Heart Patients (For PROSTHETIC JOINTS: See below)
Find out why the use of preventive antibiotics prior to certain dental procedures is recommended for patients with certain heart conditions like Infective Endocarditis (IE).
In the past, patients with nearly every type of heart defect needed to receive antibiotics one hour prior to dental procedures or any invasive procedure in the mouth, throat, gastrointestinal genital, or urinary tract. However, in 2007 the American Heart Association simplified its recommendations. Today, taking antibiotics before dental procedures is only recommended for patients with the highest risk of IE, those who have:
- A prosthetic heart valve or who have had a heart valve repaired with prosthetic material.
- A history of endocarditis.
- A heart transplant with abnormal heart valve function
- Certain congenital heart defects including:
- Cyanotic congenital heart disease (birth defects with oxygen levels lower than normal), that has not been fully repaired, including children who have had a surgical shunts and conduits.
- A congenital heart defect that’s been completely repaired with prosthetic material or a device for the first six months after the repair procedure.
- Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at or adjacent to a prosthetic patch or prosthetic device.
Antibiotic Prophylaxis For Prosthetic Joints
- Compared with previous recommendations, there are currently relatively few patient subpopulations for whom antibiotic prophylaxis may be indicated prior to certain dental procedures.
- In patients with prosthetic joint implants, a January 2015 ADA clinical practice guideline, based on a 2014 systematic review states, “In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.”
- According to the ADA Chairside Guide, for patients with a history of complications associated with their 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; in cases where antibiotics are deemed necessary, it is most appropriate that the orthopedic surgeon recommend the appropriate antibiotic regimen and, when reasonable, write the prescription.