Pre-medications and Preventions

It is important to understand that the mouth is full of bacteria of many kinds. This is why you are urged to have your teeth and gums professionally cleaned every few months. The tissues of the mouth are very fragile and professional cleaning as well as most other dental procedures can rupture those fragile tissues even with the most gentle of clinicians and allow bacterial populations to enter the blood stream in larger than normal amounts.

In its normal state, the inside of the blood system and joint capules are very smooth. However after surgery or heart disease, areas of these tissues can become roughened such that bacterial populations can stick to, infect and possibly impair the function of these important tissues. Infection of the heart and heart valves is known as Infectious or Bacterial Endocarditis (IE).

Until very recently, it has been common practice to prescribe antibiotics to all people with heart problems before they receive dental treatment. In May of 2007 the American Heart Association updated its guidelines for the prevention of IE saying that preventative doses of antibiotics should only be given to patients who are at the highest risk of adverse outcomes from IE.

Antibiotics carry risks. Fatal allergic reactions occur. Increasingly, bacteria that cause IE and other diseases and conditions are becoming resistant to antibiotics. The American Heart Association reported new evidence that the risks outweigh the benefits for many patients receiving antibiotics prior to dental treatment.

We have seen that this is confusing for patients. There are still those that will require antibiotic therapy prior to dental treatment. Each patient’s situation is unique. If you have any kind of heart condition or have received artificial joint replacement, check with your dentist and/or primary care physician to determine your status.

The American Heart Association advises that regular treatment of dental and gum disease is the best way to limit the potential rise of oral bacteria. Because on-going research continues to correlate systemic diseases with gum disease and dental decay, it is extremely important to your overall health that you see your dentist regularly.