With certain patients a dentist will sometimes recommend that some antibiotics are taken prior a dental procedure. This form of premedication is known as antibiotic prophylaxis. What purpose does this preventative step take, and who is eligible for it?
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Our mouths are teeming with bacteria. This includes even the healthiest or cleanest mouth. There is a risk with several different kinds of medical procedures that some of this bacteria actually enters the bloodstream. This is known as bacteremia. The blood that pumps through your veins is normally completely sterile. When bacteria is present in the blood there’s an increased risk of infection and other complications, like shock, as the immune system attempts to fight off the bacteria. Some of the procedures that pose a risk for infecting the blood are:
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Any invasive medical procedure like a surgery.
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Several dental procedures most commonly a tooth extraction or rooth canal.
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While there is a risk of bacteremia for everyone who undergoes one of the procedures listed above, it’s not as dangerous for people who have a healthy and functioning immune system. In fact, there’s even a risk of bacteria entering the bloodstream during normal hygienic procedures, like brushing or flossing. Who are the people that are at risk of suffering complications as a result of bacteremia?
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Often the biggest concern is that people who experience bacteremia will contract infective endocarditis (IE), which is an infection of the lining of the heart and its chambers. This can occur as a result of bacteria, fungi or other organisms. Therefore the best candidates for antibiotic prophylaxis are people who are more likely to contract IE. These people include:
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Those with a prosthetic heart valve.
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Those who have undergone valve repair.
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People who have had a history with IE.
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People with cardiac abnormalities. This can include people with heart murmurs, although this is a lower risk.
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People with pacemakers.
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The reason the people above are most susceptible to experiencing IE is because when bacteria is circulating through the bloodstream it is more likely to stick onto a place that has experienced a previous injury or been the site of a procedure. The bacteria then grow on this surface and form a mass that can become infected.
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For this reason it’s even more important that people who are at risk for IE very carefully attend to their oral hygiene needs. This means having a professional cleaning done every six months, brushing twice a day for two minutes and flossing once. These steps can help prevent harmful plaque buildup and bacteria that could enter the bloodstream.
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The premedication is as simple as a person taking one dose of an antibiotic one hour before a procedure. Just by doing this the risk of IE is nearly completely ruled out.
Make sure that your dentist knows about anything that could be of importance in your medical past. If you have any concerns you should feel comfortable discussing them with your dentist openly. Call Dr. D’Alfonso of Lakeway Cosmetic Dentistry if you’re looking for a dentist you can trust!