Endocarditis is a rare, life-threatening inflammation of the lining of the heart muscle and its valves that is caused by a bacterial infection. Although it can occur in anyone, it is much more likely to occur in people who have certain heart conditions and in those who’ve had endocarditis previously. If you are at high risk for endocarditis, your doctor may recommend that you take antibiotics before dental procedures. Read on to learn more.
Who should take preventive antibiotics?
The American Heart Association (AHA) recommends antibiotics before certain dental procedures for patients with heart conditions that put them at the highest risk of developing endocarditis. The AHA recommends that patients receive antibiotics prior to dental treatment only if they have:
- had bacterial endocarditis before.
- a prosthetic (artificial) cardiac valve or prosthetic material used in valve repair.
- cardiac valve disease and have had a cardiac transplant.
- congenital (present at birth) heart disease. This includes people with the following conditions: unrepaired cyanotic congenital heart disease (including those with devices that relieve symptoms only); completely repaired congenital heart defect with prosthetic material or device during the first six months after the procedure; and repaired congenital heart disease with defects that remain at or near the site of a prosthetic patch or prosthetic device.
With these recommendations in mind, you and your physician can determine whether or not preventive antibiotic treatment is recommended for your condition.
How are preventive antibiotics taken?
Patients who require preventive treatment take a single dose of an antibiotic, typically about one hour prior to dental appointments.
For which dental procedures are the antibiotics taken?
For patients at highest risk for endocarditis, the AHA guidelines suggest preventive antibiotic treatment for the following:
- Dental procedures that involve manipulation of gingival tissue (around bone and teeth) or the periapical region of teeth (tip of the tooth root)
- Dental procedures in which the inside lining of the mouth is perforated
The guidelines do not recommend that high-risk patients receive preventive antibiotics for the following dental procedures or events:
- Placement of removable orthodontic appliances
- Adjustment of orthodontic appliances
- Placement of orthodontic brackets
- Shedding of baby teeth
- Bleeding from trauma to the lips or inside of the mouth
If you have concerns about whether or not preventive antibiotics are needed for your condition, talk to your doctor.
What can I do to lower my risk for infections?
To lower your risk for infection, it’s important that our dental team is up to date on your current health condition. Be sure to tell us if your health has changed since your last visit, including if you have been diagnosed with a heart condition. Also, let us know if you’ve had heart or vascular surgery, or any other surgery or medical procedure, since your last visit.
In your patient record, make sure your dentist has a complete list of the names and dosages of all of your medications, both prescription and over-the-counter, including vitamins and herbal remedies. Also be sure that your dentist has all of the names and phone numbers of your current physicians, in case a consultation is necessary. Of course, it’s also important to practice regular good oral hygiene. Brush your teeth at least twice a day for 2 minutes each time, and floss daily. See your dentist every six months for regular exams and cleanings.
If you have questions about preventive antibiotic treatment, talk to your doctor and dentist.
Published with permission by the Academy of General Dentistry. © Copyright 2015 by the Academy of General Dentistry. All rights reserved.