New guidelines have been issued by the AHA ( American Heart Association) regarding premedicating for dental work and cleanings.
In past years, it was believed that IE (Infective Endocarditis) was caused by bacteria in the blood also known as “Bacteremia”. It was believed that after dental procedures, the bacteria in the bloodstream could settle on susceptible areas such as prosthetic valves and so on. New evidence has found many variances.
Previous AHA guidelines on the prevention of IE were largely based on opinion and limited studies. The most recent recommendations were devloped through an evidence based approach that was made after 20 years of extensive review. The new recommendation reduces the number of conditions that need premedication. Guidelines went under review due in part to the risk associated with a widespread immunity to antibiotic treatment.
Patients with these conditions NO LONGER require prophylactic antibiotic:
- Mitral valve prolapse
- Rheumatic heart disease
- Bicuspid valve disease
- Calcified aortic stent
- Congenital heart disease, like ventricular septal defect, atrial defect, and hypertophic cardiomyopathy
The new recommendation does suggest antibiotic treatment for the patients with the following conditions:
- Prosthetic cardic valve
- Previous infective endocarditis
- Congential Heart disease(CHD)
- Unrepaired cyanotic CHD, including pallative shunts and conduits
- Completely repaired congential heart defect during the first 6 months after the procedure
- Cardiac transplant pt who devlop cardiac valvulopathy
Patients with any of these conditions should consult a medical doctor and bring a letter with your physician’s recommendations to keep in your dental file. For more information, questions, or to schedule an appointment, please call or email us today.
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