Premedication


For decades the guidelines regarding prophylactic medications and dentistry have been changing. We would like to share the latest information from the American Heart Association.

In the past, the AHA recommended that patients with certain heart conditions take antibiotics shortly before dental treatment. This was done with the belief that antibiotics would prevent infective endocarditis (IE). IE is an infection of the heart's inner lining or valves, which enters the heart through the blood stream.

As of April 2007, the AHA guidelines have changed. The AHA recommends that most of these patients no longer need to take short term antibiotics as a preventative measure. This change has been based on a growing body of evidence that shows that the risks of taking a preventative antibiotic outweigh the benefits. The risks include adverse reactions or inappropriate use that can lead to drug-resistant bacteria.

The guidelines say that patients who have routinely taken prophylactic antibiotics but no longer need to take them include people with mitral valve prolapse, rheumatic heart disease, bicuspid valve disease, calcified aortic stenosis, or cogenital heart conditions such as ventricular septal defect, atrial septal defect, and hypertrophic cardiomyopathy. Click here to visit the ADA website.

Preventative antibiotics before dental procedures are still advised for patients with artificial heart valves, a history of infective endocarditis, certain specific serious cogenital heart conditions including unrepaired 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 device, or a cardiac transplantation that develops a problem in the heart valve.

The recommendations apply to many dental procedures, including teeth cleaning and extractions.

Patients should check with their cardiologist if there is any question at all as to the category that best fits their needs.