This paper is designed to provide scientifically based guidance to clinicians regarding the use of antibiotics in endodontic treatment.
These recommendations are taken from 2017 American Heart Association and American College of Cardiology focused update of the 2014 AHA/ADA Guideline for Management of Patients with Valvular Disease and cited by the ADA.
Prophylaxis against infective endocarditis is reasonable before dental procedures that involve manipulation of gingival tissue, manipulation of the periapical region of teeth, or perforation of the oral mucosa in patients with the following:
In 2017, the AHA and American College of Cardiology (ACC) published a focused update to their previous guidelines on the management of valvular heart disease.
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This reinforced their previous recommendations that AP is reasonable for the subset of patients at increased risk of developing IE and at high risk of experiencing adverse outcomes from IE.
The practitioner and patient should consider possible clinical circumstances that may suggest the presence of a significant medical risk in providing dental care without antibiotic prophylaxis, as well as the known risks of frequent or widespread antibiotic use.