Antibiotics were commonly prescribed for prevention of bacterial infections. Often they were given before a surgical or dental operation to deter a potential infection from occurring; this method is called “antibiotic prophylaxis.” In the past, both doctors and dentists recommend that patients with medical conditions should take antibiotics before some regular dental procedures. These conditions include a variety of heart issues and some forms of bone or joint replacements.
An abundance of research now suggests that far fewer patients need to take this protective measure than previously believed. As a result, the recommendations for administering antibiotic prophylaxis have been updated and could change again in the future. Here’s what you need to know about the changing guidelines and taking antibiotics before dental procedures.
Infection Risk
There are both beneficial and dangerous bacterias that living in many parts of your body, especially your mouth. If conditions are right, they make it possible for these microorganisms to reach the bloodstream, there is a small possibility that an infection may form. This may occur in certain dental procedures. It may also happen during normal tasks such as chewing, brushing and flossing. Often times, the risk is so limited that the probability of having a reaction to the antibiotics (albeit rare) is much higher than the risk of contracting an infection; thus, antibiotics are not routinely used.
However, some people need to take special care before they have dental operations. If you have been diagnosed with certain cases of heart disease or have undergone such orthopedic surgeries (including complete joint replacement), we might recommend you take antibiotics to defend against even minimal chance of infection. Recommendations are given on a case by case basis, taking into consideration the personal background and the medical knowledge of the clinician.
Premedication Antibiotic Guidelines
Prophylactic antibiotics may be prescribed prior to dental operations if you have one or more of these heart conditions:
- Artificial Heart Valves
- Past Occurrences of Infective Endocarditis
- Heart Transplant
- Congenital Heart Problems – Especially when unrepaired or if prosthetic material is involved.
A joint replacement surgery can also be a risk factor, we may recommend prophylactic antibiotics if you have any of the following:
- Rheumatoid arthritis, lupus erythematous, or other systemic inflammatory disease.
- You’re malnourished or undernourished
- Hemophilia or Type I Diabetes
- Previous infection in prosthetic joints
- A compromised or weakened immune system from cancer, radiation, chemotherapy, HIV, or other condition.
Other circumstances where taking prophylactic antibiotics are necessary are determined on a case by case basis. There are plenty of scenarios where antibiotics may have been used but aren’t necessary any longer. Pacemakers, defibrillator, certain heart diseases, congenital defect, and benign heart murmur may no longer need antibiotic prophylaxis.
Recently, studies of drug-resistant bacteria and adverse reactions of certain medicines have raised general understanding of the risks of overuse of antibiotics. Fortunately, modern medical research is allowing healthcare practitioners to create proper, evidence-based antibiotic treatment decisions. If you have any concerns about if you should receive antibiotics prior to dental care, please feel free to inquire.
