Wednesday, June 27, 2007

Antibiotics and the Dentist

Many patients have been taking antibiotics every time they have been to the dentist for as long as they remember but now wonder why they no longer have to. This is due to a recent change in the guidelines published by the American Heart Association (May 2007). There was always a concern that if you had almost any problem with the valves in your heart and you had a dental procedure that you may get an infection of the heart called "infective endocarditis." The American Heart Association has been reviewing the topic and looking at how rare this disease is and who seems to be getting it. Based on this review they have reduced the number of people the recommend get antibiotics before a procedure. Now only people with:

1) An artificial heard valve
2) A history of infective endocarditis
3) Certain birth defects of the heart
4) A heart transplant under certain conditions

If you do not have one of these problems you should not take antibiotics before your dental procedure. Two big reasons that people were getting antibiotics before their dentist visit were mitral prolapse and a history of rheumatic heart disease. If you have these you no longer need antibiotics.

Wouldn't it be better to still take the antibiotics just in case? No. The reason is that the chance of getting endocarditis is so small that you have a much higher chance of dealing with side effects of the antibiotics. The most common is diarrhea but you can have a number of different side effects from the medication even if you never did in the past.

This information should be very well spread around the medical world since it was advertised in the medical journals in May and was just published in the June edition of the Journal of the American Dental Association. So by now both your doctor and your dentist should be on the same page about this matter.

If you have any questions about these changes please call your doctor's office.