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
Learn About Seniors Dental Care
Q. Why do teeth seem to darken as people age?
A. Teeth may seem darker because plaque can build up faster and in larger amounts as one ages. Changes in dentin can cause teeth to appear a little darker as well.
Q. Why do some seniors lose their sense of taste?
A. Seniors tend to lose their sense of taste because age decreases the sense of taste and smell. Certain diseases, medications, and dentures also can contribute to a decreased sense of taste.
Q. Should seniors be worried about cavities?
A. Yes. The majority of seniors havetooth-root decay and are more susceptible to cavities.
Q. What is root decay?
A. Over time, tooth enamel can wear away in the crowns of teeth and around the tooth roots. Receding gums expose the roots, making them more prone to decay.
Q. What makes seniors more cavity-prone?
A. Seniors are more prone to root decay and gum recession. Additionally, many seniors have "dry mouth" (caused from medications or medical conditions), which increases the risk of cavities. Some also may have difficulty maintaining good oral hygiene due to physical limitations.
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