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Too Few Heart Patients Take Antibiotics Before Dental Work

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Manning's study looked at about 200 patients seen at the Beth Israel Deaconess Medical Center in December 1997. As directed by the new AHA guidelines, all the study patients had an echocardiogram, a test that uses sound waves to look at the heart and its valves.

Almost half of the patients who took part in the study had abnormal echocardiograms, suggesting that they needed antibiotics before dental work. Almost 90% of the patients who were at high risk for heart infection were told by their doctors to use preventive antibiotics, but only 60% of those at moderate risk got this advice. About 25% of those at low risk of heart infection -- who the AHA guidelines say don't need antibiotics -- were instructed to take them.

"The problems with taking antibiotics when you don't need them are the inconvenience, the cost, and the risk of an allergic reaction," Manning says. "On the other hand, if you need antibiotics and don't take them, there could be a life-threatening complication."

When asked for his recommendations, Manning says: "If you're taking antibiotics and it's been awhile since your situation has been reviewed, you should ask your doctor if you still need them. If you've had an echocardiogram and you're not using antibiotics for dental procedures, you should ask your doctor to review the echocardiogram to see if you do need them."

Although most patients in Manning's study followed their doctor's advice to take antibiotics, 13% did not. Better education for both doctors and patients may allow more appropriate antibiotic use while avoiding misuse, the study says.

Vital Information:

  • People with certain heart conditions, especially those involving the heart valves, should take antibiotics one hour before dental work or similar procedures to avoid a potentially fatal heart infection called endocarditis.
  • A study published in the Journal of the American Medical Association showed that about 40% of those who should take preventive antibiotics were not advised by their doctors to do so, and about 25% of those who are at low risk of endocarditis take antibiotics needlessly.
  • Patients with valve problems or other heart conditions should have an echocardiogram, and should consult their doctors about preventive antibiotic use.
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Only 18.5% of Americans never floss. You are missing out on a simple way to make a big difference in the health of your mouth. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Floss removes food trapped between the teeth and removes the film of bacteria that forms there before it turns to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Try flossing just one tooth to get started.

You are one of 31% of Americans who don't floss daily. You are missing out on a simple way to make a big difference in the health of your mouth. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Aim for 3 more days!

You are one of 31% of Americans who don't floss daily, but you're well on your way to making a positive impact on your teeth and gums. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Aim for all 7 days!

Only 50.5% of Americans floss daily, and good for you that you are one of them! Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Congratulations on your good oral health habit!

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American Dental Association, Healthy People 2010

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