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Based on a review of new and existing scientific evidence, most dental patients with heart disease do not need antibiotics before dental procedures to prevent infective endocarditis (IE), a rare, but life-threatening heart infection.

But some heart patients need antibiotics before undergoing any dental procedure. The medication can prevent a life threatening infection that often begins with bleeding gum tissue.

The fear is that bacteria in the mouth will migrate to the heart and cause a life threatening infection. But many dental patients may be prescribed unnecessary antibiotics.

In most cases, you do not need antibiotics if you have had:

• Bypass surgery
• Pacemaker
• Defibrillator
• Heart Murmur

Preventive antibiotics prior to a dental procedure are advised for patients with:

1. Artificial heart valves
2. A history of infective endocarditis
3. Certain specific, serious congenital (present from birth) heart conditions, including
   • Uunrepaired 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
4. A cardiac transplant that develops a problem in a heart valve.According to revised guidelines from the American Heart Association (AHA) with input from the American Dental Association (ADA), antibiotics are now only recommended for patients at greatest risk of negative outcomes from IE including those with artificial heart valves or certain congenital heart conditions, heart transplant recipients who develop cardiac valve problems, recipients of an artificial patch to repair a congenital heart defect within the past six months and patients with a history of IE.

The new recommendations apply to many dental procedures, including teeth cleaning and extractions. The guidelines emphasize that maintaining optimal oral health and practicing daily oral hygiene are more important in reducing the risk of IE than taking preventive antibiotics before a dental visit.

Categories: Gums, Teeth