Long Island Cosmetic Dentists

Gary L. Sandler, DDS & Bonnie E. Lipow, DDS
201 Moreland Road, Suite #8
Hauppauge, NY 11788
Compared with previous recommendations, there are currently relatively few patient subpopulations for whom antibiotic prophylaxis may be indicated prior to certain dental procedures.

In patients with prosthetic joint implants, a January 2015 ADA clinical practice guideline, based on a 2014 systematic review states, ￿In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.￿

According to the ADA Chairside Guide, for patients with a history of complications associated with their joint replacement surgery who are undergoing dental procedures that include gingival manipulation or mucosal incision, prophylactic antibiotics should only be considered after consultation with the patient and orthopedic surgeon; in cases where antibiotics are deemed necessary, it is most appropriate that the orthopedic surgeon recommend the appropriate antibiotic regimen and, when reasonable, write the prescription.

For infective endocarditis prophylaxis, 2007 guidelines by the American Heart Association, written with input from the ADA and approved by the CSA as they relate to dentistry in 2008, support premedication for a smaller group of patients than previous versions. This change was based on a review of scientific evidence, which showed that the risk of adverse reactions to antibiotics generally outweigh the benefits of prophylaxis for many patients who would have been considered eligible for prophylaxis in previous versions of the guidelines. Concern about the development of drug-resistant bacteria also was a factor.

Infective endocarditis prophylaxis for dental procedures should be recommended only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from infective endocarditis. For patients with these underlying cardiac conditions, prophylaxis is recommended for all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa.

If you are in the group of patients who generally no longer are advised to take prophylactic antibiotic Premedication, we strongly advise you to consult with your cardiologist or physician to be sure that he/she evaluates your specific needs and confirms that you no longer need to be premedicated for dental treatment.

If you have any questions, please do not hesitate to call our office.
Dr. Sandler and Dr. Lipow
American Heart Association Premedication Guidelines
Long Island Cosmetic Dentists
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