Premedication with antibiotics is recommended before dental procedures for people with specific medical conditions. If you’re healthy and have never been told that you need to take medication before having dental work done, chances are good that you will not need premedication.
Your Medical History Form
When you start seeing Dr. Burgdorf, we’ll ask you to fill out some forms. One of those is a medical history form. It’s important for Dr. Burgdorf to know what health conditions you currently have or have had in the past because this affects which procedures will be appropriate for you and, yes, whether you will need medication before your treatment.
Which Conditions Require Pretreatment?
If you have specific heart conditions, you may require pretreatment. These include certain valve replacements, a history of endocarditis (an infection that affects the heart), and some congenital heart defects.
Premedication may also be the right option if you have a compromised immune system for any reason.
Why Are Antibiotics Necessary in These Cases?
We all have bacteria in our mouths at any given time. For the most part, they aren’t harmful (although if you don’t brush and floss, they are a key factor in developing cavities). But for people with certain heart conditions, these bacteria pose a problem.
When you brush and floss or get professional cleanings (or other dental procedures), there’s a chance that these bacteria can enter your bloodstream. For most of us, that’s no big deal. Our immune system simply rallies and gets rid of them. If someone’s heart is compromised by surgery or a pre-existing condition, however, these bacteria may create a dangerous infection.
Do I Need Antibiotics if I Have a Replacement Joint?
Up until about two years ago, the American Dental Association recommended that everyone with any type of artificial joint be pre-medicated prior to their dental appointments. In 2012, after much research, the ADA determined that this was not in fact necessary, so unless your doctor has specifically said that you need premedication, you don’t need to worry about it.
Why Did the Recommendation Change?
In medicine, we are constantly analyzing the potential risks vs. the potential benefits. For example, we choose to use x-rays despite the small amount of radiation they give off because the substantial benefits more than outweigh any possible risks.
Antibiotics have side effects, and these can sometimes be unpleasant. If the risk of side effects from antibiotics is greater than any potential benefit we might see, then the antibiotics will not be necessary.
Another concern that has risen in the past few years is the concern about overuse of antibiotics and the development of antibiotic-resistant bacteria. It’s better to save antibiotic use for the situations that truly call for it and not as a general practice.
If you have questions about premedication with antibiotics, we encourage you to contact your medical provider and Dr. Burgdorf. We are happy to answer your questions and provide you with more information.