Many patients are advised that they should taking antibiotics prior to undergoing certain dental appointments – to premedicate themselves. What is premedication? Premedication is a preventative step of taking antibiotics before dental procedures that can cause gum or bone bleeding such as a cleaning, extraction, root canal, deep cleaning, etc. Why do medical and dental professionals suggest this extra step?
We all have bacteria in our mouths which can enter the bloodstream through exposed areas of our oral mucosa during dental procedures. Our bodies are mostly a bacteria-free zone, although there are certain areas within the body that contain bacteria such as the mouth, intestines and surface of the skin. These areas are all protected by a layer of epithelial cells which form a protective barrier to keep the bacteria from entering the bloodstream. During a dental cleaning or other dental procedure, the protective lining may be disturbed and can provide an opening for bacteria to enter the bloodstream. Once the bacteria are in the bloodstream, they can travel to the internal tissues and organs.
For most people, their immune system is healthy and can fight off the bacteria without any harm. However, a small group of people are recommended to have antibiotic prophylaxis. They involve patients with specific heart conditions. The American Heart Association and American Dental Association have created guidelines identifying these people as the following:
- Patients with prosthetic cardiac valves, including transcatheter-implanted prostheses and homografts
- Patients with prosthetic material used for cardiac valve repair, such as annuloplasty rings and chords
- Patients with history of bacterial endocarditis
- Patients with unrepaired cyanotic congenital heart disease or repaired congenital heart disease, with residual shunts or valvular regurgitation at the site of or adjacent to the site of a prosthetic patch or prosthetic device
- Cardiac transplant patients with valve regurgitation due to a structurally abnormal valve
In coordination with American Dental Association these guidelines are constantly revised and updated so they can change with time. Our office team and doctors would be glad to address any questions or concerns you might have.