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Antibiotics Before Dental Work

There has been much debate in the medical community, from both dentists and orthopedists, regarding the use of antibiotics as a preventative measure before dental procedures. There is evidence to support and deny the benefits and risks of using antibiotics prior to surgery, but there are still some patients who will need some form of precautionary dental antibiotics.

Patients who no longer need precautionary antibiotics

According to the American Heart Association (AHA) publication “Circulation,” some patients who needed to take antibiotics before having any dental work done no longer need to pre-medicate. Only those at the greatest risk of contracting endocarditis, an infection that targets the inner lining and/or valves of the heart when bacteria travels to the heart via the bloodstream, are in need of preventative antibiotics.

The AHA recommendations state numerous patients, including those who have had a joint replacement or have rheumatic heart disease, calcified aortic stenosis, mitral valve prolapse, bicuspid valve disease, ventricular septal defect, atrial septal defect, or hypertrophic cardiomyopathy no longer need to take preventative dental antibiotics.

It is best to speak with your physician and dentist before having any dental procedure to see if your case still requires necessitates a course of preventative dental antibiotics.

Patients who still require preventative antibiotics

While the recommendations have changed when it comes to who needs to take preventative dental antibiotics, there are still patients who are considered to be at high risk for infection.

Patients with congenital heart defects, artificial heart valves, and those who have had issues with their heart valves after a heart transplant have an elevated risk of contracting endocarditis, as do those who have had a previous endocarditis infection, and they will still require a course of preventative dental antibiotics.

Only your doctor can tell you if you are at risk of endocarditis, so discuss your risk before having any medical, surgical, or dental procedures.

What dental procedures require antibiotics

Your gums and teeth are very sensitive areas of your body and they can bleed easily. If you at risk of an endocarditis infection, which is contracted by bacteria getting invading your blood stream and traveling to your heart, you will need to take antibiotics before most dental procedures.

Your dentist and physician will let you know if your circumstances require antibiotics as a precautionary measure. High-risk patients, those are having extractions, dental implant(s), gum surgery, fillings and cleanings, or sutures removed may need a course of antibiotics. Periodontal and orthodontic procedures may require antibiotics. Discuss your procedure and your risk of infection to determine whether your situation warrants the use of precautionary medication. If you need a preventative dose of dental antibiotics, it is typically given to you orally, thirty to sixty minutes prior to your procedure.

While the new findings from the AHA imply that the risks of preventative antibiotics prior to dentals procedures outweigh the benefits, this may not be the case for every patient. Discuss your specific procedure and risk of infection to determine whether your situation warrants the use of precautionary medication. If so, they are typically given to you orally 30 to 60 before your procedure.

Patients and their families should discuss the benefits and the risks of using dental antibiotics with their primary physician and cardiologist prior to having any dental work done. Only your team of practitioners will know what is best for you.

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