Antibiotics Before Your Dental Treatment

Should You Take Antibiotics Before Your Dental Treatment?

Most Dental Patients Should Not Take Antibiotics Before Treatment

For the majority of dental patients, the American Dental Association does not recommend taking antibiotics before dental treatment.

In the past, people who had orthopedic/joint implants like hip or knee replacements, metal plates or rods, etc. used to take preventive antibiotics before dental treatment. This is no longer recommended in most cases.

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A small number of people with specific heart conditions may need to pre-medicate with antibiotics before dental treatment to prevent a serious heart infection.

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

Why Would Certain People Take Antibiotics Before Dental Treatment?

Taking antibiotics before dental treatment is called preventive medicine, or antibiotic prophylaxis (pro-fuh-LAX-is). This is done with the belief that antibiotics might help prevent infections. But most people are able to fight infections on their own, so taking an antibiotic doesn’t lower their chance of developing an infection.

Certain people who have other health conditions and also had a joint replaced may benefit from taking an antibiotic before dental treatment. They may have an increased risk of a problem, so taking an antibiotic can lower their risk.

Those dental patients who may benefit from taking preventive antibiotics include:

People who may not be able to fight an infection on their own, which can increase the chance of developing something more serious from an infection
People who have a medical condition or are taking certain medications that increases their risk of infection

Why Shouldn’t Most People Take Preventive Antibiotics?

Many people think that there are no harms associated with taking an antibiotic for preventive reasons. But, as with any treatment, there are both benefits and potential harms. In most cases, taking antibiotics as a preventative measure is more likely to cause a problem than to defend against one.

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

Antibiotics can cause side effects that can range from mild stomach problems to severe and life-threatening 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 dental treatment procedures are not connected with prosthetic joint implant infections. The antibiotics that are provided before dental treatment do not prevent these types of infections.

Who May Be Recommended to Take Preventive Antibiotics?

The list below explains why some people with certain health conditions are told to take antibiotics before having certain dental treatments.

If You Are One of a Small Group of People Who Have a Specific Heart Condition (described below)

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 in the most danger if they developed a heart infection. This affects a very small and specific type of person with a heart condition(s).

If you have one of these heart conditions, we or physician/cardiologist may recommend that you take an antibiotic before dental treatment:

artificial heart valves
a history of infective endocarditis
certain specific, serious congenital heart conditions, including:
- unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits
- a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, 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
a cardiac transplant that develops a problem in a heart valve

If You Had Complications with Your Joint Replacement Surgery or if You Are at Increased Risk of Infection

You may be taking antibiotics to prevent joint implant infections or because you experienced complications from a joint replacement surgery. Or, you may take antibiotics if you are at increased risk of infection because of other drugs or diseases.

Talk to your orthopedic surgeon before any dental treatment. They can best determine if you need to keep taking antibiotics before you see your dentist for planned treatment.

Talk to Your Dentist or Physician, Orthopedic Surgeon or Cardiologist

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.