Updated Preventative Antibiotic Recommendations
by Sheri Prohaska, RDH at Gentle Family Dentistry

The American Heart Association recently updated their guidelines for pre-medication requirements prior to a dental visit. A preventive medication is a high dose of a doctor recommended antibiotic taken one hour prior to a dental cleaning, filling or extraction appointment.  Previously, pre-medication was thought to be the best way to prevent Infective Endocarditis. Research has now shown that maintaining proper oral hygiene habits at home on a daily basis is more important in reducing the risk of IE. Studies have also shown that IE is more likely to occur from bacteria entering the blood stream from everyday activities rather then from a dental procedure. The evidence also shows that the risk of taking preventative antibiotics outweighs the benefits for most patients. The AHA is recommending that only those people who are at the greatest risk of bad outcomes from IE continue to take a pre-medication. The new guidelines are outlined below.

• Individuals with artificial heart valves
• Previous infective endocarditis
• Certain congenital heart disease
  • Unrepaired cyanotic CHD including palliative shunts and conduits
  • Completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention-only during the first six months after the procedure
  • Repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device
• Cardiac transplant recipients who develop cardiac valvulopathy

• Individuals with 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