Antibiotic Premedication

Antibiotics and Dental Treatments

Traditionally, physicians and dentists have advised patients with a wide range of conditions (including heart problems and bone and joint replacements) to take antibiotics before a routine dental procedure, to help prevent possible infection. This practice is called “antibiotic prophylaxis.” However, mounting evidence suggests that this practice should be limited to a much smaller group of patients than was previously thought. Why has the prevailing medical opinion changed? And what do you need to know about the current use of antibiotics in relation to dental procedures?

Reason for Concern

Our mouths are full of bacteria. Routine activities, such as chewing, brushing, and flossing can allow that bacteria into the bloodstream. Dental procedures may also release bacteria into the blood; however, our immune systems normally keep us from harm, leaving nothing to worry about.
Although some patients are at higher risk of developing infection than others, recent research indicates that the risk of adverse reaction to antibiotics (although rare) is greater than that of developing an infection from dental treatment. This is why antibiotic use has gone down. Still, for higher risk patients (such as those treated for heart disease or who have undergone major orthopedic procedures), taking antibiotics may be recommended to help prevent serious problems from developing.

Factors Warranting Antibiotics

Your dentist may decide to prescribe prophylactic antibiotics prior to a dental procedure if you have experienced one or more of the following heart conditions:

  • A heart transplant;
  • Placement of prosthetic valves;
  • A history of infective endocarditis;
  • Certain types of congenital heart problems.

Additionally, you may be recommended antibiotics if you have artificial joints or have one of the following risk factors:

  • A chronic inflammatory disease such as rheumatoid arthritis;
  • A weakened immune system due to battle with serious disease (such as HIV or cancer), or respective combative treatment;
  • Type I diabetes or hemophilia;
  • A history of previous infection in a prosthetic joint;
  • Malnourishment.

This list is not meant to be exhaustive. However, there are many situations that dentists previously felt called for antibiotics (such as the presence of a benign heart murmur or use of a pacemaker) where their use is now believed unnecessary.

Reports in recent years of drug-resistant bacteria led to further study on the matter, and new scientific research aids dental professionals to make better informed decisions regarding the use of antibiotics. Be sure, your Yuba City Dentist will carefully review your personal history and circumstances, then make a recommendation that is best for you. Feel free to inform us of your medical history and ask any specific questions to determine whether or not antibiotics are warranted before certain dental procedures.