bloodstream and cause problems with heart valves.

 

This is supported in the main by by the dental/medical profession, even though there is still debate over it.

 

2). My next stance was that the bacteria Streptococcus sanguinis can cause problems in other areas of the body, namely the prostate, where it has been found.

 

This is also supported by knowledgeable professors and urologists, as well as research and tests, and I posted a couple of links on it.

 

So I rest my case and really don't want to get into further debate with this poster, so I will let this post explain my rationale.

 

Over and out..............

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