Antibiotic prophylaxis – is it necessary?

Antibiotic prophylaxis – is it necessary?

March 10, 2020 11:02 am Published by

You might have heard the term antibiotic prophylaxis being used in the past – may be at the dentist, or through family and friends when having dental work done. So what exactly is it? And do you need it? Here, we explain more about what the term means and what you should ask your dentist.

  • What is it?

The word ‘prophylaxis’ means to prevent disease. So, in this context, antibiotic prophylaxis simply means taking antibiotics as a premedication for dental treatment. It’s meant to protect you against infection, rather than treat an infection later on as might normally be the case. If you need dental surgery then your dentist might have advised this course of action.

  • What does it do?

An antibiotic prophylaxis is used in situations where there’s a higher risk of infection, or where infection might cause more damage than elsewhere. it’s important in dental surgery because of the number of bacteria that are present in the mouth –millions and billions, in fact! Don’t worry, because that’s totally normal. Our bodies usually do a great job of regulating good and bad bacteria, and a good dental hygiene routine supports that. However, if you have surgery then there’s a risk some of those bad bacteria could find their way into your bloodstream and to your heart. This can be bad news if you have a pre-existing heart condition or anything else that makes you more vulnerable to attack.

  • What could happen?

There is a risk that a type of bacteria called streptococci can cause blood clots on heart valves, leading to infection – called infective endocarditis. However, this is rare, so don’t panic. It’s a greater risk for those who are vulnerable, and whose immune system isn’t as strong as normal.

  • Who needs it?

You might be surprised to hear that relatively few people need an antibiotic prophylaxis nowadays. That’s because in recent years, studies have found that it doesn’t have as much of a beneficial effect as first thought. In fact, there’s greater risks associated with prescribing antibiotics when they aren’t really necessary – side effects like sickness or allergic reactionsmight actually make healing even more difficult, as well as encouraging antibiotic resistance. In the past, doctors would routinely prescribe antibiotics for vulnerable individuals before all kinds of dental treatment – not just surgery, but also more routine procedures like scaling, cleaning. However, a doctor or dentist will now only give antibiotics if it’s deemed to be essential, on a case-by-case basis. Your surgeon might even need a cardiologist’s opinion to decide.

  • How do I know if I need one?

If you have a heart condition or have had a joint replacement, then you probably have been given antibiotics for tooth infection in the past, when getting dental work done. That wouldn’t be the case now, and unless you are particularly at-risk it’s likely you won’t be given them at all. The ADA has been giving this kind of advice since 2012. One exception is those that have very compromised immune systems, such as those undergoing chemotherapy treatment for cancer, or those with a condition like diabetes or rheumatoid arthritis. Ultimately the surgeon has to decide if it’s right for your individual case.

  • What do I do now?

At this point, it’s important to know that there are lots of things you can do yourself to manage the situation. To start, having a really great dental hygiene routine in place is going to have a really great impact. Boring but true! So, make sure you brush your teeth for two minutes at a time, twice a day. Floss regularly and see your regular dentist in Dubai, such as at Drs. Nicolas & Asp, every six months.

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