Dentist and Skin Care Blog from Boston's Area Leading Dental Office

If you or a family member has rheumatic heart disease, bicuspid valve disease, aortic stenosis or a mitral valve prolapse, you’re probably used to taking prophylactic antibiotics prior to dental procedures. However, you may not be aware that the American Heart Association recently revised its antibiotic guidelines following their review of benefits vs. potential risks. After reading this valuable update regarding precautionary antibiotics, feel free to contact the Smile and Skin team with questions about your specific health condition. 

1. While antibiotics were previously recommended for a variety of heart conditions, the AHA now recommends the following: “Patients at the greatest risk of bad outcomes from infective endocarditis (IE) – an infection of the heart’s inner lining or the heart valves – should receive short-term preventative antibiotics before common, routine dental procedures.” This means that only patients who have received heart transplants or have artificial heart valves, serious congenital heart conditions or a history of serious endocarditis should receive prophylactic antibiotic prescriptions before going to the dentist. Remember to discuss your health history with Dr. Meola and his staff so they can make an educated recommendation about your need for antibiotics.
2. While there is limited evidence that prophylaxis works, the primary reason for the AHA recommendation change is due to the potential risks involved with some antibiotic doses. First, overprescribing of these prophylactic medications makes IE bacteria progressively more resistant to antibiotics. Second, some patients can have severe allergic reactions to antibiotics. At this point, physicians believe that antibiotics are best reserved for those with severe heart conditions, only.     
3. Finally, the AHA’s recommendations are based on evidence that infective endocarditis is far more likely to begin from bacteria entering the bloodstream through everyday activities, rather than through sterile dental procedures. According to Mayo Clinic physician, Walter R. Wilson, “…maintaining good oral health and hygiene appears to be more protective than the prophylactic antibiotics. This changes the whole philosophy of how we have constructed these recommendations for the last 50 years.”

If you’re concerned about IE or another serious health problem that may be impacted by secondary infection, ask the Smile and Skin team about the use of prophylactic antibiotics. Using the most updated guidelines and dental research, Dr. Meola and his team will assess your concerns and make recommendations that protect your health and address your specific medical condition.