Antibiotic Prophylaxis

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The trend is to definitely more conservative these days as to when antibiotic coverage is indicated before invasive dental treatment but there are still some cardiac conditions or new joint replacements that may call for such coverage. (When in doubt, contact the patient’s physician or orthopedist and be sure to enter their recommendation in the patient’s chart.)
If called for, many patients will have never had this requirement mentioned to them before and will challenge you as to “Why is that important? I never had any trouble before!” They can especially object since they are “just having a cleaning”, (one of the more potentially bacteremia inducing procedures!) A calm and understandable explanation most often ensures compliance:

Mrs. Jones, there are normal bacteria that live on our bodies all of the time, especially in our mouth and digestive tract and they usually cause us no harm. However, during certain Medical and Dental procedures there can be a little bleeding of the gums and these bacteria get into your bloodstream briefly. They usually pass right on through the blood vessels heart and cause us no harm. But once in a while, in a heart with a valve like yours (artificial valve, etc) the blood flow is not smooth through these valves and those temporary bacteria in your bloodstream can “get caught” around the valve and cause an infection on the inside of your heart, which of course would be quite serious. Or, these bacteria can gather around your new artificial knee (or hip) and cause it to become infected and possibly fail.

The American Heart (Orthopedic) Association officially recommends that you just take a dose of antibiotic before this dental procedure to help prevent this type of infection from ever happening. After all, that’s what dentistry is all about: protecting you from disease problems!

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