Dental care and antibiotics – Heart Matters Magazine


I have a heart valve problem. In the past I have been told to take antibiotics before going to the dentist, but this was not the case on my last visit. Why not?

Dr Angela Nobbs says:

Your mouth is home to a large number of different bacteria, which normally do not cause harm. But sometimes, for example if they enter the bloodstream, the bacteria can become harmful. Oral bacteria known as streptococci can cause unwanted clots on heart valves, leading to heart disease known as infection endocarditis – an infection of the inner lining of the heart. It’s rare, but difficult to treat and potentially deadly.

In previous years, people at risk of developing endocarditis, such as those with heart valve problems, often received antibiotics before dental procedures such as extractions or scaling. The antibiotics were to kill any oral bacteria entering the bloodstream and prevent infected clots from forming on the heart valves.

Endocarditis is rare, but difficult to treat and potentially fatal

But there are growing concerns about the safety of antibiotics for patients and the issue of rising antibiotic resistance.

In 2008, the National Institute for Health and Care Excellence (NICE) released new guidelines recommending that antibiotics no longer be routinely given to high-risk patients. The decision as to whether or not antibiotics are necessary before a dental procedure will be based on these recommendations and the clinical judgment of the dentist – the dentist will also seek advice from cardiologists or physicians if necessary.

Whether or not you receive antibiotics before a dental procedure, if you are at risk for endocarditis, you should take extra precautions to maintain excellent oral hygiene, know the symptoms of endocarditis, and seek medical attention urgently. if symptoms develop.

Doctor Angela NobbsMeet the expert

Dr Angela Nobbs is a Lecturer in Oral Microbiology at the University of Bristol Dental School.


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