Antibiotics and Dental Treatment — Who Needs Them, Who Doesn’t

Your mouth is a interesting environment and some patients mouth’s are cleaner than others. Even during certain times in the day or night the amount of food and bacteria inside your mouth varies. Morning breath, bad breath and halitosis can be an indication that your mouth contains some pretty nasty bugs.

Since we all know that the mouth is a dirty place many patients are concerned that they may require antibiotics before a dental appointment. The concept is to kill the bacteria from our saliva and around the our teeth (that enters the bloodstream) so it can’t cause an infection in our system, heart or orthopedic implants.

Bacteria from the mouth can enter the bloodstream from dental treatments but it also occurs on a daily basis when you chew food or brush your teeth. It’s not practical or safe to take antibiotic every time you think you may introduce bacteria into your bloodstream every time you eat a bagel, popcorn or other abrasive food.

Also the new scientific studies show there is no evidence that taking antibiotics prevents any infections such as endocarditis or implant infections. You also have to think about the risk of an antibiotic side effect or allergic reaction from taking a medication that hasn’t been proven to prevent what you are taking them for. Some bacteria are now resistant to the antibiotics so all you have are the side effects to deal with.

Granted certain very hight risk cardiac patients may need antibiotics. If you have an artificial heart valve, a history of infective endocarditis or recent complicated surgery speak to the dentist to discuss the risks and benefits of taking antibiotics before a dental appointment.

These guidelines are relatively new and many physicians and nurse practitioners are not aware of the new changes in antibiotic protocols. To sum it up: There is no science proving taking antibiotics with prevent you from getting a heart, joint, or blood vessel infection. These infections or conceivable but not probable. If you still have any concerns or questions feel free to ask Dr. Gottlieb.