When to Use Prophylaxis for Dental Procedures

The guidelines (2007), published in Circulation: Journal of the American Heart Association, are based on a growing body of scientific evidence that shows that, for most people, the risks of taking prophylaxis antibiotics for certain procedures outweigh the benefits. These guidelines represent a major change in philosophy.

The new guidelines show taking preventive antibiotics is not necessary for most people and, in fact, might create more harm than good. Unnecessary use of antibiotics could cause allergic reactions and dangerous antibiotic resistance.

Only the people at greatest risk of bad outcomes from infective endocarditis — an infection of the heart's inner lining or the heart valves — should receive short-term preventive antibiotics before common, routine dental and medical procedures.

Patients at the greatest danger of bad outcomes from IE and for whom preventive antibiotics are worth the risks include those with:

Except for the conditions listed above, antibiotic prophylaxis is no longer recommended for any other form of CHD.
** Prophylaxis is reasonable because endothelialization of prosthetic material occurs within 6 months after the procedure.

Endocarditis prophylaxis is recommended for these groups for all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa. This includes procedures such as biopsies, suture removal, and placement of orthodontic bands

The following procedures and events do not need prophylaxis:

Antibiotic Regimens

Dental ppx

Source: Circulation. 2007;116:1736-1754.

Prevention of Infective Endocarditis
Guidelines From the American Heart Association
A Guideline From the American Heart Association Rheumatic Fever,
Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular
Disease in the Young, and the Council on Clinical Cardiology, Council on
Cardiovascular Surgery and Anesthesia, and the Quality of Care and
Outcomes Research Interdisciplinary Working Group