SD Cards heart valve leakage

HEALTH MATTERS: Benefit of antibiotics before teeth cleaning usually isn't ...

By: Dr. Joshua Wynne , Grand Forks Herald

Q. I have mitral valve prolapse and for years I was instructed to take antibiotics prior to dental procedures like teeth cleaning. I recently saw my dentist and she told me that antibiotics are no longer required. I’m confused.

A. No wonder. The confusion is the result of a recent change in our official recommendations.

Here’s the background: For years, we recommended that people who have various kinds of heart murmurs take antibiotics before dental and certain surgical procedures to reduce the risk of bacteria (“bugs”) being introduced into the body by the procedure, infecting the heart valve and damaging it.

Your condition of mitral valve prolapse, for example, is one where the mitral valve (one of the four valves in the heart that regulates the flow of blood through the heart) is abnormally thickened. The thickening of the valve makes it more susceptible to infection; hence the recommendations to take antibiotics. But our prior antibiotic recommendations never were based on good scientific evidence showing that they really worked; the recommendations were made because they made sense.

As we’ve seen more bacteria become resistant to antibiotics because their use has skyrocketed, we’ve reconsidered the value of antibiotics in conditions like yours. The newest guidelines, released just a few years ago, recommend antibiotics before procedures in only four settings:

n In patients with heart valve replacement.

n In patients who have had a previous infection of their heart valve.

n In heart transplant recipients.

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