Fewer People Need Pre-Dental Antibiotics

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By Lisa Ellis, InteliHealth News Service - May, 2007

Many people with heart problems no longer need to take antibiotics before seeing the dentist. The change is in new guidelines from the American Heart Association.

For many years, people with heart defects were told to take antibiotics before most dental work. This included tooth cleaning in a dentist's office.

The guidelines advise antibiotics only for "patients with the highest risk of adverse outcome" from infection. The new guidelines still recommend antibiotics before dental work for people with:

• Artificial heart valves
  
• A history of infective endocarditis
  
• Cyanotic heart disease that has not been repaired or was repaired incompletely. This includes people with shunts and conduits.
  
• A heart defect that was completely repaired with a prosthetic material or device. (Antibiotics are advised only during for the first six months after the repair is made.)
  
• Any repaired heart defect that still has some defect remaining at the site of a prosthetic patch or device, or next to it
  
• A heart transplant that develops a valve problem

The American Dental Association helped to create the new policy. The Infectious Diseases Society of America and the Pediatric Infectious Diseases Society have endorsed it. The guidelines are in the April 20 issue of the journal Circulation.