New Premedication Guidelines

For decades, The American Heart Association recommended patients with certain heart conditions take antibiotics shortly before dental treatment.  This was done with the belief that antibiotics would prevent infective endocarditis, previously referred to as bacterial endocarditis.  The American Heart Association's (AHA) latest guidelines were published in its scientific journal, Circulation, in April 2007 and there is good news: the AHA recommends that most of these patients no longer need short-term antibiotics as preventive measure before their dental treatment.

The guidelines say patients who have taken prophylactic antibiotics routinely in the past but no longer need them include people with:

• Mitral valve prolapse
• Rheumatic heart disease
• Bicuspid valve disease
• Calcified aortic stenosis
• Congential heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy

The new guidelines are aimed at patients who would have the greatest danger of a debilitating outcome if they developed a heart infection.

Preventive antibiotics prior to a dental procedure are advised for patients with:

1. artificial heart valves
2. a history of of infective endocarditis
3. a cardiac transplant that develops a problem in the heart valve
4. 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.

We ask you to contact your physician and/or specialist regarding your determined needs to premedicate.  We will denote on your medical history to continue premedication or to discontinue based on your physician and/or specialist's recommendation.

We will continue to request that you premedicate (if you are in a risk category) until our office is notified otherwise by your physician.