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Dental Premedication Guidelines Have Changed

pdf Printable Version of New Premedication Guidelines

New guidelines have been issued by the AHA ( American Heart Association) regarding premedicating for dental work and cleanings.
In the past years, it was believed that IE ( Infective Endocarditis) was caused by bacteria in the blood also known as "Bacteremia". It was believed that after dental procedures, the bacteria in the bloodstream could settle on susceptible areas , such as prosthetic valves and so on. New evidence has found many variances.
Previous AHA guidelines on the prevention of IE were largely based on opinion and limited studies. The most recent commendations were developed through and evidence based approach that was made after 20 years of extensive review. The new recommendation reduces the number of conditions that premedication. Guidelines went under review due in part to the risk associated with widespread immunity to antibiotic treatment.

Patients with these conditions NO LONGER require prophylactic antibiotic:

  1. Mitral valve prolapse
  2. Rheumatic heart disease
  3. Bicuspid valve disease
  4. Calcified aortic stent
  5. Congenital heart disease , like ventricular septal defect, atrial defect, and hypertophic cardiomyopathy

The new recommendation suggest antibiotic treatment for patients with the following conditions:

  1. Prosthetic cardic valve
  2. Previous infective endocarditis
  3. Congential Heart disease
  4. Unrepaired cyanotic CHD, including pallative shunts and conduits
  5. Completely repaired congential heart defect during the first 6 months after the procedure
  6. Cardiac repaired transplant patient who develop cardiac valvulopathy
  7. Patients with any of these conditions should consult a medical doctor and bring a letter with your physician's recommendations to keep in your dental file. For more information, questions, or to schedule and appointment, Contact Smiles by Design!

If you have any questions or concerns, please call our office at 334-687-0088.