In recent years there has
been some debate over the need for prophylactic antibiotics before a dental
appointment. Unfortunately, there are varying opinions among different medical
specialties or organizations. In light on some of the more recent changes, we
would like to discuss where the dental community stands and how it will affect
your visits.
There have
been differing opinions on the use of antibiotics before dental treatment for
those who have had total joint replacements. Some have argued to continue premedication
for two years following surgery while others for your entire lifespan. While
your physician should have the final say, the dental community currently only
recommends antibiotic prophylaxis for the first two years following surgery. If
further premedication is recommended by your doctor, we would like them to be responsible
for providing the prescription.
There are
still certain situations where we will continue to provide the prescriptions needed for antibiotics.
The ADA (American Dental Association) currently recommends the following:
·
artificial
heart valves
·
a history of
infective endocarditis
·
a cardiac
transplant that develops a heart valve problem
·
the following
congenital (present from birth) heart conditions:
o
unrepaired or
incompletely repaired cyanotic congenital heart disease, including those with
palliative shunts and conduits a completely repaired congenital heart defect
with prosthetic material or device, whether placed by surgery or by catheter
intervention, during the first six months after the procedure
o
any repaired
congenital heart defect with residual defect at the site or adjacent to the
site of a prosthetic patch or a prosthetic device
If you are
uncertain whether or not you fall into any of these categories, we will need to
consult with your cardiologist before proceeding with any dental treatment.
There are also some conditions that
have required antibiotics in the past that are no longer included:
·
mitral valve
prolapse
·
rheumatic heart
disease
·
bicuspid valve
disease
·
calcified
aortic stenosis
·
congenital
(present from birth) heart conditions such as ventricular septal defect, atrial
septal defect and hypertrophic cardiomyopathy
The future will likely bring changes to regulations and
guidelines regarding the need for prophylactic antibiotics before dental
appointments. While we will continue to update you with any changes, the best
way to reduce the likelihood of infection related to oral bacteria is to
maintain excellent oral hygiene and great homecare.
For more
information, go to www.brownandkupper.com.
Lee T Brown,
DDS
Brown and
Kupper, DDS Inc.
(513) 860-3660
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