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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

New Dentistry, A Partnership For Your Health And Well Being

A world of opportunities for dental health awaits us in the new dentistry. Using the old dentistry, dentists did their best to provide a high quality of service given the state of knowledge and technology at that time.

Through advancements in treatment, research, and the desire of the dental profession to do more and do it better, the new dentistry has emerged. It is based on a foundation with specific characteristics that are of great benefit to us as consumers.

• Efficiency: Your time and your resources are valuable to you, and your dentist recognizes this. New dentistry treatment techniques and methods have considerably reduced the amount of time that the dental care now takes. The return on your investment in dental health is excellent.
• Comfort: Not only are the dental chairs and the dentistry office environments more comfortable and pleasant, improvements in the use of local anesthetics and new equipment provide more comfort than ever before.
• Collaboration: The dental relationship is now based on the value that you can derive from your dentistry team and what you want for your dental future rather than just on the techniques and procedures your dentist can do. Through continuing education, your dentist has the skills and knowledge to help you make decisions for your dental health in a positive and informed way.
• Predictability: New materials and advances in treatment provide you with opportunities to maintain your dental health throughout your life. With the innovative cosmetic and specialized dentistry approaches to reclaiming teeth that formally would be lost, your dentistry professional can help create and maintain teeth and gums. Predictable treatment, effective prevention methods, and the longevity of treatment are now part of any dental plan.
• Thoroughness: Advances in assessment and diagnosis now enable dentists to make thorough evaluations of your overall dental and oral health. The outcome is a plan for your health that will give you peace of mind, knowing you can have a well-informed dental plan in place.
• Prevention: This characteristic of the new dentistry has received much publicity in recent years. It has been proven over and over again that there are several measures that you can take as a consumer of dental care to create and maintain your dental health in collaboration with your dental team. It bears repeating again -- flossing and brushing combined with regular dental hygiene checks are your greatest allies in maintaining your teeth and a bright smile.
• Precision: The new dentistry utilizes instruments and technologies that are far advanced from what was available even 15 years ago. Both general dentists and specialists have access to technologies that provide precision in diagnosis and treatment. The value for you is higher quality care.

The dental profession has established a strong foundation for a pleasant smile and a healthy dental future for all of us. Dentistry improvements are continuously being made to this foundation. You can choose to avail yourself of these improvements by asking your dentist, "What can help me to maintain my dental health?" Your dentist has the knowledge and the desire to help you.

By Brian DesRoches, PhD

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