Antibiotics Before Dental Treatment

Any time there is bleeding in the mouth, oral bacteria can enter the bloodstream and travel to the heart. This presents a risk for some patients who have cardiac abnormalities or endocarditis, a serious inflammation of the heart valves or tissues.

Precautions
The American Heart Association and the American Dental Association publish guidelines for dentists to help them protect patients at risk of developing bacterial endocarditis. The AHA guidelines are listed in the “Dental Guidelines” section of the DRC site. The guidelines recommend the use of antibiotics before dental treatment, based on patient's medical conditions and on the dental treatment they receive.
Premedication -- taking antibiotics before dental treatment -- may be necessary for dental procedures such as professional tooth cleaning; extractions; incision and drainage of infected oral tissue; some types of injections; and some oral surgeries.

Below is a list of conditions that require antibiotic prophylaxis:
· heart surgery within the last 6 months
· vascular surgery (replaced artery) within the past 6 months
· pacemaker
· history of rheumatic fever
· history of heart murmur (mitral valve prolapse)
· previous bacterial endocarditis
· systemic pulmonary shunt
· congenital heart defect
· acquired valvular dysfunction
· diagnosed with other heart ailments

Consult with the patient’s physician or cardiologist to determine which antibiotics you should prescribe. Have the patient fill the prescription before their next visit and make sure they understand the dosage and frequency.

Periodontal infections and poor dental hygiene at home may spread heart-threatening bacteria. Encourage your patients to brush and floss regularly, maintain a healthy diet and schedule regular dental appointments to have their teeth cleaned and examined.
If your patient has heart disease or has a special heart condition, taking good care of their teeth and gums is a must -- not just for a healthy smile, but also for a healthy body.