Absence of Preventative Antibiotics May Lead to Dental Heart Infection
British health experts have encouraged dentists to avoid writing prescriptions for preventative antibiotics prior to performing dental procedures for years. However, a recent study reveals this may serve as dental malpractice, as an increasing number of dental patients have developed heart infections as a result of this prescription delay.
On November 18, representatives from medical journal, The Lancet, presented a study at the American Heart Association’s annual conference and published results revealing that dentists have seen an increase in heart infections among their patients since they began reducing the number of prescriptions for preventative antibiotics.
Previously, it was very common for dentists both in the U.S. and England to prescribe a preventative course of antibiotics prior to beginning dental work. This was done to prevent instances of dental heart infection, such as endocarditis.
The American Heart Association issued a warning in 2007, urging dental providers to stop prescribing preventative antibiotics, due to increasing concerns regarding prescription antibiotics and the risk of drug-resistance.
Research teams from Oxford University and the University of Surrey studied the impact of cutting back on prescription antibiotics. Results indicated that as the number of prescriptions went down, the number of endocarditis cases increased by 35 more per month.
While this new research does not verify beliefs that a decrease in the number of preventative prescriptions is the cause for the upsurge in the amount of endocarditis cases, it does strongly suggest a link.
In total, prescriptions for patients undergoing dental work dropped from nearly 11,000 per month during the four year period prior to the policy change, to an average of 2,200 per month in the five year period following the change. When the study ended on March 31, 2013, the average number dropped even farther to 1,300 per month.
In March 2008, researchers also noticed that the number of heart valve infections began to increase above normal levels. Researchers determined that 277 antibiotic prescriptions would need to be written to prevent just once case of endocarditis.
Risk of heart infection from dental work
Some dental procedures allow bacteria in the mouth to be pushed into the bloodstream. The bacteria proceeds to travel to the heart, causing endocarditis. While this infection is very rare, it is incredibly severe, infecting the tissues lining the chamber of the heart. In fact, endocarditis is fatal in 10 to 20 percent of cases.
It is challenging for a healthy immune system to combat endocarditis and especially problematic for those who already have a heart condition. Patients with congenital heart disease, naturally leaky heart valves, artificial heart values and other heart implants are at a much greater risk for developing the infection.
Dentists in England stopped the formerly common practice of prescribing preventative antibiotics to patients prior to undergoing dental work. Officials believed there wasn’t enough evidence to support the benefits of this practice. Additionally, they were concerned about allergic reactions and overuse of antibiotics, which can promote drug-resistant bacteria.
It is important to note that dental patients in the U.S. are still prescribed preventative antibiotics.