According to new guidelines, far fewer people need preventive antibiotics before dental procedures than previously recommended, according to a recent issue of Mayo Clinic Women’s HealthSource.
The use of preventive antibiotics for people with certain heart conditions stemmed from worries about endocarditis. That condition is an infection of the thin membrane that lines the chambers and valves inside the heart, called the endocardium. Endocarditis occurs when bacteria or germs from another part of the body, such as the mouth, enter the bloodstream and travel to the heart and attach to abnormal heart valves or damaged heart tissue.
An American Heart Association (AHA) committee found that for most people, the risk of endocarditis from dental procedures was low. Daily activities, such as brushing, flossing or chewing, are much more likely to cause endocarditis than are bacteria that enter the bloodstream from a single dental procedure.
“Preventive antibiotics before dental work are now recommended only for people who, if they develop endocarditis, are more likely to die or have serious complications,” says Walter Wilson, M.D., an infectious diseases specialist at Mayo Clinic. Dr. Wilson headed the AHA committee that recently revised the guidelines.
The new recommendations suggest preventive antibiotics before dental work only for those people with artificial heart valves, a history of infective endocarditis, certain forms of congenital heart disease and cardiac valve abnormalities following a heart transplant.
Preventive antibiotics are no longer recommended for many people who have common heart conditions such as mitral valve prolapse or rheumatic heart disease. Before their next dental visit, patients who have taken preventive antibiotics should check with a doctor or dentist to discuss the guideline changes and determine if the medication is necessary.