Tooth Talk: Antibiotics before teeth are cleaned

Something you may not know, but definitely should

— Q: Hey Doc, my wife went to the dentist the other day for a cleaning and was told she needed to take an antibiotic because she had a knee replacement. We never heard anything about this and she was too embarrassed to ask. Is this common? What should she do?

A: It is extremely common. Unfortunately, recent changes to the guidelines regarding the use of antibiotic prior to dental treatment have made it very confusing for patients and practitioners alike. Many people who in the past have always taken antibiotics prior to dental treatment are now being told it is no longer necessary. The same is true for other people who are unaware that their medical condition or their recent surgery now makes taking antibiotics prior to dental treatment a necessity.

The general rule of thumb is that anyone who has had a knee or hip replacement or aortic valve transplant needs antibiotic pre-medication prior to dental treatment. For hip and knee replacement, antibiotics are taken for two to three years and for aortic valves they are taken for a lifetime.

In certain instances, the length of time for pre-medication may be extended. I would advise anyone who has had any of these surgeries to consult with their physician and/or orthopedic surgeon. Each physician will have specific guidelines regarding the use of antibiotics for those patients in their care.

Okay, so now you know its necessary, but you may be wondering why? Most people are aware that the human mouth contains a huge amount of bacteria. When you have your teeth cleaned or have dental work performed, some of that bacteria are released into the bloodstream. People that have had these types of surgeries are at a higher risk of systemic infection because the bacteria can travel to the site of the transplant or replacement and attack the site.

Antibiotics play a very important role in that they prevent that from happening. I’ll go further into this topic in my next column.

For now, suffice it to say, that no one should ever be embarrassed to ask questions about something pertaining to their health. Ask away, we are here to help.

Dr. Eck would like to thank everyone for all of the e-mails and questions he receives.

Questions can be sent to Fred Eck, D.D.S. at Marco Dental Care, 950 N. Collier Blvd., Suite 305, Marco Island; call 389-9400 or visit He received his Doctor of Dental Surgery at the University of Detroit Mercy and is licensed by the Florida State Board of Dentistry.

© 2008 All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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