Antibiotic Therapy Prior to Dental Treatment

Antibiotic therapy has been used for almost a century to treat bacterial infections in the human body. In 1928, Alexander Flemming discovered the first antibiotic, Penicillin. Since that time many antibiotics have been discovered that are most effective for a variety of different infections throughout the body. Because of the early pioneer of efforts of Fleming and other scientists, we can effectively treat bacterial infections. The most common antibiotic used for oral infections and prophylactic (preventative) needs is Amoxicillin.

Prophylactic Dental use of Antibiotics for Prevention of other Body systems Infections

Recent evidence-based treatment guidelines by the American Heart Association, American College of Cardiology, American Academy of Orthopedic Surgeons and the American Dental Association (2007, 2008, 2015) have more clearly defined the use of antibiotic therapy to prevent Infective Endocarditis (heart infections) and Prosthetic Joint Infections. They concluded that the use of antibiotic therapy before dental procedures is reasonable for only patients with underlying heart conditions that are associated with the highest level of risk of adverse outcomes from endocarditis. For a complete list of heart conditions requiring antibiotic therapy prior to dental visits, click on the following link from the ADA. Their views are in accordance with many scientists and healthcare professionals who understand the importance of avoiding antibiotics unless absolutely needed. This constraint is because there is a risk that the patient may develop allergies and resistance to the antibiotic.

In general, for patients with prosthetic joint replacements, prophylactic antibiotics are NOT recommended prior to dental treatment to prevent prosthetic joint infection. Their recommendations are based on the fact that there is no evidence that oral microbes infect prosthetic implants.  You may require antibiotic treatment prior to your dental hygiene (cleaning) and dental implant surgery. These are a relatively new recommendation, so we urge patients to consult with their personal physicians on their views and advice.

Antibiotic Therapy & Dental Implants

With the mouth being an inherently “dirty field” with a multitude of flora, the potential of bacteremia (infection through the blood stream) is also high. The placement of a dental implant is a surgical procedure. The aim is to prevent the onset of infection in the surgical wound by achieving an antibiotic concentration in the blood that will prevent bacterial proliferation and dissemination. Early implant success rates are improved by the use of antibiotic therapy 1 hour prior to surgery. A 2010 Cochrane systematic review, showed a statistically significantly higher number of patients experiencing implant failures in the group NOT receiving antibiotics.

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