Guidelines for Antibiotic Pre-medication

Wendy Parker RDH

Guidelines to Follow

How do I prevent heart disease?

With an increase in antibiotic resistance, the American Dental Association has revised their guidelines for Antibiotic Pre-medication prior to dental appointments. Their goals are aimed at those who are at the greatest risk and to prevent any risks of infective endocarditis (an infection around the heart)

In years past, the following medical conditions have needed to routinely pre-medicate with antibiotics for dental procedures:

mitral valve prolapse
rheumatic heart disease
bicuspid valve disease
calcified aortic stenosis
congenital heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy

However, after careful consideration and studies, here are the latest guidelines for pre-medication prior to dental procedures, according to the ADA:

The current guidelines state that use of preventive antibiotics before certain dental procedures is reasonable for patients with:

prosthetic cardiac valve or prosthetic material used for cardiac valve repair
a history of infective endocarditis
a cardiac transplant that develops cardiac valvulopathy
the following congenital (present from birth) heart disease:^a
- unrepaired cyanotic congenital heart disease, including 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^b
- any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device (that inhibit endothelialization)

If you do not fit into these categories, you do not need to premedicate unless otherwise indicated by your physician.

If you do fit into the above categories, and are currently taking an antibiotic when you are going in for dental procedures, it is recommended that your dentist select an antibiotic from a different class than the one you are currently taking. For example, if you are taking amoxicillin and you need to pre-medicate for a dental prophylaxis, you should be prescribed clindamycin, azithromycin, or clarithromycin.

The other catch to taking antibiotics, is REMEMBERING to take them. If you’re like me, I will forget things if they are not written down! So, if, by chance you do forget before coming in, no worries! The ADA states that if antibiotics are not administered before the procedure, they can be administered up to two hours after the procedure and still have the adequate amounts in the blood to still prevent infective endocarditis.

If you have any questions or concerns about where you fit in these categories, don’t hesitate to mention it to your medical doctor, dentist, or hygienist. We are here to help and keep you healthy, from head to toe!

Heart Disease and Stroke Diabetes Osteoporosis Pregnancy Complications ...