What is endocarditis?
Endocarditis is a rare, potentially fatal condition affecting the heart lining and its valves and started by bacterial infection. It is much more frequently found in people who have certain heart conditions and in previous endocarditis cases. If you are at high risk for endocarditis, your doctor may recommend antibiotics be taken before dental procedures.
Who should take preventive antibiotics?
The American Heart Association (AHA) recommends antibiotics prior to certain dental procedures for people with heart conditions associated with the highest risk of developing endocarditis. The AHA recommends that patients receive antibiotics prior to dental treatment only if they have:
- had bacterial endocarditis before
- a prosthetic (artificial) cardiac valve
- prosthetic material used in valve repair
- cardiac valve disease and have had a cardiac transplant
- congenital (present at birth) heart disease. This includes only people having the following conditions:
- unrepaired cyanotic congenital heart disease (including those with devices that relieve symptoms only)
- completely repaired congenital heart defect with prosthetic material or device during the first six months after the procedure
- repaired congenital heart disease with defects that remain at or near the site of a prosthetic patch or prosthetic device
With these recommendations in mind, you and your doctor can decide whether or not preventive antibiotic dosing is preferred for your condition.
How are preventive antibiotics taken?
Patients who require preventive treatment take a single dose of an antibiotic, usually by mouth about one hour before certain dental treatments.
For which dental procedures are the antibiotics taken?
For patients at highest risk for endocarditis, the AHA guidelines suggest preventive antibiotic treatment for only the following:
- Dental procedures that involve manipulation of gum tissue (around bone and teeth) or the tip of the tooth root
- Dental procedures in which the inside lining of the mouth is penetrated
The guidelines do not recommend that high-risk individuals take preventive antibiotics for the following dental procedures or events:
- Routine anesthetic injections through noninfected tissue
- Dental X-rays
- Placement of removable dental prostheses or orthodontic appliances
- Adjustment of orthodontic appliances
- Placement of orthodontic brackets
- Shedding of baby teeth
- Bleeding from trauma to the lips or inside of the mouth
If you have concerns about whether or not preventive antibiotics are needed for your condition, talk to your doctor.
What can I do to lower my risk for infections?
To reduce your risk for infection, it’s important that your dental team knows about your current health status. Be sure to tell us if your health has changed since your last visit, including if you have been diagnosed with a heart condition. You should let us know if you’ve had heart or vascular surgery, or any other surgery or medical procedure, within the past six months.
In your dental record, make sure we have a complete list of the names and dosages of all of your medications, both prescription and over-the-counter, including vitamins and herbal remedies. It’s important that we have all of the names and phone numbers of your current physicians, in case we need to consult with them. Finally, it’s especially important to practice regular good home care of your teeth. Brush at least twice a day for 2 minutes each time, and floss every day. Visit our office at least every six months for regular exams and cleanings.
If you have questions about preventive antibiotic treatment, you should talk to your doctor and Dr. Cardon at Stadium Dental Center in Jefferson City, Missouri. Learn more at http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Infective-Endocarditis_UCM_307108_Article.jsp#.Vwc4l8fntPY and http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/Heart-Valves-and-Infective-Endocarditis_UCM_450448_Article.jsp#.Vwc4_MfntPY
