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What You Need to Know About Antibiotics and Dentistry

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Has your doctor recommended that you take antibiotics prior to visiting the dentist? This is referred to as antibiotic prophylaxis. Since it can be a controversial topic in the dental community, we thought we would provide you with current information and options to help you prepare for your next dental visit.

In patients with a history of complications associated with joint replacement surgery who are undergoing dental procedures that include gingival manipulation or mucosal incision prophylactic antibiotics should only be considered after consultation with the patient and orthopedic surgeon.
The 2015 ASA clinical practice guideline states “In general, for patients with prosthetic joint implants, prophylactic antibiotics are NOT recommended prior to dental procedures to prevent prosthetic joint infections.”

Prophylactic antibiotics are recommended for patients undergoing dental procedures that involve manipulation of gingival tissue or the periapical region of the teeth or perforation of the oral mucosa and have the following conditions:

• “A prosthetic heart valve or who have had a heart valve repaired with prosthetic material.”
• A history of endocarditis
• A heart with abnormal heart valve function
• Congenital heart disease such as cyanotic congenital heart disease or a congenital heart defect.

Antibiotic prophylaxis for dental procedures is NOT recommended for patients with coronary artery stents.
Coronary bypass surgery is a surgical procedure that diverts the flow of blood around a section of a blocked or partially blocked artery in the heart by creating a new pathway to the heart.

Antibiotic prophylaxis for dental procedures is NOT needed in persons who have undergone a coronary bypass surgery. There is no evidence that coronary artery bypass graft surgery is associated with a long-term risk for infection.