AHA changes tact: Fewer patients need antibiotics prior to dental care

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The American Heart Association (AHA) has shifted its recommendations to emphasize routine oral care and pre-procedure antibiotics only for some people, according to a report in the October issue of the Harvard Heart Letter.

For years, the AHA has urged the majority of people to take antibiotics before having dental work or other procedures that might flood the bloodstream with bacteria. The association proposed that antibiotics prevented infective endocarditis, a potentially serious infection of the heart's lining.  

While the recommendation has held strong since the 1950s, no large trials have tested whether taking antibiotics before dental work actually prevents endocarditis. If antibiotics do help, the effect is so small that the risk of side effects from the medication outweighs the benefits for most, according to the Harvard Heart Letter.

The AHA now says antibiotics are only needed before dental procedures if the patient has an artificial heart valve, had endocarditis before or had a heart transplant and developed a valve problem.