Amy Dukoff, D.M.D.
Finally, Premedication Makes Sense! |
Amy Dukoff
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 URING
MY MANY YEARS of practice, the issue of antibiotic premedication has
been constantly debated, and guidelines for premedication regimens have
often changed. For all those years, practically speaking, none of
the regimens seemed credible. At one time, antibiotics were given
preoperatively and postoperatively, which seemed excessive. After
that, the prescribed regimen changed many times, adhering to different
philosophies. Finally, the consensus has arrived at a regimen
that makes sense. The current thinking is that antibiotics are
not needed for many of the medical conditions that previously were
thought to require medication. That does make sense. In the
past, some patients probably had a condition that needed antibiotics
and lied about having taken their premedication, yet they lived!
I’m glad that the American Heart Association (AHA)
recognizes the fact that people are more likely to develop infective
endocarditis (IE) as a result of everyday activities than from a dental
procedure. Finally, we need no longer fear the loss of chair time
when a patient fails to take a suggested premedication.
Premedication is still necessary in certain instances according to the
AHA. Patients with artificial heart valves, previous history of
endocarditis, heart transplants, and certain congenital heart
conditions require it. Furthermore, the American Academy of
Orthopaedic Surgeons still recommends premedication for patients with
hip replacement within the first two years following the
procedure. However, premedication is no longer needed for
patients with mitral valve prolapse, bicuspid valve disease, calcified
aortic stenosis, and other conditions that were formerly considered to
require it. One can always check with the American Dental
Association for questions about the new antibiotic prophylaxis.
September - October 2007
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Premedication is necessary in certain circumstances.
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To speed up access without perforation, use the PulpOut™ Bur. |
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