Antibiotic Prophylaxis & Dental Work: Dental Premedication Guidelines

There is concern of bacteria from dental procedures going to the heart.  This is why dentists & cardiologists give antibiotic prophylaxis for dental work.

While these recommendations have typically been for patients with heart valve problems or a history of rheumatic fever, it is not uncommon for an antibiotic prescription to accompany many dental procedures.  However, in 2007, the American Heart Association revamped the decades old recommendations in an attempt to curb the overuse of antibiotics in this country.

You see, it is not antibiotic overuse leading to the development of superbugs resistant to every antibiotic known to man that is the true concern.

The true concern is the destruction of the normal flora present in our bodies.  In today’s society it can begin as early as a C-section birth, perpetuated with treatment of ear infections as an infant and toddler and followed through with antibiotics anytime we get a sniffle or sinus infection.  Any antibiotic prescription has the potential to permenantly disrupt the normal bacterial flora in your gut and send your GI health and immune system into a tailspin.

There would be less of a problem with indiscriminate antibiotic use is providers would be more liberal with recommendations to follow up with probiotics.

While I typically say that it takes about 20 years for the research to make it into most doctors’ offices (specialists included), the first published study on probiotics was in 1908 and mainstream medicine STILL has yet to use them to their full effectiveness.

For those of you having problems with the math, that’s 104 years.  Talk about behind on the medical literature!

Back to this particular study

Researchers looked at the rates of infective endocarditis (an infection of the heart, in this case supposedly caused by bacteria released during dental work) before and after the AHA changed the standard recommendations.

They found that there had been no increases in the risk of infections after the use of antibiotics were curbed.

I know many of you who have been getting antibiotic prescriptions for decades prior to any dental work may be shocked, but consider this…

The mere act of brushing your teeth twice per day (hopefully) creates a transient bacteremia.  In other words, just brushing your teeth sends bacteria into your bloodstream.  If the heart was that sensitive, you would’ve died a long time ago from brushing your teeth without using antibiotics beforehand.

So why have you been told you need antibiotics before dental work?

James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.


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One thought on “Antibiotic Prophylaxis & Dental Work: Dental Premedication Guidelines

  1. Fortunately I’m an avid researcher and when I was diagnosed w/heart valve problem, did not even ask for antibiotic w/my many dental visits…thanks for this article…nice to have my decision verified.

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