If you have certain medical conditions, your doctor may call for you to take an antibiotic dose prior to many dental procedures – such as a cleaning. That’s because there is a risk that the bacteria in your mouth could accidentally be introduced into your bloodstream and cause an infection for a small number of patients with specific heart conditions:
- Artificial heart valves.
- A history of an infection of the lining of the heart or heart valves known as infective endocarditis.
- A heart transplant in which a problem develops with one of the valves inside the heart.
- Heart conditions that are present from birth:
- Unrepaired cyanotic congenital heart disease, including people with palliative shunts and conduit.
- Defects repaired with a prosthetic material or device—whether placed by surgery or catheter intervention—during the first six months after repair.
- Cases in which a heart defect has been repaired, but a residual defect remains at the site or adjacent to the site of the prosthetic patch or prosthetic device used for the repair.
In the past, patients with artificial joints were also prescribed antibiotics before a dental visit. But:
In 2012, the ADA and American Association of Orthopedic Surgeons updated the recommendations and no longer recommend antibiotics for everyone with artificial joints. As a result, your healthcare provider may rely more on your personal medical history to determine when antibiotics are appropriate for people with orthopedic implants. For example, antibiotic prophylaxis might be useful for patients who also have compromised immune systems (due to, for instance, diabetes, rheumatoid arthritis, cancer, chemotherapy, and chronic steroid use), which increases the risk of orthopedic implant infection. If you have a heart condition or an orthopedic implant, talk with your dentist or physician about whether antibiotic prophylaxis before dental treatment is right for you.
The fact that the ADA and AAOS no longer recommend antibiotics doesn’t mean you may not need to take them. That is for you and your doctor decide. The reason for the decision to forego premedication with antibiotics is due to the growing problem with antibiotic resistant strains of bacteria.
If you have any questions about this, please contact us or your doctor to ensure whether or not antibiotic premedication is appropriate for you.