Based on a review, most dental patients with heart disease do not need antibiotics before dental procedures to prevent infective endocarditis (IE), a rare// , but life-threatening heart infection.

According to revised guidelines from the American Heart Association (AHA) with input from the American Dental Association (ADA), antibiotics are now only recommended for patients at greatest risk of negative outcomes from IE including those with artificial heart valves or certain congenital heart conditions, heart transplant recipients who develop cardiac valve problems, recipients of an artificial patch to repair a congenital heart defect within the past six months and patients with a history of IE.

For decades, the AHA recommended that patients with certain heart conditions take antibiotics shortly before dental treatment. This was done with the belief that antibiotics would prevent IE, previously referred to as bacterial endocarditis. IE is an infection of the heart’s inner lining or valves, which results when bacteria enter the bloodstream and travel to the heart. Bacteria are normally found in various sites of the body including on the skin and in the mouth.

The ADA participated in the development of the new guidelines and has approved those portions relevant to dentistry. The guidelines are also endorsed by the Infectious Diseases Society of America and by the Pediatric Infectious Diseases Society.

The new guidelines are based on a growing body of scientific evidence that shows the risks of taking preventive antibiotics outweigh the benefits for most patients. The risks include adverse reactions to antibiotics that range from mild to potentially severe and, in rare cases, death. Inappropriate use of antibiotics can also lead to the development of drug-resistant bacteria.

Scientists also found no compelling evidence that taking antibiotics prior to a dental procedure prevents IE in patients who are at risk of
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