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health advisory Hospital Dentists Yu 2007-11-11 18:18:46

I haven't been to the dentist in a while (bad me) but I decided to schedule a cleaning and they asked if I had a heart murmur, which I do. They told me I would have to have antibiotics before they could do it. This is a new dentist but in the past I have never been asked this before and the murmer has never alarmed my regular doctor. Any ideas?

Answer:

I'm a dentist.

This issue is somewhat disputed within the dental profession.

Heart murmers are not all the same. Some require antibiotic premedication (e.g. nonphysiologic murmers), others do not (physiologic murmers). Your physician should tell you whether or not it's required.

Concerning dental care, there are certain procedures that require antibiotic premedication and others that do not. Cleanings do not, technically. Nonetheless, the vast majority of dentists won't touch patients with nonphysiologic murmers who have not premedicated.

You need to take a high dose of antibiotics in order to prevent a condition called subacute bacterial endocarditis, which is caused by oral bacteria introduced into your bloodstream that can infect the endocardium--especially around the prolapsing heart valve--under certain conditions (such as turbulent blood flow caused by a heart murmer).

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A heart murmur is an indication of a pathology of the heart valves, which could be either benign or an indication of something serious. You should ask your family physician what kind of heart murmur do you have. Antibiotics are given to people with heart murmur before dental procedures to prevent endocarditis which basically means infection of your heart valves.

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It may just be a case that everyone is trying to cover their butt just in case there is a problem,