that a patient take antibiotics before certain
dental procedures. This is called “antibiotic
prophylaxis.” But why do healthcare
providers suggest this extra step?
We all have bacteria in our mouths, and a
number of dental treatments—and even daily
routines like chewing, brushing or flossing--
can allow bacteria to enter the bloodstream
(bacteremia). For most of us, this isn’t a
problem. A healthy immune system prevents
these bacteria from causing any harm. There
is concern, however, that for some people
bacteremia can cause an infection elsewhere
in the body.
Who is at risk? Antibiotic prophylaxis is
recommended for a small number of people
who have specific heart conditions. The
American Heart Association has guidelines
identifying people who should take
antibiotics prior to dental care.
According to these guidelines, antibiotic
prophylaxis should be considered for
-Artificial heart valves.
-A history of an infection of the lining of the
heart or heart valves known as infective
endocarditis, an uncommon but life-
-A heart transplant in which a problem
develops with one of the valves inside
Heart conditions that are present from birth,
-Unrepaired cyanotic congenital heart disease,
including people with palliative shunts and
-Defects repaired with a prosthetic material or
device whether placed by surgery or catheter
intervention during the first six months after
-Cases in which a heart defect has been repaired,
but a residual defect remains at the
site or adjacent to the site of the prosthetic
patch or prosthetic device used for the repair.
Talk to your dentist about these guidelines if
you have any questions about antibiotic
Antibiotic prophylaxis guidelines have also been
revised for people with orthopedic implants such
as artificial joints. Learn more about why the
ADA and American Association of Orthopedic
Surgeons updated the recommendations and
no longer recommend antibiotics for everyone
with artificial joints.