A new study led by Ron Milo of the Weizmann Institute of Science states an average human male body is comprised of 30 trillion cells and 40 trillion bacteria. Crazy right? Well, based on these statistics alone, you shouldn't be surprised to hear that you have bacteria in your mouth.
Although bacteria is completely normal, there is a possibility bacteria in the mouth can enter the bloodstream during oral surgery and routine dental cleanings and appointments. This can also occur during normal daily activities such as chewing, brushing your teeth, and flossing.
Now we are not saying to completely eliminate the dentist or stop brushing your teeth! For the majority of people, the body’s immune system is able to fight off bacteria upon entering the bloodstream. Therefore, the risk for infection is very low.
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Where do antibiotics and dental treatment come in?
Of course, this isn’t the case for everyone. For some people, when bacteria enters the bloodstream, there is concern it will develop an infection of the heart lining or valves (infective endocarditis) or an infection of orthopedic implants.
Before oral surgery, antibiotics are prescribed to anyone with certain heart conditions and those who have orthopedic implants (such as artificial joints or metal plates or rods) to prevent these infections. This practice is called antibiotic prophylaxis, or preventative medicine.
Who is a candidate for preventative antibiotics?
Previously, the American Heart Association advocated nearly everyone with a heart condition needed to take antibiotics before dental procedures or oral surgery. However, in 2007 the AHA simplified its recommendations to include only those who posed the highest risk of IE.
This includes anyone with:
Artificial heart valves
A history of IE
A heart transplant causing irregular heart valve function
Specific heart defects including:
Non-repaired or incompletely fixed cyanotic congenital heart disease (a condition present at birth causing low oxygen levels in the blood). This includes those with palliative shunts and conduits.
A heart defect completely repaired by either a device or prosthetic material during the first six months after the procedure.
A repaired heart defect with residual defects at or next to a prosthetic patch or device. This includes persisting leaks or abnormal flow at or near the site.
What about antibiotics and dental treatment for those with orthopedic implants?
The American Dental Association and American Academy of Orthopedic Surgeons do not necessarily recommend preventative antibiotics to everyone with an orthopedic implant.
Dental patients with orthopedic implants may opt for antibiotics if they have a weak immune system. This includes everyone with diabetes, rheumatoid arthritis, and cancer. Also, anyone undergoing chemotherapy and chronic steroid use will have weaker immune systems as well.
To clarify whether or not antibiotics are right for you, make sure to consult your dentists and/or physicians before treatment.
Why can't everyone take preventative antibiotics before surgery?
It may seem like a good idea to simply prescribe everyone antibiotics before surgery to prevent infection. However, antibiotics can do more harm than good for those who don't need them.
Antibiotics can cause side effects ranging from an upset stomach to severe allergic reactions. By taking antibiotics, you destroy good germs in your body that already fight against infection. Lastly, drug-resistant bacteria can develop through improper use of antibiotics.
In conclusion, it's best to discuss the use of antibiotics with your dentist, oral surgeon, or physician. For any additional questions/concerns, please contact our team today.
