Why are antibiotics so important before any dental work or surgery?

As I had posted before I have HBP and valvular disease. My FP stated that before I have any dental work or surgery, I need to take antibiotics. Why is that? What happens if a person doesnt take antibiotics before a procedure? Is it very risky or life threatening not to take antibiotics before surgery or dental work? Thank you for your time!

[CCF-M.D.-RCJ]

Dressagequeen,

Thanks for the post.

Persons with valvular disease have a somewhat higher incidence of developing endocarditis -- infection of the heart valve -- after a dental procedure.  Most dental procedures involve some degree of bleeding.  Bleeding means that a portal of entry exists between the mouth and the blood stream.  It is estimated, broadly, that between 8 to 80% of dental procedures are associated with some transient bacteria being present in the blood.

The evidence to for the benefit of antibiotics is not as firm as the recommendation from the ACC/AHA.  Most of the studies showing benefit are animal studies.  A controlled trial in humans has not been performed.  However, a higher incidence of endocarditis after dental procedures exists for persons with valvular disease, and thus the recommendation to take antibiotics.

To find out more, check out the ACC site:
http://www.acc.org/clinical/guidelines/valvular/dirIndex.htm

Hope that helps.