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  • Spring Hatfield, RDH

Lets talk about the overuse of antibiotics

Updated: Oct 13, 2018

It has been suggested that dentistry is a contributing factor to the over use of antibiotics, contributing to antibiotic resistance bacteria. I can't disagree with this, when I first started practicing dental hygiene, prophylactic antibiotics were recommended for patients with mitral valve prolapse, joint replacements, history of rheumatic fever, patients with heart stints and valve replacements. I have worked for dentists that prescribe antibiotics before wisdom teeth extractions, to reduce the risk of infection.

New research has discovered antibiotics before dental treatment is not necessary. The 2015 ADA clinical practice guideline states "In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection." Change is hard for patients and dentists that have always followed a protocol to give patients with prosthetic joints prophylactic antibiotics, but we must follow the science.

The American Heart Association updated their recommendation for prophylactic antibiotics to only be used in patients with increased risk of infective endocarditis, those who have:

1. A prosthetic heart valve or who have had a heart valve repaired with prosthetic material.

2. A history of endocarditis.

3. A heart transplant with abnormal heart valve function.

4. Certain congenital heart defects including:

*Cyanotic congenital heart disease, that has not been fully repaired including children that have had surgical shunts and conduits.

*A congenital heart defect that has been completely repaired with prosthetic material or a device for the first six months after the repair procedure.

*Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at or adjacent to a prosthetic patch or prosthetic device

Lets work to improve the overuse of antibiotics by staying educated on proper protocol. Patients rely on healthcare providers for guidance and education. Below are links for more information on the proper protocol for pre-medication in the dental office. This is a good resource for dental professionals as well as patients.

*Information retrieved from https://www.ada.org/en/member-center/oral-health-topics/antibiotic-prophylaxis