Do You Need Antibiotics Before Dental Procedures

Until recently, the American Heart Association (AHA) recommended that patients with certain heart conditions take antibiotics before dental procedures such as cleaning and extractions to prevent infection of the heart valves know as infective endocarditis.

However, according to the latest guidelines which were published in Circulation, in April 2007, the AHA recommends that most of these patients no longer need antibiotics as a preventive measure before their dental treatment. These recommendations were based on a comprehensive review of studies which did not show a strong correlation between the use of antibiotics prior to dental procedures and the risk of developing infective endocarditis in those who were at risk for developing this infection. These patients are already often exposed to bacteria from the mouth, which can enter their bloodstream during basic daily activities such as brushing or flossing.

Patients who have taken prophylactic antibiotics in the past but who may no longer need them include people with:
--mitral valve prolapse
--rheumatic heart disease
--bicuspid valve disease
--calcified aortic stenosis
--congenital heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy.

Patients who are still advised to get the antibiotics are anyone with:
--artificial heart valves
--a history of infective endocarditis
--certain specific, serious congenital (present from birth) heart conditions, including
unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits
--a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure
--any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device
--a cardiac transplant that develops a problem in a heart valve.