Antibiotic Prophylaxis

Antibiotic prophylaxis is a method of preventing infection and its complications through the use of antimicrobial therapy (typically antibiotics) prior to dental and other medical or surgical procedures that may possibly introduce bacteria into the bloodstream. While not necessary for most patients, antibiotic prophylaxis is utilized for dental procedures performed at Frisco Kid’s Dentistry on patients with specific susceptibility for bacterial infections. For our patients with high-risk factors, antibiotics are given prior to the dental procedure to greatly reduce the chance of an infection developing afterward.

Guidelines for Antibiotic Prophylaxis Prior to Dental Procedures

As more research has been conducted, the guidelines for administering antibiotic prophylaxis has evolved over recent years for several reasons, including:

• Increased bacterial resistance to antibiotics
• Technological improvements in detecting infections
• Changes in the bacteria that cause infections

While antibiotic prophylaxis is recommended more cautiously now, certain medical conditions warrant the use of premedication to prevent dangerous, potentially fatal, infections from occurring.

One of the most common uses of antibiotic prophylaxis is to prevent infective endocarditis (IE), an infection of the heart’s inner surface (commonly involving the heart valves). Infective endocarditis prophylaxis is recommended prior to dental procedures only for those patients who have underlying cardiac conditions with high risk for IE.

The American Heart Association and American College of Cardiology jointly published updated guidelines in 2017 for antibiotic prophylaxis use.

Patients currently recommended for antibiotic prophylaxis include those with:

• Prior incidence of infective endocarditis
• Artificial heart valves, such as homografts and transcatheter-implanted prostheses
• Prosthetic materials from heart valve repair, including annuloplasty chords or rings
• Unrepaired cyanotic congenital heart disease
• Repaired congenital heart disease with valvular regurgitation or residual shunts adjacent to or at the site of the prosthetic device or patch
• Previous cardiac transplant involving valve regurgitation from a structurally abnormal valve

For these patients, any dental procedure involving perforation of the oral mucosa (mucous membrane lining inside the mouth) or manipulation of the gingival tissue and/or periapical area (apex of the tooth root) of the teeth should involve premedication.