In some cases, patients may need to take antibiotics before they have a dental appointment. Antibiotic prophylaxis, a term for premedication, simply means taking antibiotics before a procedure.

Although certainly not indicated in every case, for some patients, taking antibiotics as prescribed before treatment may help lower the risk for an infection or another adverse health event during or after the procedure.

But why exactly would you need antibiotics before your dental appointment? Here are a few reasons your dentist may prescribe antibiotics prior to your visit.

If You Have a Heart Condition or a History of Heart Problems

During many dental procedures, oral bacteria are disrupted. When these bacteria are disturbed during procedures such as a tooth extraction or gum disease therapy, they can enter the bloodstream and travel throughout the body until the body naturally gets rid of them.

Patients who are at higher risk for infective endocarditis, a condition in which the inner tissue of the heart becomes infected, may require antibiotic therapy before dental work. This is because the bacteria implicated in infective endocarditis may come from the oral cavity and can influence whether or not one develops the condition.

Although antibiotics aren’t 100% effective at preventing bacteria from affecting the body in a dental procedure, research shows they can reduce the risk of complications by 50% [1].

Patients with specific cardiac risk factors, such as having a prosthetic valve, having previously had infective endocarditis, or having congenital heart disease or a heart transplant may indicate that antibiotics are needed prior to dental work.

When You Are Immunocompromised

Patients that have a compromised immune system may be prescribed antibiotics before dental work. These include patients who have cancer and are undergoing treatments such as chemotherapy or radiation. However, it may also include patients who have uncontrolled diabetes or are taking high doses of immunosuppressants [2].

In cases such as these, antibiotic therapy may help reduce the risk of complications after a procedure such as a tooth extraction or implant placement, so talk to your dentist if you are taking immunosuppressant drugs or are otherwise immunocompromised about taking antibiotics before your appointment.

What About People Who Have Had Joint Replacements?

Previously, patients who had undergone a joint replacement in the last two years were required to take an antibiotic prior to dental work. However, the American Dental Association has updated its guidelines regarding this practice, and antibiotics are not generally necessary patients with artificial joints [3].

However, patients with a history of complications after their surgery or those that need dental work that involves gum incisions or gum disease therapy may benefit from an antibiotic. The treatment protocol here is highly individualized and should be considered on a case-by-case basis.

Talk to Your Dentist About Antibiotic Prophylaxis

Like all medical treatment, antibiotic prophylaxis should be considered based on your unique health and circumstances. Talk to your dentist if you have a heart condition or have had a heart procedure in the past or if you are immunocompromised to see if you qualify for antibiotic use prior to your appointment!

Sources:
1. https://www.ncbi.nlm.nih.gov/books/NBK587360/
2. https://pubmed.ncbi.nlm.nih.gov/30677537/
3. https://www.ada.org/en/resources/research/science-and-research-institute/oral-
health-topics/antibiotic-prophylaxis