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posted Apr 24, 2014, 7:56 AM by Dr. Elham Khajavi

            There are times when your dentist may suggest a patient take antibiotics before certain dental procedures.  But do we know why the dentist would be asking a patient to do this?

            We all have bacteria in our mouths.  No matter how meticulous we are with our brushing, flossing, rinsing and oral hygiene, the bacteria are still present.  When these bacteria enter the bloodstream through the gum tissue it is called “bacteremia.”  This can occur while we are performing our daily oral hygiene routines but more likely happens upon having invasive dental work performed such as dental cleanings, deep tissue cleanings, extractions and any procedure that can involve the bleeding of the gums.  For most of us this does not pose a problem because a healthy immune system prevents these bacteria from causing harm.  However, for some patients who may have a compromised immune system, these bacteria can cause infection elsewhere in the body.

  The American Heart Association has guidelines identifying patients who they recommend needing antibiotic prophylactic treatment prior to their dental procedure.  Any type of “heart” issue is one the conditions requiring a patient to take a dose of antibiotics before their dental appointment.  This may include artificial heart valves, previous heart transplant, any history of infection in the lining of the heart, heart conditions that have been present since birth and shunts or other prosthetic material.

Also included in antibiotic prophylaxis guidelines are those patients who have orthopedic implants such as artificial joints including hip and knee replacements.  The American Dental Association and the American Association of Orthopedic Surgery work closely together to frequently update their recommendations for these types of conditions.  Currently, they no longer recommend antibiotics for everyone with artificial joints.  The current guidelines suggest that a thorough health history is necessary for your healthcare provider to assess whether or not antibiotic prophylaxis is necessary.  A patient with a compromised immune system due to diabetes, arthritis, cancer, chemotherapy or steroid use is likely to be a good candidate for a dose of antibiotics prior to dental treatment to reduce the risk of orthopedic implant infection.  These guidelines are re-evaluated every few years to make sure they are based on the best scientific evidence available.

Penicillin is the antibiotic of choice for patients needing antibiotic prophylaxis prior to dental care.  However, if the patient is allergic to Penicillin, Clindamycin would be prescribed.

Hopefully this information is helpful in understanding the need for antibiotic prophylaxis.  Whether it is for a heart condition or any type of artificial replacement in your body, taking a dose of prescribed antibiotics prior to your dental appointment can keep the rest of your body healthy too!