The current practice of giving patients antibiotics prior to a dental procedure is no longer recommended EXCEPT for patients with the highest risk of adverse outcome resulting from endocarditis.
Those people at highest risk include those with:
1. Prosthetic cardiac valve
2. Previous endocarditis
3. Congenital heart disease for these conditions: – Unrepaired cyanotic congenital heart disease, including palliative shunts and conduits – Completely repaired congenital heart disease with prosthetic material or device either by surgery or catheter intervention during the first six months after the procedure – Repaired congenital heart disease with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit endothelialization)
4. Cardiac transplantation recipients who develop cardiac valve abnormalities
The American Heart Association has concluded that an exceedingly small number of cases, if any, of endocarditis may be prevented by giving antibiotics prior to a dental procedure. If such benefit from prophylaxis exists, it should be reserved ONLY for those patients at highest risk (listed above) who would have the worst outcomes if they contract endocarditis.
The American Heart Association recognizes the importance of good oral and dental health including regular brushing and flossing and regular visits to the dentist for patients at risk of endocarditis.
The American Heart Association no longer recommends administering antibiotics solely to prevent endocarditis in patients who undergo a GI or GU tract procedure.
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