Antibiotics Before Dental Procedures, An Updated Recommendation

Taking a precautionary antibiotic before a trip to the dentist isn’t necessary for most people and, in fact, might do more harm than good, according to updated recommendations from the American Heart Association.

The new guidelines

The AHA’s updated guidelines say that many patients who have taken preventive antibiotics regularly in the past no longer need them. The AHA now recommends that only people who are at the greatest risk of bad outcomes from infective endocarditis (IE) should receive short-term preventive antibiotics before routine dental procedures. IE is an infection of the heart’s inner lining or the heart valves, which results when bacteria enter the bloodstream and travel to the heart.

Risks outweigh the benefits

The new guidelines are based on current evidence that shows the risks of taking preventive antibiotics outweigh the benefits for most patients. These risks include adverse reactions to antibiotics and the development of drug-resistant bacteria.

The overuse of antibiotics has caused a huge increase in the number of bacteria that are now resistant to them. When this happens, new antibiotics must be created to treat these drug resistant bacteria.

The guidelines emphasize that maintaining good oral health and practicing daily oral hygiene are more important in reducing the risk of IE than taking preventive antibiotics before a dental visit.

Some patients still need preventive antibiotics

However, there are some patients who should still take antibiotics prior to dental procedures, specifically patients who have the highest likelihood of negative outcomes from developing a cardiac infection.

Patients should ask their primary care doctor or their cardiologist if there is any question whether they should take preventive antibiotics. They should also be aware that overuse of antibiotics many times can lead to a worse outcome than if they were not used at all.


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