Dental FAQsDo I need antibiotics before treatment?

What’s Your Situation?

Amoxicillin is one of the most commonly prescribed antibiotics.

Your mouth has bacteria that can get into your bloodstream. For most people, these bacteria don’t cause a problem. There is however concern for some people, as bacteria in the bloodstream can cause an infection elsewhere in the body.

That’s why your doctor may advise you to take an antibiotic before some dental procedures. The antibiotic can kill infection-causing bacteria.

However, not everyone should take antibiotics before dental treatment.

Antibiotics & Routine Dental Treatment

Regardless of your situation, antibiotic coverage is NOT required for routine dental treatment.

In fact, antibiotic coverage is ONLY required for treatment that is likely to cause bleeding. This includes treatment such as surgery and deep cleaning (scaling and root planing).

Do I need antibiotics?

“I had bypass surgery.”
No, antibiotics are not required before dental treatment.

“I have a heart murmur.”
No, antibiotics are not required before dental treatment.

“I had joint replacement (such as knee or hip).”
If the surgery was within the past two years, antibiotics may be required if your dental treatment is likely to cause bleeding. Please ask your surgeon!

“I have a serious heart condition.”
Depending on your condition, antibiotics may be required if your dental treatment is likely to cause bleeding. Please read the “Heart Conditions Requiring Antibiotics“ section below for more information.

Heart Conditions Requiring Antibiotics

There are only a few specific heart conditions that require the patient to take antibiotics.

Conditions that require antibiotic coverage include:

1. Prosthetic cardiac valve or prosthetic material used for cardiac valve repair.
2. A history of infective endocarditis.
3. Certain specific, serious congenital (present from birth) heart conditions, including:
   • Unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits.
   • A completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure.
   • Any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device.
4. A cardiac transplant that develops a problem in a heart valve.

Taking antibiotics before dental treatment is called “antibiotic prophylaxis” (or preventive medicine).

Questions?

If you’d like to ask Dr. Klaus or Dr. Mo about whether you require antibiotics before dental treatment for your own unique situation, please contact us. We are always happy to help!

Resources

• CDA: Prevention of Infective Endocarditis
• CDA: Dental Patients with Total Joint Replacement
• American Heart Association: Prevention of Infective Endocarditis (PDF Download)