Frequently Asked Questions

Do I Need to Take a Pre-Medication?

Please note: Guidelines for patients who have total joint replacement have not been changed.

For decades, the American Heart Association has recommended that patient with certain heart conditions take an antibiotic prior to dental treatments. In 2007 the AHA changed it’s guidelines on pre-medication and recommends that most of these patients no longer need to take short term antibiotics as a preventative measure before their dental treatment.

These new guidelines are based growing scientific evidence that shows that the risk of taking preventive antibiotics outweigh the benefits for most patients. The new guidelines for patients who have taken antibiotics prior to dental treatments routinely in the past but no longer need them include people with:

  • mitral valve prolapse rheumatic heart disease
  • bicuspid valve disease
  • calcified aortic stenosis
  • congenital heart such as ventricular septal defect, atrial septal defect and hypertrophic cariomyopathy

Preventive antibiotics prior to dental treatment are still advised for patient with:

  • artificial heart valves
  • a history of infective endocarditis
  • a cardiac transplant that develops a problem in a heart valve
  • certain specific, serious congenital (present from birth) heart conditions, including:
    • unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts, and conduits.
    • a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or my catheter intervention, during the first six months after the procedure.
    • any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device.

Patients should always check with their physician before discontinuing use of preventive antibiotics. For more information, please visit the American Heart Association’s website at:

Cold Sores

Cold sores, also called fever blisters or Herpes simplex are fluid filled blisters, which can be very painful and annoying. They most often erupt around the lips and occasionally under the nose.

Once a person is infected with primary Herpes, the virus stays in the body and causes occasional attacks. These attacks can follow a fever, sunburn, skin abrasions and stress. Cold sores are very contagious and during their “bubbly” stage they can be easily ruptured and spread to other areas of the face--especially during a dental procedure. If you are experiencing a cold sore in it’s “bubbly” phase, please call our office to reschedule your appointment.

By the time that they cold sore has ruptured and has moved to the “crusty” stage, we are still able to see you. Discussing concerns about cold sores at your next dental appointment gives Dr. James an opportunity to give you a prescription to prevent or minimize another attack.

Canker Sores

Canker sores appear inside the mouth and appear as small ulcers with a white or gray base and a red border. There may be only one canker sore present, or there could be many, but they are not contagious. Their exact cause is uncertain but some experts believe that viruses, bacteria or immune system problems may be involved.

Stress, fatigue, allergies, cuts caused by biting your cheek or tongue, as well as a loose orthodontic wire may increase the likelihood of canker sores. Those with intestinal diseases such as ulcerative colitis and Crohn’s seem to be extra susceptible. Reactions to very hot beverages and foods may also contribute to the development of canker sores.

Canker sores generally heal on their own after about a week or two, however over the counter topical anesthetics and mouth rinses may temporarily relieve the symptoms. While you have a canker sore avoid spicy or acidic foods, which may agitate them.

Jaw Pain / TMJ

Did you know that more than 15% of American adults suffer from some kind of jaw pain? Common symptoms include tenderness of the jaw, pain in or around the ear, headaches, or neck aches or popping and clicking noises when opening the jaw.

The cause of the pain is often just a sinus, toothache or early stage of periodontal disease, but for some pain the cause could be related to the facial muscles, the jaw, or the temporomandibular joint (TMJ) located in the front of the ear. Dr. James can help diagnose the source of the pain with proper X-rays and a thorough examination.

Treatments for this pain may include muscle relaxants, stress reducing exercises, or most commonly the wearing of a mouth guard or protector to prevent teeth from clenching and grinding. This mouth guard is usually worn at night and is therefore sometimes referred to as a night guard.



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  • (303) 254-4484
  • 9351 Grant Street, Suite 340
    Thornton, Colorado 80229
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5280-whiteDr. Sue James has been recognized as a "Top Dentist" by 5280 Magazine every year since 2008.

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