Do I need to pre-medicate with an antibiotic before my appointment?
The American Heart Association’s current guidelines from April 2007:
Preventive antibiotics prior to a dental procedure are advised for patients with:
- artificial heart valves
- a history of infective endocarditis
- 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 intervention, 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 a prosthetic device
4. a cardiac transplant that develops a problem in a heart valve.
The new recommendations apply to many dental procedures, including teeth cleaning and extractions. Patients with congenital heart disease can have complicated circumstances. They should check with their cardiologist if there is any question at all as to the category that best fits their needs.
The American Academy of Orthopaedic Surgeons current guidelines:
Antibiotic prophylaxis may be considered when the higher risk dental procedures are performed on dental patients within two years post joint replacement surgery, on those who have had previous prosthetic joint infections, and on those with some other conditions.
Patients at Potential Increased Risk of Total Joint Infection:
- Immunocompromised/immunosuppressed patients
Inflammatory arthropathies: rheumatoid arthritis, systemic lupus erythematosus
Disease, drug or radiation-induced immunosuppression - Other Patients
Insulin-dependent (Type 1) diabetes
First two years following joint placement
Previous prosthetic joint infections
Malnourishment
Hemophilia
