Antibiotics Before a Dental Procedure

Here are some examples of when to talk to your health care provider about antibiotics:

Do you have a penicillin allergy?

• If you had a mild reaction, like a rash, to penicillin more than 5-10 years ago, in most cases, you will not be considered to have an allergy to it. Your provider might suggest a direct oral challenge, where you take a small dose to check for a reaction. This is often as safe as a skin test, with less than a 1% chance of a serious reaction.
• If you had a reaction in the last 5 years, depending on the type of reaction, the antibiotic may need to be avoided completely, and a skin test may be needed.

Heart condition?

• Antibiotics are only helpful for patients with certain congenital heart conditions, valve replacements, or history of heart valve infection. There is no evidence that antibiotics are helpful for patients with other types of heart conditions, but they can cause harmful side effects if used when they are not needed.

Heart device?

• If you have a heart device not located in your heart valves or if you have other implanted devices, you do not need antibiotics before a dental procedure. There is no evidence that antibiotics help in these cases, but they can cause harmful side effects if used when they are not needed.

Joint replacement?

• You do not need antibiotics before a dental procedure if you have a joint replacement, orthopedic pins, plates, and screws. There is no evidence that antibiotics help in these cases, but they can cause harmful side effects if used when they are not needed.

Medical condition?

• Some patients with certain medical conditions, like immunocompromised patients, might need antibiotics before dental procedures, even if they do not have signs of infection, like fever, trouble opening their mouth, feeling unwell, or facial swelling. Talk to your health care provider about your medical condition before a dental procedure.