Update on Antibiotics Prior to Dental Procedures

Update on Antibiotics Prior to Dental Procedures

Wilderness dentistry is an art form, often improvised and rarely practiced in an optimal setting. Most health care professionals are not trained in dentistry and are therefore forced to improvise when faced with an injured or lost tooth, gum infection, lost crown, or other dental emergency. Furthermore, most first aid kits are not supplied with proper tools for managing dental problems unless a traveler has had the foresight to carry the necessary supplies and learn how to use them properly.One traditional concept in dentistry has been that certain antibiotic coverage is necessary for persons with certain structural heart problems prior to certain dental manipulations. I was taught this in medical school, and dogma about this has notchanged until just recently. The American Heart Association (AHA) has released new recommendations that state that the use of antibiotics prior to dental procedures is rarely needed. This information is applicable to the wilderness as well as the urban setting.The update states that giving antibiotics to patients prior to dental procedures is unlikely to prevent many cases of infective endocarditis [inflammation of the lining of the heart and its valves].A specially appointed writing group sponsored by the AHA was created because of its collective expertise in prevention and treatment of infective endocarditis. This group, along with members representing the American Dental Association, the Infectious Diseases Society of America, and the American Academy of Pediatrics, concluded that the use of prophylactic (preventive) antibiotics should be restricted to patients at risk for infection, such as those with artificial heart valves or certain congenital heart defects.