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 deviceIf 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 cardiomyopathyThe 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.