What is Dental Antibiotic Prophylaxis?

Dental antibiotic prophylaxis is the administering of antibiotics to patients who are in a high-risk category to develop infections as the result of certain dental procedures. It is mainly used to prevent a condition known as infective endocarditis, which is an infection that can happen on the outside of the heart or the valves of the heart. The use of dental antibiotic prophylaxis is only needed in a very few situations, according to the American Heart Association, which worked with the American Dental Association to update guidelines.

The main purpose of using dental antibiotic prophylaxis is simply to prevent infection that can affect the heart, but it is only needed for patients in certain situations. Some of the most common needs for the treatment include those patients with artificial heart valves, a history of infective endocarditis, a transplant that eventually develops problems with a heart valve, or one of a number of congenital heart defects. The list of patients who were once required to have dental antibiotic prophylaxis, but who no longer need it under the new guidelines, are those with mitral valve prolapse, bicuspid valve disease, rheumatic heart disease, and calcified aortic stenosis. In addition, the procedure is no longer recommended for certain congenital heart defects.

The dosage for this type of treatment often depends on the type of antibiotic used. Generally, the standard practice is to administer 2 grams of amoxicillin orally to adults. Those who cannot take oral medication could be given 2 grams of ampicillin intravenously. Children are often given 50 milligrams of amoxicillin or ampicillin for every 2.2 pounds (1 kilogram) of weight. Those who are allergic to penicillin products may be given a different antibiotic.

In addition to the various medical conditions that require the use of dental antibiotic prophylaxis, there are specific dental procedures that would require it. These procedures include those that involve dealing with gingival tissue, also known as the gum tissue. For some procedures, such as anesthetic injections into healthy tissue, treatment with antibiotics is not required. Those with questions or concerns should consult their dentist or oral surgeon.

One of the dangers of administering dental antibiotic prophylaxis is the unpredictability of the side effects. These could include rashes and even potentially severe breathing problems. While these may be rare, the risks associated with the treatment ultimately outweigh the benefits for populations considered at lower risk. Further, the overuse of antibiotics has been tied to the proliferation of antibiotic-resistant bacteria that are more difficult to treat with conventional medications.