Our bodies are home to bacteria which are common in our mouths, but which can be dangerous elsewhere. For some people, especially those who have chronic medical conditions, specific cardiac conditions, or whose immune systems are compromised, bacteria that spreads throughout the bloodstream and into the heart can lead to a serious bacterial infection called infective endocarditis.
Antibiotic premedication is no longer recommended for most people before dental procedures. In the past, it was common for patients with joint replacements or certain heart conditions to take antibiotics before a dental visit. However, recent research shows that, for most individuals, the risks of taking antibiotics — such as allergic reactions or antibiotic resistance — outweigh the potential benefits.
Antibiotic premedication is still recommended for some patients with specific heart conditions or risk factors:
A history of infective endocarditis
Certain congenital heart conditions (heart conditions present since birth)
An artificial heart valve
A heart transplant
If you fall into one of these categories, you may need antibiotics before dental procedures that involve manipulation of the gums, the area around the tooth roots, or any part of the oral tissue.
In some cases, patients with very weakened immune systems — such as those undergoing cancer treatment, organ transplants, or with poorly controlled diabetes — may need antibiotics as a precaution. This decision should always be made in collaboration with your physician.
The most commonly used antibiotic for premedication is amoxicillin, taken about one hour before the dental procedure. If you’re allergic to penicillin, safer alternatives such as azithromycin or clarithromycin may be used. Clindamycin is no longer recommended due to the risk of severe gastrointestinal infections.
If you’re not sure whether you need antibiotic premedication, just let us know! At Dental Arts of Sunset, we always review your medical history carefully and will consult with your physician or specialist when needed to make the safest decision for your care.
