Antibiotics, Dentists, and You

Earlier this year the American Heart Association changed its guidelines on which patients would require antibiotics prior to a dental procedure. Last revised in 1997, these recommendations were established to provide guidance on what antibiotics to use and which patients were at risk to developing an infection of the heart valve which is known as endocarditis.

Endocarditis, fortunately, is a rare but serious infection. It occurs when bacteria enter the blood stream and deposit on to a heart valve causing damage. Bacteria enter the bloodstream via intravenous drug use but also can occur, but uncommonly, through medical procedures as well as dental procedures. Once present, bacteria can then to spread to different parts of the body causing further organ damage. If severe enough, surgery is required to replace the diseased valve. Treatment is usually intravenous antibiotics for many weeks.

The current recommendations for endocarditis prevention will mean fewer individuals will need antibiotics.

Individuals recommended to still take antibiotics prior to dental work include those with:

• A prosthetic heart valve.
• A history of previous endocarditis.
  
• A history of congenital heart disease (check with your doctor on the specifics).
• Individuals who received a heart transplantation with heart valvular disease.

If you previously took antibiotics routinely prior to any dental work, there is a good chance you won’t need to any more. Check with your dentist and doctor. Research has shown that it often take years for newly announced guidelines or beneficial research results to become commonplace and practiced routinely. You might have an opportunity to gently educate them. The Council on Scientific Affairs of the American Dental Association also endorsed the new guidelines so your dentists should be aware as well.