Ben and Gary Show - Episode 54

Who Needs Antibiotics Before Dental Procedures?

Patients who have heart issues or joint replacements are often advised to take a precautionary antibiotic before undergoing dental procedures. 

Is this a good idea for all patients? There is a presumed risk of infection related to dental procedures for susceptible patients.

There is also the possible risk of antibiotic resistance which might compromise a patient's treatment in the future. 

What is the tradeoff? Our view is that it depends upon the health of an individual patient. 

Patients Who've Had Joint Replacement Surgery

Orthopedic surgeons have varying opinions about precautionary antibiotics:

• some recommend it
• some recommend it for the first year following surgery
• some do not recommend it

Nobody really seems to know for sure what is the best practice. We follow the recommendation of the surgeon. 

Patients With Heart Issues

 The American Heart Association recommended prophylactic antibiotics before dental procedures for all patients with heart conditions. This precaution arose from a fear that dental procedures posed the risk of endocarditis. 

The AHA currently does not recommend antibiotics before dental procedures except for susceptible or immune-compromised patients.

AHA changed its position several times.

Bottom Line?

To be continued...