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1st Dentist - Why Some People Take Antibiotics Before Visiting The Dentist |
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Why Some People Take Antibiotics Before Visiting The Dentist
By Denise J. Fedele, DMD, MS
Dentists prescribe prophylactic (to prevent the spread of disease)
antibiotics before dental treatment for people with certain medical conditions.
The American Heart Association, the American Dental Association, and the
American Academy of Orthopedic Surgeons have recommended the guidelines for
preventive antibiotics for these medical conditions. The current guidelines were
developed for patient well-being, as well as in consideration of the current
concern regarding the overuse of antibiotics. The guidelines outline specific
medical conditions and provide examples of which dental procedures indicate the
need for prophylactic antibiotics.
The risk of infective endocarditis (infection and inflammation of the lining
of the heart and its valves) is increased with dental procedures that cause
bleeding and the potential release of oral bacteria into the bloodstream of
people with certain medical conditions. Individuals who have certain congenital
or acquired heart defects, as well as some conditions or abnormalities of the
heart, have an increased chance of a bacterial infection.
The link between dental procedures and infective endocarditis is
controversial. Not all dental procedures require the use of antibiotic
prophylaxis. Dental procedures that have minimal potential to cause bleeding are
considered low risk for infective endocarditis. Antibiotic prophylaxis may be
indicated for invasive dental procedures that are likely to cause bleeding and
release of oral bacteria in the bloodstream.
Also, the release of oral bacteria into the bloodstream appears to increase
the risk of developing an infection around a prosthetic joint in people with a
depressed immune system. Use of prophylaxis antibiotics is recommended for
individuals with total joint replacements who have certain other health
conditions.
Antibiotic prophylaxis also can be prescribed for circumstances other than
prevention of infective endocarditis and prosthetic joint infections. Some other
conditions or situations that may indicate antibiotic prophylaxis include
in-dwelling catheters, hemodialysis patients with arteriovenous shunts, shunts
for hydrocephalus, oral surgical or operative procedures (depending on the
patient's immune system), insulin-dependent diabetes, or diabetics whose
disease is poorly controlled.
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