Special Conditions

Blood Thinners

If you are taking a blood thinner, make sure we know and have reviewed specific instructions for your appointment. Drs. Wunderlich & Chang will generally recommend the following pending a medical consult with your physician.


If you take aspirin daily, please continue to do so. Please let Drs. Wunderlich and Chang know.


If you are on Coumadin or blood thinners, Drs. Wunderlich & Chang or your physician will instruct you. Most patients do not stop their Coumadin for periodontal surgery. You will need an INR reading  1 day prior  surgery appointments (INR of 2 – 2.5 is acceptable).

Prosthetic Joint Replacement

Prophylactic antibiotics for dental treatment is not generally recommended, however, if you have a prosthetic joint replacement that is less than 2 years old, your orthopedic surgeon may recommend taking an antibiotic before dental treatment. We will review your specific needs before surgery.

Heart Valves & Heart Murmur

In the past people with heart murmur were given antibiotics before dental visits to prevent an infection in the heart valves. We now know that the bacteria in your mouth can enter you body from simple things like eating or brushing your teeth. Researchers have looked at this question and have limited the recommendation for pre-dental antibiotic prophylaxis to patients with:

  • Artificial Heart Valve Replacement
  • History of Bacterial Endocarditis
  • Weak Immune system in some cases.

Diabetes & Hypoglycemia

Individuals suffering from diabetes, especially uncontrolled diabetics, have a higher risk of developing bacterial infections. These infections may impair your ability to process insulin, resulting in greater difficulty with controlling your diabetes. Drs. Wunderlich & Chang must know your history and the current status of your condition. You can help resist periodontal infection and improve healing by controlling your blood sugar levels.

Drs. Wunderlich & Chang will give you specific instructions for insulin and food intake depending on the length and extent of your treatment.

  • Ask your physician for your last HbA1c- it shows average sugar levels
  • Make sure you eat before your appointment
  • Check your blood sugar before your appointment (better to be high)
  • Let us know immediately if you feel any symptoms of low blood sugar.


If you have any questions regarding your prescribed medications, please contact us.

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Dental Health

As dental professionals it is our priority to provide quality dental care you can trust.