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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

Maximizing The Benefits Of Your Dental Team

The new dentistry brings together a unique complement of skills, knowledge, and capabilities with one primary focus: ensuring your dental health care. Working as a team, your dentist and the dental finance team he or she has assembled wants to recruit you to join them in making sure this focus is maintained. The dental team has two major parts that you may hear referenced during your visits: the "back" and the "front." These terms refer to two very specific functions of your dental team. The front office handles all the administration, scheduling, and dental financing, and the back office provides the treatment.

Your front office team makes sure you know about scheduling opportunities, handles dental finance, and keeps the administrative details under control to provide you efficient services and support. The back office team is thus free to do what they do best: provide the best dental health care, financing health care and service for you. You'll find the dentist, dental hygienist, and dental assistant ready to assist you during your appointments.

The key component for success of any team is each member's commitment to do their part. As a consumer and team member, your commitment involves three things:

• Maintaining your commitment to your dental health through regular hygiene appointments and the daily practice of flossing and brushing.
• Asking questions and getting the essential information you need about your teeth and gums or to understand any treatment plans or dental financing.
• Staying open to options and opportunities that the new dentistry offers you by thinking about the information and feedback that your dentist provides you about the status of your dental health.

You can maximize the benefits of the skills and expertise of your dental finance team by deciding for yourself what kind of relationship you want with your dentist and the dental team and how they can help you achieve a positive outcome for your dental future.

By Brian DesRoches, PhD

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