Antibiotic Pre-Medication for Dental Treatment

New Guidelines for Pre-Medication

For our patients who take an antibiotic prior to certain dental procedures, the American Heart Association has relaxed their recommendations on who needs to be pre-medicated.

The most frequent use of pre-medication, for mitral valve prolapse (heart murmur), is no longer recommended.

These conditions still warrant pre-medication:
A. Prosthetic Cardiac Valve
B. Previous Infective Endocarditis
C. Congenital Heart Disease (CHD) including;

  1. Unrepaired CHD (including palliative shunts and conduits)
  2. Completely repaired congenital heart defect with prosthetic material or device, whether placed by a surgeon or by catheter intervention, during the first 6 months after the procedure
  3. Repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit endothelialization)

D. Cardiac transplantation recipients who develop cardiac valvulopathy.

Please check with your physician to see if you still need to take an antibiotic prior to your dental appointment. We will continue with the old recommendation until your MD changes your protocol.

The online version of the American Heart Association article can be found at:

The guidelines for premedication for dental patients with joint replacements have not changed.

These are:

A. Patients in their first 2 years following joint replacements
B. Insulin-dependent diabetics
C. Those with rheumatoid arthritis or systemic lupus crythemaotsus
E. Patients with previous prosthetic joint infections
F. Patients with disease, drug, or radiation-induced immunosuppression
G. Patients with acute infections at a distant site G. Hemophiliacs.

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