Premedication

If you are a patient with heart disease or you have a special heart condition, taking good care of your teeth and gums is a must — not just for a healthy smile, but for the health of your heart.

Your dentist or physician may recommend that you take special steps at home and before dental visits. These steps may include taking antibiotics before your dental appointment. Here's why:

Bacterial Endocarditis

During dental treatment, bleeding sometimes occurs. As a result, bacteria from the mouth can possibly enter the bloodstream and work their way to the heart. This presents a risk for some persons with cardiac abnormalities because the bacteria may cause bacterial endocarditis, a serious inflammation of the heart valves or tissues.

Certain heart conditions are more often associated with endocarditis than others. To determine if an existing heart condition poses a risk, your dentist needs complete health information on your medical history form. The form should also include the name and address of your family physician or cardiologist as well as the names and dosages of all medications that you take.

Tell Your Dentist

Do any of these apply to you?

Recent heart surgery within past six months
Pacemaker
Within six months of vascular surgery (replaced artery)
Artificial heart valve
History of rheumatic fever
History of heart murmur (mitral valve prolapse)
Previous bacterial endocarditis
Systemic pulmonary shunt
Congenital heart defect
Acquired valvular dysfunction

If you have any of these conditions, if you were diagnosed with other heart ailments, or if your health status has changed since your last dental visit, tell your dentist.

Precautions

The American Heart Association routinely publishes guidelines for physicians and dentists so that they can protect patients who are at risk for developing bacterial endocarditis.

The guidelines, which the American Dental Association helps develop, recommend the use of antibiotics prior to dental treatment, based on the patient's medical condition and on the treatment to be performed. Your dentist or physician may prescribe antibiotics for dental procedures that would result in bleeding from the gums or mucous membranes in the mouth. Such procedures could include professional teeth cleaning, incision and drainage of infected oral tissue, some types of injections, extractions and some surgeries that involve the maxillary sinus.

Use as Directed

If you are taking new or different medicine (prescription or over-the-counter drugs) since your last dental appointment, advise your dentist so your medical records can be updated. If you have developed allergies to any medicine since your last visit, advise your dentist.

Your dentist may consult with your physician or cardiologist to determine which antibiotics you should take before your dental visit. Your prescription should be filled before your next visit.

Carefully follow instructions for the medication's dosage and frequency.

Don't try to stretch the useful life of your medicine. Always check the bottle's expiration date. Prescriptions that have passed their prime will not help you. Dispose of them promptly.

A Clean Smile

Poor dental hygiene and periodontal (gum) infections may also spread heart threatening bacteria even in the absence of dental procedures. Establish and maintain the best possible oral health by brushing twice a day with fluoride toothpaste that displays the American Dental Association's Seal of Acceptance. The Seal is a symbol of safety and effectiveness. Look for other oral care products that display the Seal, too.

It doesn't hurt to review your brushing techniques with the dentist or hygienist. Over-zealous brushing may irritate gums, causing them to bleed. Clean between your teeth with dental floss or an interdental cleaner (a special pick, stick or brush) each day. The dental team also can explain the correct way to floss or use an interdental cleaner so you can prevent bleeding. Schedule regular dental appointments to have your teeth cleaned and examined. Even patients who wear full dentures should have regular dental checkups.

Dentures that no longer fit properly can cause sores that may serve as entry points for bacteria. Your dentist and your physician want to keep you healthy. Don't hesitate to talk with them about the medication prescribed to protect your heart and keep you smiling.

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