Should You Take Antibiotics before Your Dental Treatment?

Most dental patients should not take preventive antibiotics before treatment

Antibiotic prophylaxis (pro-fuh-LAX-is) is when patients take antibiotics before dental treatment to prevent infection. This step is recommended for very few patients.

In the past, anyone who had an orthopedic implant like a hip or knee replacement, or metal plates or rods, used to take preventive antibiotics before certain dental treatments. This is no longer recommended in most cases.

Also, a small number of people with specific heart conditions might be prescribed antibiotics before some dental treatments to help prevent a serious heart infection.

This brochure explains both the possible harms and benefits of taking antibiotics before dental treatment. Use it to help talk with your dentist, physician, orthopedic surgeon or cardiologist to understand whether taking preventive antibiotics is right for you.

Why shouldn’t most people take preventive antibiotics?

People who take antibiotics before some dental treatments usually do so because research suggests that antibiotics may help prevent certain types of infections.

Many people think that there are no harms associated with taking an antibiotic. But, as with any treatment, there are both benefits and potential harms. Because infections after dental treatment are not common and taking antibiotics as a preventative measure may cause a problem rather than defend against one, they are not recommended for everyone.

Here are some problems that can happen with taking preventive antibiotics:

• Antibiotics can cause side effects that can range from an upset stomach to severe diarrhea.
• As with any medication, antibiotics can cause life-threatening allergic reactions.
• Taking antibiotics can destroy good bacteria that protect against infection.
• Improper use of antibiotics can lead to the development of drug-resistant bacteria.

Also, there is scientific evidence that most dental treatment procedures are not connected with prosthetic joint implant infections.

Who may be prescribed to take preventive antibiotics?

Some people with certain health conditions are told to take antibiotics before having certain dental treatments.

Heart Conditions

For a small group of people, there’s concern that bacteria in their bloodstream can cause an infection of their heart lining or valves. This infection is called infective endocarditis (end-oh-car-DYE-tis).

The American Heart Association only recommends preventive antibiotics for people who would be at risk of more serious disease if they developed a heart infection after dental treatment. This affects a very small group of people with specific types of heart conditions.

If you have one of these heart conditions, your dentist, physician, or cardiologist may recommend that you take an antibiotic before certain dental treatments.

• Artificial heart valves or heart valves repaired with prosthetic material
• A history of infective endocarditis
• A heart transplant that develops a problem in a heart valve
• Certain specific, serious congenital heart conditions, including:
• Unrepaired or incompletely repaired cyanotic congenital heart disease, including those with surgical shunts and conduits
• A completely repaired congenital heart defect with prosthetic material or device, during the first 6 months after the procedure
• Any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device

Joint-Replacement Complications or Infection Risk

You may be prescribed antibiotics before certain dental procedures to prevent joint implant infections if you have experienced previous complications from a joint replacement surgery. Or, a person with a total joint replacement might take antibiotics if they are at increased risk of infection because of other drugs or diseases.

Talk to your dentist or orthopedic surgeon before any appointment. They can best determine if you might benefit from taking antibiotics before your planned treatment.

Talk to Your Dentist, Physician, Orthopedic Surgeon, or Cardiologist

Antibiotics should always be prescribed by a health care provider and used as directed. If you have any questions, or if there are any changes in your health history or the medicines you take, let your dental office know so they can update your records.