Changing Pre-Treatment Antibiotic Rules

If you suffer from mitral valve prolapse or had a knee replacement, you were probably asked to take antibiotics prior to your dental procedure if it was more than two years ago. However, the guidelines for taking a precautionary antibiotic before a trip to the dentist has recently changed. It is no longer necessary for most people and it may actually do more harm than good.

The American Heart Association now recommends that only those who are at the highest risk of bad outcomes from infective endocarditis (IE) should take antibiotics prior to their dental procedure. This condition is an infection of the heart’s inner lining or the heart valves caused by bacteria entering into the bloodstream and traveling to the heart. Scientists found no significant evidence that taking antibiotics prior to a dental procedure prevented IE in patients who are at risk of developing a heart infection, as their hearts already are exposed to bacteria from the mouth. Basic daily activities such as brushing or flossing are perhaps more likely to cause bacteria to become dislodged and enter the bloodstream, which could cause infection.

In the past, the list for short-term preventative antibiotic treatment requirements included joint replacement, mitral valve prolapse, rheumatic heart disease, bicuspid valve disease and calcified aortic stenosis. Why did the guidelines change? Put simply, the risks outweigh the benefits. Continued scientific research and evidence shows that risks such as adverse reactions to antibiotics and the development of drug-resistant bacteria puts patients at a greater risk than benefit from taking preventative antibiotics.

If you have a heart problem and have an upcoming dental appointment, it is always best to tell your dentist about the specifics of your condition. Patients who have had a heart transplant or have an artificial heart valve may still need to take antibiotics. Dr. Paul Gilreath stays informed on the latest AHA guidelines surrounding pre-antibiotic treatments and he can advise you on the safest, most beneficial steps to take.