Long Island Cosmetic Dentists
Gary L. Sandler, DDS & Bonnie E. Lipow, DDS
201 Moreland Road, Suite #8
Hauppauge, NY 11788
631-499-1800
April 21, 2007
We want to make you aware of the current American Heart Association guidelines regarding premedication with antibiotics prior to dental treatment. The following changes in recommendations were reported in April, 2007.
The guidelines were based on a growing body of scientific evidence that shows that the risk of taking preventive antibiotics outweigh the benefits for most patients and that most of these patients no longer need short-term antibiotics as a preventative measure before their dental treatment.
The current practice of giving patients antibiotics prior to a dental procedure is no longer recommended EXCEPT for patients with the highest risk of adverse outcomes resulting from (BE)Bacterial Endocarditis. The Committee cannot exclude the possibility that an exceedingly small number of cases, if any, of BE may be prevented by antibiotic prophylaxis prior to a dental procedure. If such benefit from prophylaxis exists, it should be reserved ONLY for those patients listed below. The Committee recognizes the importance of good oral and dental health and regular visits to the dentist for patients at risk of BE.
Changes in these guidelines do not change the fact that your cardiac condition puts you at increased risk for developing endocarditis. If you develop signs or symptoms of endocarditis –– such as unexplained fever –– see your doctor immediately. If blood cultures are necessary (to determine if endocarditis is present), it is important for your doctor to obtain these cultures and other relevant tests BEFORE antibiotics are started.
Antibiotic prophylaxis with dental procedures is recommended only for patients with cardiac conditions associated with the highest risk of adverse outcomes from endocarditis, including:
- Prosthetic cardiac valve
- Previous endocarditis
- Congenital heart disease (only in certain cases)
- Cardiac transplantation recipients with cardiac valvular disease
The guidelines say patients who have taken prophylactic antibiotics routinely in the past but no longer need to be premedicated include people with: Mitral valve prolapse, Rheumatic Heart Disease, Bicuspid valve disease, Calcified Aortic stenosis, and congenital heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy.
If you are in the group of patients who generally no longer are advised to take prophylactic antibiotic premedication, we strongly advise you to consult with your cardiologist or physician to be sure that he/she evaluates your specific needs and confirms that you no longer need to be premedicated for dental treatment.
If you have any questions, please do not hesitate to call our office.
Sincerely yours,
Dr. Sandler and Dr. Lipow
American Heart Association Premedication Guidelines
Long Island Cosmetic Dentists
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