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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.

But the rules have changed in recent years. 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.

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.

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

  • Mitral valve prolapse

  • Rheumatic heart disease

  • Bicuspid valve disease

  • Calcified aortic stenosis

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

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 valve

  • Previous infective endocarditis

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

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

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.

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.

“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 2013.

“Premedication Antibiotics.” Mouth Healthy, American Dental Association. http://www.mouthhealthy.org/en/az-topics/p/Premedication-or-Antibiotics Accessed 2013.

“Antibiotic Prophylaxis for Patients After Total Joint Replacement.” American Academy of Orthopedic Surgeons, February 2009. http://orthodoc.aaos.org/davidgrimmmd/Antibiotic%20Prophylaxis%20for%20Patients%20after%20Total%20Joint%20Replacement.pdf Accessed 2013.

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