Taking Antibiotics Before Your Dental Appointment: Do I have to?

Have you ever been required to take an antibiotic before your dental appointment?  That may have changed recently.  Based on an extensive review of scientific evidence, new guidelines are in place.  For many years antibiotic prophylaxis has been recommended for two groups of patients.

The first group is those patients with a heart condition that may predispose them to infective endocarditis, which is an inflammation of the valves of your heart.  If you have an artificial heart valve, a history of infective endocarditis, a heart transplant or certain congenital heart defects, you may be required to take an antibiotic before most dental procedures.  This is because bacteria from your mouth may be introduced into the blood stream during many routine dental procedures including cleanings.  This bacterium has the potential to cause a heart valve infection.  For these conditions, your cardiologist will normally recommend an antibiotic and a dose.  It is usually required that you take the antibiotic at least an hour before your appointment so that adequate levels of the antibiotic can reach the blood stream before any bacteria can.  For these patients, we will work with your cardiologist and our office can keep you supplied with the prescriptions needed for your dental visits.

It is important to know that if you are on an antibiotic for any other reason, the type of antibiotic required for you dental visit may change.  Please contact our office before your appointment if you are currently taking an antibiotic for another condition.  Studies into infective endocarditis are on-going.  These current recommendations may be changed in the near future.  We will keep you informed.

The second group of patients who have been required to take antibiotics before their dental visits are patients with a prosthetic joint.  This was due to the perceived risk for developing infections at the site of the prosthetic.  Last year the American Dental Association assembled an expert panel to update and clarify the clinical recommendations for patients with artificial joints.  This panel has concluded that, in general, for patients with prosthetic joint implants, prophylactic antibiotics are NOT recommended prior to dental procedures. No evidence could be found linking dental procedures to prosthetic joint infections.  In addition, the risk of developing antibiotic resistance and opportunistic infections were greater than the possible benefit of the antibiotic regiment.

For our patients with artificial joints, we will be happy to work with your osteopathic doctors if they feel an antibiotic is still necessary in your case.  However, we will not be requiring antibiotics before your dental appointment nor we will be re-filling any antibiotic prescriptions without first consulting with your doctor.

Again, these recommendations are constantly evolving and we will keep you informed of any changes.  The trend is toward fewer unnecessary prescriptions and we at Dr. Bruce Sexton heartily endorse this trend.  If you have any questions, please don’t hesitate to call our office at 269-792-2220.

Thanks for Reading,

Dr. Bruce