For decades, doctors have given short-term antibiotics, prior to a dental procedure, to many patients with the belief the drugs would prevent, infective endocarditis (IE) – an infection of the heart's inner lining or the heart valves, states Lancisi Heart Hospital in Italy.
These drugs, like most drugs carry risks. The risks with the drugs for infective endocarditis include fatal allergic reactions, which possibly make the bacteria that causes infective endocarditis to become resistant to antibiotics. Although these allergic reactions are minimal, new evidence shows the risks outweigh the benefits for most patients receiving these antibiotics.
Endocarditis is an infection of the inner lining of the heart, according to the Mayo Clinic. Infective endocarditis (IE) is a lethal disease if not promptly treated with antibiotics, either in association with surgery or not. Complications of IE may involve cardiac structures when the infection spreads within the heart, or extra cardiac ones when the cause is usually from embolic origin; they may also be due to medical treatment or to the septic condition itself.
Taking a precautionary antibiotic before a trip to the dentist isn’t necessary for most people, and in fact, might create more harm than good, according to updated information from the American Heart Association.
In 2007, the American Heart Association, released a new set of guidelines with major changes and clarifications regarding who should receive antibiotic prophylaxis and who does not require it for prevention of infective endocarditis.
The guideline from the National Institute for Health and Clinical Excellence, NICE, of the U.K. recommends that antibiotic prophylaxis solely to prevent IE should not be given to people at risk of IE undergoing dental and non-dental procedures.
In summary, the basis to support this recommendation is:
- there is no consistent association between having an interventional procedure, dental or non-dental, and the development of IE
- regular toothbrushing almost certainly presents a greater risk of IE than a single dental procedure because of repetitive exposure to bacteraemia with oral flora
- the clinical effectiveness of antibiotic prophylaxis is not proven
- antibiotic prophylaxis against IE for dental procedures may lead to a greater number of deaths through fatal anaphylaxis than a strategy of no antibiotic prophylaxis, and is not cost effective.
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