September 28, 2016 While taking preventative antibiotics prior to dental procedures used to be fairly commonplace for patients with certain heart conditions or orthopedic implants, now we know they can actually do more harm than good. In short, patients shouldn’t take antibiotics unless absolutely necessary, and our Sparks dentist office follows these guidelines. Antibiotics were prescribed for these type of patients based on the idea that bacteria from the mouth could enter the bloodstream during a general dentistry procedure, root canal, gum disease treatment or cosmetic dentistry procedure and put susceptible structures, like a stent or knee replacement, at risk for infection. According to research by the American Heart Association, American Dental Association and others, it appears this type of antibiotic usage doesn’t actually prevent these infections. In the meantime, the general overuse of antibiotics has increased the number of bacteria that are resistant to them. These types of bacteria are often prone to causing more serious issues. Most heart patients don’t need antibiotics In 2012, the American Heart Association revised its guidelines on which heart patients should take preventative antibiotics, recommending that only patients with the greatest risk of developing infection should continue to take them. The AHA and other regulatory organizations have determined that the risks outweigh the benefits, namely adverse reactions to the antibiotics and the trend of antibiotic resistance. The AHA also found that infective endocarditis was more likely to occur from everyday activities than dental procedures, and patients at risk of developing a heart infection were already exposed to oral bacteria from brushing and flossing. In fact, good oral hygiene was found to be more important in reducing the risk of IE than antibiotics. Patients with prosthetic joints, orthopedic implants are not exempt The American Dental Association follows the AAOS guidelines for patients with orthopedic implants to take preventative antibiotics. The ADA reported that dental procedures aren’t associated with prosthetic joint implant infections and antibiotics don’t prevent these infections. Again, good oral hygiene is most important: patients who had total knee arthroplasty and maintained good oral hygiene actually decreased frequency of infection by 20 percent. Who still needs preventative antibiotics? While antibiotics are no longer necessary for most patients, there are some who may still require them. Therapeutics and Clinical Risk Management recommends the use of antibiotics when there is an acute and obvious infection in the oral cavity. Conditions that might require antibiotic use prior to dental procedures include facial cellulitis, lateral periodontal abscess, pericoronitis and necrotizing ulcerative gingivitis. The AHA recommends patients with artificial heart valves, a history of IE, certain congenital heart conditions or a cardiac transplant continue to make use of pre-dental antibiotics. Patients with compromised immune systems may also benefit. If you have questions about whether you need a pre-dental antibiotic, consult with your general physician and contact Caffaratti Dental Group to discuss how our Sparks general dentistry or Sparks cosmetic dentistry procedures might affect our personal recommendation for you.