Many patients have been told to take antibiotics before dental procedures.  This recommendation was made to prevent an infection of the lining or valves of the heart called infective endocarditis (IE).  Patients who had leaky heart valves or other heart conditions that were thought to increase the risk of IE were told to take antibiotics before seeing the dentist.

Last week the American Heart Association published new guidelines about which patients should receive antibiotics to prevent IE.  These guidelines are based on the realization that in most patients, dental and other medical procedures are exceedingly unlikely to result in IE, and that antibiotics are more likely to cause harm than benefit in all patients except in those at highest risk for IE.

The only patients for whom preventive antibiotics are now recommended are those with

artificial heart valves
a history of having had IE
certain specific, serious congenital (present from birth) heart conditions, including:
– unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits
– a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter interventions, during the first six months after the procedure
-any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or prosthetic device
a cardiac transplant which develops a problem in a heart valve

That means the vast majority of the people taking antibiotics before dental procedures can stop.  Obviously, if you’re not sure if this applies to you, check with your doctor.

Thanks to Dr. Yaron Elad for pointing me to the new recommendations.