Who Needs To Pre-Medicate For Dental Appointments...
Things have changed
Infective endocarditis is a series disease that occurs in nearly 18,000 Americans yearly. If not caught in a timely fashion, the results can lead to death. For years, the AHA (American Heart Association) has determined who needs to premedicate and what the regimen needs to be. It is always changing, and there is a new, less rigid standard for premedicating prior to your dental visit. The AHA recommends that most of these patients no longer need short-term antibiotics as a preventive measure before their dental treatment. These guidelines were endorsed by the Infectious Disease Society of America. It is important to first understand the rationale as to why premedication is necessary.
It was thought that the bacteria that is normally present in your mouth gets into your bloodstream during dental procedures that involves some degree of bleeding. The bacteria travels through the bloodstream and finally reaches the heart. In the case where a valve was faulty, or a history of Mitral Valve Prolapse (MVP), a murmur, etc.. the bacteria gets trapped in these area of the heart and cause an infection. By taking the antibiotic one hour prior to your dental appointment, the bacteria is reduced and there should be no concern for an endocarditis to occur. The new guidelines, however, are based on a growing body of scientific evidence that shows the risks of taking preventive antibiotics outweigh the benefit for most patients. The risks include adverse reactions to antibiotics that can range from mild to potentially life-threatening. Inappropriate use of antibiotics can also lead to the development of drug-resistant bacteria.
The guidelines say patients who have taken prophylactic antibiotics routinely in the past but no longer need them are people with:
- mitral valve prolapse
- rheumatic heart disease
- bicuspid valve disease
- calcified aortic stenosis
- congenital heart conditions such as ventricular septal defects, atrial septal defect and hypertrophic cardimyopathy.
Preventive antibiotics prior to dental procedure are advised for patients with:
- artificial heart valves
- a history of infective endocarditis
- specific serious congential heart conditions ( check with your cardiologist)
- a cardiac transplant that develops a problem in a heart valve.
So the good news is that for many that have been taking the preventive antibiotic regimen no longer need to. Hopefully, this will be a major step in the reduction of over prescribing antibiotics, leading to the potential of drug-resistant diseases. For more information, contact the American Heart Association, or your physician or cardiologist.
Wayne Myles DDS - Providing services in cosmetic dentistry and headache relief to the areas of Reston, Fairfax and Arlington, Northern Virginia (VA).
11730 Plaza America Drive, Suite 110 Reston, VA 20190
Ph. 703.925.0800, Fx. 703.925.0279
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