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Antibiotic prophylaxis is typically recommended for patients that are undergoing invasive dental procedures and/ or those that are at high risk of an adverse outcome from infective endocarditis (inflammation of the inner lining of the heart’s chambers and valves). For years, guidelines recommended that people with most heart problems (e.g., murmurs) take a short-term course of antibiotics prior to visiting the dentist to reduce the risk of infection caused by oral bacteria. Delta Dental underscores the current American Heart Association (AHA) recommendations regarding specific heart problems that require antibiotics in dental procedures. The AHA only recommends antibiotics before dental procedures for patients with the highest risk of infection, and/ or for patients with the following underlying cardiac conditions:

  1. A prosthetic heart valve or who have had a heart valve repaired with prosthetic material
  2. Certain congenital heart defects, including:
    1. Cyanotic congenital heart disease (birth defects with oxygen levels lower than normal), which has not been fully repaired, including in children who have had surgical shunts and conduits
    2. A congenital heart defect that has been completely repaired with prosthetic material or a device for the first six months after the repair procedure
    3. Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at, or adjacent to, a prosthetic patch or prosthetic device
  3. A history of endocarditis
  4. A heart transplant with abnormal heart valve function

These guidelines are supported by a study published in the Journal of the American College of Cardiology, in 2022. The study relied on health and dental records from nearly eight million people, including more than 36,000 at high risk for endocarditis, and others with a replaced or repaired heart valve, certain congenital heart defects, or a history of endocarditis. Nearly one-third of people at high risk for endocarditis received antibiotics before invasive dental procedures. Among those who did not receive antibiotics, the risk of endocarditis was 10 times higher following a tooth extraction and 12.5 times higher after oral surgery compared with those who received antibiotics prior to the procedures. The findings from this study confirm the benefit of antibiotic prophylaxis for reducing the risk of endocarditis caused by bacteria from the mouth in patients with certain heart conditions.

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