Some people who have heart conditions, and some patients with artificial joints have to take antibiotics on a regular basis. They take these, to ward off infection. Taking antibiotics to reduce the chance of infection is called antibiotic prophylaxis.
These same patients have to also get dental work done from time to time. As such, dentists have to use guidelines from the American Heart Association, or the AHA, with guidance from the ADA. Dentists who are treating joint patients will need guidance from the American Academy of Orthopedic Surgeons, or the AAOS.
Recommendations for Patients with Heart Problems
The AHA created recommendations to reduce risk of IE, or infective endocarditis. This is an infection of the lining of the heart, or the heart valves. It was thought in the past that dental procedures increased the risk of a patient developing IE, but now, new findings have been noted. It has been recommended that fewer patients need to be medicated before dental treatments.
Why The Change?
The AHA stated that the risk of using the antibiotics outweighed any benefit of taking them for prevention. Some health risk included:
- Allergic reactions, such as hives.
- The studies weren’t conclusive that pre-dental medication stopped IE.
- It was shown that more bacteria could be introduced into the bloodstream from normal daily activities, such as eating, as opposed to dental work. The overuse of antibiotics could create resistant strains of bacteria in the body. Doctors have been advised to limit the prescription of antibiotics.
Patients Who Need Pre-Dental Treatment:
It has been determined that these patients are good candidates for pre-dental antibiotic treatment:
- People with artificial heart valves
- People with a history of IEA patient who had a cardiac transplant, and they develop heart valve problems
- Patients who have the following conditions from birth-
- Incomplete or un-repaired cyanotic congential heart disease, and those with palliative shunts and conduits
- A completely fixed congenital heart defect with the use of prosthetics, within 6 months after the procedure. If the patient isn’t clear if they fall under these categories, they should consult their doctor.
People who were advised to take antibiotics pre-dental, but no longer need to include those who have:
- congenital heart conditions
- calcified aortic stenosis
- biscuspid valve disease
- rheumatic heart disease
- mitral valve prolaspe
Consult your dentist if you think these might apply to you.