Dear Patients and Friends,

The American Dental Association has released new guidelines for antibiotic prophylaxis to prevent infective endocarditis as a result of dental treatment.  For decades, the ADA has recommended antibiotics be taken prior to dental treatment for many people who have had certain cardiac conditions.  The theory was that the antibiotics would help prevent a potentially fatal disease known as infective endocarditis.  Recent evaluation of literature has brought to light the fact that this therapy is not really effective in preventing this disease.  Using an evidence based model, there are new guidelines for antibiotic prophylaxis and most people who have had to take antibiotics in the past will no longer need to do so.

The new guidelines are as follows:

Patients who DO NOT need to take antibiotics prior to dental treatment to prevent infective endocarditis include those with a history of :

• Mitral Valve Prolapse
• Rheumatic Heart Disease
• Bicusbid Valve Disease
• Calcified Aortic Stenosis
• Congenital heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy
  

Antibiotic prophylaxis IS RECOMMENDED for those with a history of:

• Artificial Heart Valves
• Past Infective Endocarditis
• 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;

A cardiac transplant that develops a problem in a heart valve.

The new recommendations apply to many dental procedures, including teeth cleaning and extractions. Patients with congenital heart disease can have complicated circumstances. They should check with their cardiologist if there is any question at all as to the category that best fits their needs.

Patients who have had total joint replacement will need antibiotic prophylaxis under the following guidelines:

• All patients two years after joint replacement
• Immunocompromised/Immunosuppressed patients
• Previous prosthetic joint replacement
• Malnourishment
• Hemophilia
• HIV infection
• Insulin dependent diabetes (Type I)
• Malignancy

We hope you find this information useful and look forward to helping you attain your dental goals in the future.

Sincerely,
David Sperow, DMD | A. Dean Sperow, DMD

CONTACT:
Sperow and Sperow
Cosmetic and Implant Dentistry
811 Corporate Drive    Suite 203   
Lexington, KY 40503
859.223.7755 | www.kydentalimplants.com