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Why Some People Take Antibiotics Before Visiting The Dentist

Dentists prescribe prophylactic (to prevent the spread of disease) antibiotics before dental treatment for people with certain medical conditions. The American Heart Association, the American Dental Association, and the American Academy of Orthopedic Surgeons have recommended the guidelines for preventive antibiotics for these medical conditions. The current guidelines were developed for patient well-being, as well as in consideration of the current concern regarding the overuse of antibiotics. The guidelines outline specific medical conditions and provide examples of which dental procedures indicate the need for prophylactic antibiotics.

The risk of infective endocarditis (infection and inflammation of the lining of the heart and its valves) is increased with dental procedures that cause bleeding and the potential release of oral bacteria into the bloodstream of people with certain medical conditions. Individuals who have certain congenital or acquired heart defects, as well as some conditions or abnormalities of the heart, have an increased chance of a bacterial infection.

The link between dental procedures and infective endocarditis is controversial. Not all dental procedures require the use of antibiotic prophylaxis. Dental procedures that have minimal potential to cause bleeding are considered low risk for infective endocarditis. Antibiotic prophylaxis may be indicated for invasive dental procedures that are likely to cause bleeding and release of oral bacteria in the bloodstream.

Also, the release of oral bacteria into the bloodstream appears to increase the risk of developing an infection around a prosthetic joint in people with a depressed immune system. Use of prophylaxis antibiotics is recommended for individuals with total joint replacements who have certain other health conditions.

Antibiotic prophylaxis also can be prescribed for circumstances other than prevention of infective endocarditis and prosthetic joint infections. Some other conditions or situations that may indicate antibiotic prophylaxis include in-dwelling catheters, hemodialysis patients with arteriovenous shunts, shunts for hydrocephalus, oral surgical or operative procedures (depending on the patient's immune system), insulin-dependent diabetes, or diabetics whose disease is poorly controlled.

By Denise J. Fedele, DMD, MS

General Dentistry Care: Frequently Asked Questions

Q. When would you consider tooth bleaching?

A. You would consider tooth bleaching if your teeth have yellowed with age or are stained from tobacco, tea, coffee or food.

Q. What are the practical expectations of tooth bleaching?

A. Every case is different, but generally there is a two-shade improvement as seen on a dentist's shade guide. The success rate relies on the types of stain involved, your compliance, and the material and method used.

Q. How long does tooth bleaching last?

A. Depending on your personal habits such as smoking and drinking coffee or tea, tooth whitening should last from one to five years.

Q. Do over-the-counter bleaching products work?

A. Some over-the-counter bleaching products do whiten teeth, but many of the products can damage teeth with extended use or misuse because they are too abrasive or use ill-fitting trays. Some materials contain titanium dioxide that actually put a temporary pigment coating on the teeth. Although small doses of titanium dioxide are considered safe, the net effect is to put a layer of "paint" on the teeth that is soon lost.

Q. What is orthodontics?

A. Orthodontics, also known as malocclusion or “bad bite”, is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities.

Q. What is an orthodontist?

A. An orthodontist is a dentist who has undergone specialized training to require the advanced qualifications and specialized skills required to give their patients quality treatment.

Q. What causes orthodontic problems?

A. Most orthodontic problems are inherited, but some are acquired.

Q. What is the importance of orthodontic treatment?

A. Orthodontic treatment is important because crooked and crowded teeth are hard to clean and maintain. This may lead to conditions tooth decay, but eventually cause gum disease and tooth loss. Malocclusion (bad bite) can also lead to pain associated with TMD.

Q. What does orthodontic treatment involve?

A. Orthodontic treatment usually involves wearing braces prescribed and designed by the orthodontist. You may feel some tenderness as the teeth start to move. By placing a constant, gentle force in a carefully controlled direction, braces can slowly move teeth through their supporting bone to a new desirable position.

Q. How long does orthodontic treatment take?

A. Generally, orthodontic treatment time with braces ranges from 1 to 3 years. Early treatment procedures may take only a few months. The actual time depends on the growth of the patient's mouth and face, the cooperation of the patient and the how severe the problem is.

Q. How much does orthodontic treatment cost?

A. The actual cost of treatment relies very much on the individual case and depends largely on the length and complexity of treatment.

Q. What toothpaste should your child use?

A. You should use a match-head sized amount of toothpaste. The use of toothpaste should not begin until 2 years of age.

Q. When should you start taking children to see a dentist?

A. It is recommended that children see a dentist by age one and definitely by 16 months of age.

Q. How often should a child see a dentist?

A. It is recommended that the child be seen every six months after the initial examination.

Q. Why is it important to care for primary or baby teeth?

A. It is important to care for primary teeth because they are much more susceptible to tooth decay than the permanent teeth. There are many other reasons.

Q. How are digitized X-rays beneficial?

A. Digitized X-rays reduce the exposure of radiation to the patient, and eliminate the film and darkroom processing within the dental office.