Do You Need Antibiotics Before Your Dental Visit?

You may have heard that some people should take antibiotics before they visit the dentist for a cleaning or extractions. This is called antibiotic prophylaxis.1,2

But the rules have changed in recent years.3 Here’s what the experts say.

Heart Problems That Don’t Require Antibiotics

For years, the American Heart Association recommended that people with certain heart problems take a short-term course of antibiotics before visiting the dentist. The goal was to reduce the risk for infective endocarditis, an infection of the heart’s lining or valves.3

However, research has shown that antibiotics offer little protection against this condition for most people. And most of us have very little risk of getting the condition after a dental procedure. In fact, the risks from taking antibiotics, such as side effects, can outweigh the benefits.3

Experts say people do not need to take antibiotics before dental visits if they have these heart issues:

  • Mitral valve prolapse3

  • Rheumatic heart disease3

  • Bicuspid valve disease3

  • Calcified aortic stenosis3

  • A ventricular septal defect, atrial septal defect, or hypertrophic cardiomyopathy3

Heart Problems That Do Require Antibiotics

Certain people, however, may be more likely to have a bad reaction if they develop a heart infection after a dental visit. The American Heart Association still advises taking antibiotics before dental treatment if you have one of the following heart problems:

  • An artificial heart valve1,3

  • Previous infective endocarditis3

  • A previous heart transplant when there are problems with a heart valve3

  • Certain heart defects, such as unrepaired cyanotic congenital heart disease3

If you’re not sure about the guidelines for your heart condition, check with your heart specialist.

If You’ve Had Joint Surgery

People who have had a joint replacement, such as a hip or a knee replacement, may also need antibiotics. They may be at risk of developing infections in the joint after dental procedures, according to the American Academy of Orthopedic Surgeons. Ask your orthopedic surgeon if you need antibiotic prophylaxis before your next dental visit.4

Not Sure? Ask!

Be sure to tell your dental health professional about your medical history. If you have any questions about your treatment, ask your doctor or dentist.3

1 “Prevention of Infective Endocarditis. Guidelines from the American Heart Association.” W. Wilson et al. Journal of the American Dental Association. January 2008, vol. 139, no. 1, p. 3S. jada.ada.org/cgi/reprint/139/suppl_1/3S Accessed 2009.

2 “Oral Health Topics. Antibiotic Prophylaxis.” American Dental Association. www.ada.org/2157.aspx Accessed 2009.

3 “Oral Health Topics. Antibiotics and Your Heart.” American Dental Association. www.ada.org/2157.aspx Accessed 2009.

4 “Antibiotic Prophylaxis for Bacteremia in Patients with Joint Replacements.” American Academy of Orthopedic Surgeons, February 2009. www.aaos.org/about/papers/advistmt/1033.asp Accessed 2009.

Author: Ramos, Laura
Online Editor: Sims, Jane
Online Medical Reviewer: Eakle, Stephan W., DDS
Date Last Reviewed: 12/30/2010
Date Last Modified: 12/30/2010
The views represented by this article are that of the author and not of Delta Dental. This article is provided for information only. Please consult with a licensed dentist to discuss the best way for you to improve or maintain your oral health.

In all cases, specific group contract provisions, benefits, limitations and exclusions take precedence over oral health recommendations given here. We recommend that you contact your dental benefits carrier to determine the specific limitations and exclusions for your group.

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