The Antibiotic Law for Dental Cleaning

The previous law governing antibiotic prophylaxis for dental cleanings applied to patients at possible risk of getting infectious endocarditis (IE) due to specific health conditions. The current law applies only to patients most likely to suffer the most serious consequences if infection occurs.

Reason for Changes in the Law

• According to the American Heart Association, the risks of short-term antibiotic coverage for dental procedures, such as cleanings and extractions, exceed the benefits for the majority of dental patients taking antibiotics as a precautionary measure. Risks include fatal allergic reactions and IE bacteria becoming resistant to antibiotics. The seriousness of the risk factors and the fact that there is no evidence that antibiotic prophylaxis works, prompted the change in the law. The U.S. National Library of Medicine reports that infectious endocarditis occurs when bacteria or fungi infect the lining of the heart chambers and heart valves.

Conditions Requiring Prophylactic Antibiotics

• The patients receiving antibiotic coverage under the current law include those with artificial heart valves, a previous IE infection, congenital heart conditions, congenital heart disease, patients who have shunts or prosthetic devices, defects following surgical repairs and patients with heart transplants exhibiting heart valve problems.

Conditions No Longer Requiring Prophylactic Antibiotics

• According to the American Heart association, conditions no longer requiring short-term antibiotic coverage include mitral valve prolapse, rheumatic heart disease, bicuspid valve disease and calcified aortic stenosis. Specific congenital heart defects no longer requiring antibiotic prophylaxis include atrial septal defects and ventricular septal defects. Septal defects are holes in the heart that cause abnormal blood flow. Hypertrophic cardiomyopathy, a congenital defect characterized by a thickened heart muscle, also no longer requires antibiotic coverage.