Dental antibiotic prophylaxis

Dental antibiotic prophylaxis is the administration of antibiotics to a dental patient for prevention of harmful consequences of bacteremia, that may be caused by invasion of the oral flora into an injured gingival or peri-apical vessel during dental treatment. This issue remains a subject under constant revision, with the intention of providing recommendations based on sound scientific evidence. In the past, bacteremia caused by dental procedures (in most cases due to viridans streptococci, which reside in oral cavity), such as a cleaning or extraction of a tooth was thought to be more clinically significant than it actually was. However, it is important that a dentist or a dental hygienist be told of any heart problems before commencing treatment. Antibiotics are administered to patients with certain heart conditions as a precaution, although this practice has changed in the US, with new American Heart Association guidelines released in 2007, and in the UK as of August 2018 due to new SDCEP advice in line with the NICE guidelines. Everyday tooth brushing and flossing will similarly cause bacteremia. Although there is little evidence to support antibiotic prophylaxis for dental treatment, the current AHA guidelines are highly accepted by clinicians and patients. Currently, there are official guidelines for dental antibiotic prophylaxis for the prevention of infective endocarditis and of infection of prosthetic joint. These guidelines are in constant controversy and revisions by various professional committees. In addition, there are various medical conditions for which clinicians recommended antibiotic prophylaxis, although there is no evidence to support this practice. These conditions include renal dialysis shunt, cerebrospinal fluid shunt, vascular graft, immunosuppression secondary to cancer and cancer chemotherapy, systemic lupus erythematosus, and type 1 diabetes mellitus.