ABOUT PI
Your physician or dentist may recommend that you follow special steps at home before your dental visit to safeguard your health. These steps may include taking antibiotics before your appointment. Administration of an antibiotic prophylaxis before dental procedures is commonly called premedication.
The American Heart Association with input from the American Dental Association released new guidelines on April 19, 2007. The guidelines were developed by a group appointed by the AHA that included experts in infectious disease and cardiology and members representing the ADA. The guidelines were endorsed by the Infectious Diseases Society of America and the Pediatric Infectious Diseases Society.
Here's why premedication is required for some patients. Any time there is bleeding in the mouth, oral bacteria can enter the bloodstream and travel to the heart. This presents a risk for some patients who have:
An artificial heart valves
A history of infective endocarditis
Certain specific, serious heart conditions including:
Unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits
A completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or catheter intervention, during the first 6 months after the procedure,
Any repaired congenital heart defect at the site of a prosthetic patch or a prosthetic device and a cardiac transplant that develops a problem in a heart valve.
These new guidelines state that antibiotic premedication is no longer indicated for dental patients with mitral valve prolapse; rheumatic heart disease; bicuspid valve disease; calcified aortic stenosis; or congenital heart conditions, such as ventricular septal defects, atrial septal defects, and hypertrophic cardiomyopathy.
More information about the new guidelines:
After reviewing relevant scientific literature from 1950 - 2006, the group concluded that bacteremia resulting from daily activities is much more likely to cause IE than bacteremia associated with a dental procedure. In addition, only an extremely small number of IE cases might be prevented by antibiotic prophylaxis, even if prophylaxis is 100% effective. Based on these conclusions, antibiotic prophylaxis is now recommended before dental procedures only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from IE, such as patients with artificial heart valves, a history of endocarditis, certain serious congenital heart conditions and heart transplant patients who develop a problem with a heart valve.
For more details see ADA.org