What Is Antibiotic Prophylaxis?

If you hear the term antibiotic prophylaxis and think, “it's all greek to me,“ that's because, well... it is. Prophylaxis is Greek for “advance guard,“ and in this case, it refers to using antibiotics to help you prevent infection while undergoing certain dental treatments. If you're wondering if you'll need antibiotic prophylaxis, we'll let you know the specific conditions in which it's recommended so you can go into your appointment confident that you're getting the dental treatment that will make you smile.

An Important Note on Antibiotic Resistance

Antibiotics are considered one of the most important scientific discoveries of the 20th century. Bacterial infections that were once considered serious have become preventable and treatable. However, bacteria are adapting and beginning to build up a resistance to some antibiotics because of how much they’re prescribed, so it’s important they’re only utilized when necessary.

According to the Centers for Disease Control (CDC), antibiotic resistance is one of the biggest health challenges of our time. The CDC says that “appropriate antibiotic prescribing means antibiotics are only prescribed when needed, and when needed, the right antibiotic is selected and prescribed at the right dose and for the right duration.” They cite a study revealing that over 30% of antibiotics prescribed are unnecessary. And specific to dental procedures, an Agency for Healthcare Research and Quality-funded study found that ”about 81 percent antibiotic prescriptions given to patients before a dental procedure to prevent cardiac infections were considered unnecessary by current guidelines.”

Your dental and medical professionals are in the best position to determine if you need antibiotics. If you’re wondering if you need them and why – it’s important for you to ask.

When Are Antibiotics Needed for Prevention?

According to the American Dental Association, there are very few circumstances in which antibiotics should be used for preventive measures before dental procedures.

• People with prosthetic joints were once prescribed antibiotics before dental procedures, believed to be at a higher risk of a blood infection affecting their prosthetic. Studies have since shown otherwise, and the ADA now recommends against it.
• People with specific heart conditions may be at a higher risk of infective endocarditis (bacteria reaching the heart through the bloodstream) but in fewer cases than previously thought – limited mostly to valvular heart conditions or congenital heart defects.

Commonly Prescribed Antibiotics

Amoxicillin is the most commonly prescribed oral medication for antibiotic prophylaxis. If you're unable to take oral medication, your doctor may prescribe an intramuscular (IM) shot or intravenous (IV) infusion of another antibiotic like ampicillin or cefazolin. If you're allergic to certain antibiotics, your surgeon might give you a dose of clindamycin instead.

Dosing Requirements and Side Effects

If your dental and medical professional determine antibiotic prophylaxis is a necessary preventive measure for you, your dosage will depend on your age, size, and the antibiotic you're prescribed. Typically, oral antibiotics should be taken one hour before your procedure and are best taken with a small amount of food. They can also be taken up to a few hours after the procedure if you forgot to take them before your treatment, but it's best to follow your surgeon's instructions and arrive at your dental appointment fully prepared. Because different antibiotics have different side effects, talk with your dental professional about what you can expect and let them know if you have any questions or concerns.

Very few patients need to take antibiotics before seeing a dentist, so it's unlikely you will have to build taking a pill into your routine on appointment days. If you've recently undergone joint or heart surgery, talk to your dental professional about the need for antibiotic prophylaxis for dental or dental hygiene treatment. They know the specifics of your condition and will best be able to offer advice tailored to your individual needs. At least now, you can have an informed conversation with them without saying, “it's all Greek to me!“ And you can be confident you're getting treatment that will make you smile.