Since the 1950s, the American Heart Association (AHA)
has urged a sizable group of people to take antibiotics
before having dental work or other procedures that
might flood the bloodstream with bacteria. The antibiotics
were supposed to prevent infective endocarditis, a
potentially serious infection of the heart’s
lining. After a look at the latest evidence, the AHA
now emphasizes routine oral care and recommends pre-procedure
antibiotics for only some people, reports the October
2007 issue of the Harvard Heart Letter.
Infective endocarditis occurs when bacteria invade
the innermost layer of the heart’s chambers.
It isn’t common, but it is hard to get rid of
and potentially deadly. It can make heart tissue prone
to other infections, damage heart valves, and lead
to heart failure, stroke, or heart rhythm problems.
The organisms that kick off endocarditis live in your
mouth, among other places in the body. Having a tooth
pulled, gum surgery, or other dental work causes a
temporary spike in the number of bacteria in the bloodstream.
Even so, no large trials have tested whether taking
antibiotics before dental work actually prevents endocarditis.
If antibiotics do help, the effect is so small that
the risk of side effects from the medication outweighs
the benefits for most people, explains the Harvard
Heart Letter.
The AHA now says you need antibiotics before dental
procedures only if you have an artificial heart valve,
you’ve had endocarditis before, or you’ve
had a heart transplant and developed a valve problem.
Some people who were born with heart problems may also
need antibiotics depending on whether and how the defects
were repaired.
Also in this issue:
- Driving with a defibrillator
- Interval training and the heart
- Acupuncture and blood
pressure
- Beans lower
cholesterol
- Ask the Doctor: Does Fosamax cause atrial fibrillation?
Can I fly with heart failure?
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