Dental Prophylaxis Guidelines
Dental Prophylaxis Guidelines
http://www.americanheart.org/presenter.jhtml?identifier=4436
Therefore, the current practice of giving patients antibiotics prior to a dental procedure is no longer recommended EXCEPT for patients with the highest risk of adverse outcome resulting from endocarditis. Those people at highest risk include those with:
- Prosthetic cardiac valve
- Previous endocarditis
- Congenital heart disease for these conditions:
– Unrepaired cyanotic congenital heart disease, including palliative shunts and conduits
– Completely repaired congenital heart disease with prosthetic material or device either by surgery or catheter intervention during the first six months after the procedure†
– Repaired congenital heart disease with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit endothelialization) - Cardiac transplantation recipients who develop cardiac valve abnormalities
The American Heart Association has concluded that an exceedingly small number of cases, if any, of endocarditis may be prevented by giving antibiotics prior to a dental procedure. If such benefit from prophylaxis exists, it should be reserved ONLY for those patients at highest risk (listed above) who would have the worst outcomes if they contract endocarditis.
The American Heart Association recognizes the importance of good oral and dental health including regular brushing and flossing and regular visits to the dentist for patients at risk of endocarditis.
The American Heart Association no longer recommends administering antibiotics solely to prevent endocarditis in patients who undergo a GI or GU tract procedure.
What can you do?
Changes in these guidelines do not change the fact that your cardiac condition puts you at increased risk for developing endocarditis. If you develop signs or symptoms of endocarditis – such as unexplained fever –see your doctor right away. If blood cultures are necessary (to determine if endocarditis is present), it is important for your doctor to obtain these cultures and other relevant tests BEFORE antibiotics to treat endocarditis are started.
If you've been told you have any of the cardiac conditions listed above, be sure to tell your dentist and other physicians who may be treating you.
† Prophylaxis is recommended because endothelialization of prosthetic material occurs within six months after the procedure.
Download the Bacterial Endocarditis Wallet Card.
The Council on Scientific Affairs of the American Dental Association has approved the American Heart Association's statement as it relates to dentistry.