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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. 
The American Heart Association advises dentists that they do not need to give antibiotics prior to treating the following:
  • Correcting bleeding of the lips or mouth from trauma
  • Routine anesthetic injections in tissue that is not infected
  • Fitting and placing for dentures
  • Placement or adjustment of orthodontics
  • Natural loss of primary teeth (baby teeth) in children
  • X-rays

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.