1. The following medical conditions require antibiotic prophylaxis for dental procedures where bacteremia could occur such as after manipulation of gingiva or the tooth apex or when oral mucosa is perforated:
•Prosthetic heart valves, previous endocarditis, unrepaired congenital heart disease, post-transplant valvulopathy
o See 2007 AHA guidelines
• Vascular grafts (less than 6 months old)
• Arteriovenous hemodialysis shunts
• Neurosurgical shunts (dependent on type)
• Indwelling vascular catheters•Vascular grafts (less than 6 months old)
Antibiotic prophylaxis prior to undergoing dental procedures is NOT required for patients with cardiovascular implantable devices, such as defibrillators or pacemakers.
According to 2013 AAOS-ADA clinical practice guidelines, "the practitioner might consider discontinuing the practice of routinely prescribing prophylactic antibiotics for patients with hip and knee prosthetic joint implants undergoing dental procedures."
References:
Wilson, W et al. Prevention of Infectious Endocarditis: Guidelines from the AHA. Circulation. 2007; 116:
Watters W et al. Prevention of Orthopaedic Implant Infection in Patients undergoing Dental Procedures: Executive Report. J the Am Acad of Orthopedic Surgery. 2013; 21:
Baddour, L.M., et al. A summary of the update on cardiovascular implantable electronic device infection and their management. JADA. 2011; 142(2):
Berbarie EF, et al. Dental procedures as a risk factor for prosthetic hip or knee inf. Clinical Infectious Disease. 2010; 50:8-16.
Friedlander AH. Prevalence of staphylococci in the mouth and presence of streptococci in late infection of knee and hip joint prosthesis: antibiotic prophylaxis, a conundrum. Spec Care Dentistry. 2009; 29(6):
Little JW, Jacobson JJ, Lockhart PB. American Academy of Oral Medicine. The Dental Treatment of Patients with Joint Replacement: A Position Paper from the American Academy of Oral Medicine. JADA. 2010; 141(6):