Prophylactic antibiotic premedication is when a dentist or physician prescribes antibiotics before certain dental procedures. Antibiotics keep bacteria in the mouth from spreading to other parts of the body.
The human mouth is full of bacteria. Simple actions like chewing, flossing, or brushing can allow bacteria into the bloodstream. A healthy immune system keeps bacteria from causing harm, but some people are at risk of infection.
Prophylactic antibiotic premedication is a precaution against infection. While most patients do not need this step to avoid infections caused by bacteria in the mouth, those who do can avoid serious health problems.
Antibiotic prophylaxis is appropriate for patients who have:
- a compromised immune system
- artificial heart valves
- a history of infection in heart valves or the lining of the heart (infective endocarditis)
- a heart transplant that leads to problems with one of the heart valves
It may also be appropriate for patients who have had heart conditions from birth, such as:
- unrepaired cyanotic congenital heart disease
- palliative shunts
- residual defects from a prior heart defect
In the past, doctors recommended prophylactic antibiotics for all patients with artificial joints. In 2012, the American Dental Association and the American Association of Orthopedic Surgeons changed determined that this was no longer a recommendation.
There are no known side effects of prophylactic antibiotic premedication. In extremely rare cases, an issue may result from an overdose of antibiotics or an allergic response.
The premedication is administered orally or intravenously. Patients should follow the dosage instructions of the prescribing physician or dentist.
Antibiotic prophylaxis may be used before:
- dental extractions
- dental implant placement
- intraligamentary local anesthetic injections
- placement of orthodontic bands
- prophylactic cleaning where bleeding is anticipated
- re-implantation of avulsed teeth
- root canals
It may also be administered before periodontal procedures, such as:
- sub-gingival placement of antibiotic fibers/strips
- scaling and root planning
- recall maintenance
No preparation is necessary before the procedure. A patient receives medication orally or intravenously within an hour of a dental procedure.
After prophylactic antibiotic premedication, patients go through their dental procedures and heal accordingly. Patients do not need additional antibiotics after the procedure.
The result of the procedure is infection prevention. Under proper treatment, a patient at risk of developing infection will not have any issues after a dental procedure.