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Arizona

Kay


I am a public health dentist and practiced clinical dentistry for nearly 30 years. On January 11, 2022, I underwent periodontal surgery (tooth extraction and socket graft). The periodontist prescribed clindamycin for 6 days. There was no infection present, it was a “prophylactic” protocol to prevent possible infection. I returned to the periodontist for a 1 month post-op evaluation on February 13 and 2 days later developed acute GI symptoms. I was misdiagnosed by urgent care, twice, as having IBS. A few days later, I saw a gastroenterologist. The GE believed it was C. diff, and unfortunately for me his diagnosis was correct.

Since the initial infection, I had 3 recurrences, 4 ED hospital admissions, and 4 urgent care visits for dehydration. Within 10 weeks, I had lost 30 pounds and for the first time in my life, believed I was going to die. After 3 failed rounds of vancomycin and 1 round of Dificid, I decided to actively search a doctor in my area for FMT. I located a colorectal surgeon who had my insurance approved and scheduled me for the FMT within 1 week in Scottsdale, AZ. Symptoms were gone within 24 hours, and 6 weeks post FMT, I am cautiously feeling hope again that I am successfully treated. I am regaining weight and I am eating “real” food that I have slowly entered back into my diet. I am avoiding lactose and gluten for now. My doctor would like me to begin with yogurt to see how I react. I normally eat a very clean, plant-based diet. Yes, I have had post FMT- IBS like symptoms and bloating, but I will take this over the living hell I experienced. I think the most pressing issue for me is the anxiety and depression that developed because of this disease. Medical Trauma is real. My initial gastroenterologist was not responsive, communicated through his medical assistant. It is a frightening, isolating disease that leaves you wasted and kicked to the ground.

I have to share with all of you that although my story is no different than many of yours, my perspective may be different. I am using my platform to sound the alarm in my profession. I am the CEO of a national continuing education program for dental clinicians. I have learned a few things through my own journey and I intend to use it for change, to promote antibiotic stewardship, infection prevention, and change in public policy.

The wake up call for me, in my own case, was when I called the periodontist that performed the procedure to inform them that I was in the hospital with C Diff. I never received a call back from the periodontist. Instead the receptionist called me back to see if I could “come in for a cleaning” the day after I was discharged from the 1st hospital admission, because “we won’t need to give you antibiotics.” This tells me that most dental professionals do not understand this disease and the requirements for infection prevention. It is a National Board question, and that is the amount of time we have spent learning about C Diff. This experience also causes me great concern about cross contamination. Why? Because the majority of dental practices (99.9%) are not using infection prevention products that kill C Diff. So if they are inviting their patients back in for routine dental treatment with active C Diff infection, or prior infection, and they are not mitigating C Diff contamination. Why are we not including dental practices and clinics as potential health care settings that can spread C Diff?

I informed the receptionist that I was infectious and should not be in their dental practice. She phoned me back two months later and said “When you are ready to ‘risk it’ please schedule your cleaning appointment.”

The problem we have is that we assume the antibiotics in dental settings were the only reason for C Diff infection. However, after researching further, I found that dental practices are not required to report their cases. The surveillance is worrisome here, because there is no way of knowing if a dental practice was infecting their patients through poor infection prevention. The problem here is that the dental community at large is poorly educated around what C Diff is, the mortality rate, and the fact that they are contributing to antibiotic resistance and C Diff prevalence. The irony of this all, as a continuing education professional to dental clinicians, I have presented courses about the Gut Brain Microbiota Axis, Infection Prevention, and Probiotics. I have now added C. Difficile to our curriculum.

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