When it comes time to have dental treatments for medically compromised patient, antibiotic prophylaxis, or antibiotic premedication, may be recommended. More often than not, when we encounter these patients, they do not know whether premedication is recommended for their medical condition. This topic seems to be confusing not just for the patients, but also for some practitioners. Throughout the years, there have been changes made to the guidelines based on empirical data to determine whether or not premedication is beneficial.
The idea is very simple: risk vs. benefit. The purpose of antibiotic prophylaxis is to prevent any possible complications that may occur subsequently after invasive dental treatment. In order words, if the medical condition were significant enough where it raises concerns for post-operatory infections systemically, it would benefit the patient to have premedication beforehand. On the contrary, if there is no evidence that there is a high risk for post-operatory infection after treatment, then there should be no need to take antibiotics unnecessarily.
To make our lives easy, we have put together a guideline extracted from different literatures. Please keep in mind that these are general guidelines and, for most of the cases, consultation with your physician is recommended. It is best when effective communication is established between the patient, dentist, and physician in order to plan and provide the best medical treatment for our patients.
Sources
- American Dental Association: Antibiotic Prophylaxis Prior to Dental Procedures. March 17, 2017. [accessed 2017 March 21]. http://www.ada.org/en/member-center/oral-health-topics/antibiotic-prophylaxis
- Little, James, et. al.. Dental Management of Medically Compromised Patient, 7th Edition. St. Louis, Missouri: Mosby Elsevier, 2008.