What dental procedures no longer require antibiotics?

The question is not necessarily what dental procedures no longer require antibiotics, but what cardiac or other conditions dictate that prophylactic antibiotics be taken.

As per current American Heart Association guidelines, conditions that no longer require antibiotic therapy prior to dental treatment are:

• mitral valve prolapse (may have been identified as a heart murmur)
• rheumatic heart disease
• bicuspid valve disease
• calcified aortic stenosis
• congenital (present from birth) heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy

Currently antibiotics are recommended for patients with the following conditions when they are to receive dental care involving the gum tissue, periapical tissues of the teeth (such as root canal treatment) and puncture or perforation of the oral mucosa. For these patients this means most dental procedures other than visual clinical and radiographic examinations. The conditions are:

• artificial heart valves
• a history of infective endocarditis (an infection of the lining inside the heart or the heart valves)
• a cardiac (heart) transplant that develops a heart valve problem
• suffer from a congenital (present from birth) heart condition:
  • unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits;
  • a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure;
  • any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device.

In addition, most orthopedic surgeons advise prophylactic coverage prior to dental treatment for at least the first two years after joint replacement surgery has been performed.