By Joy Stephenson-Laws, JD, Founder

Antibiotics are great and have saved many lives. But they should only be taken if absolutely necessary. And the bad news is that they are sometimes prescribed unnecessarily. 

According to the Centers for Disease Control and Prevention (CDC), roughly “30 percent of antibiotics, or 47 million prescriptions, are prescribed unnecessarily in doctors’ offices and emergency departments in the United States, which makes improving antibiotic prescribing and use a national priority.”

“Antibiotic resistance is one of the most urgent threats to the public’s health. Antibiotic resistance occurs when bacteria develop the ability to defeat the drugs designed to kill them. Each year in the United States, at least 2 million people get infected with antibiotic-resistant bacteria, and at least 23,000 people die as a result.” 

And now there is a recent study which suggests that dentists may be overprescribing antibiotics. The report discusses a recent study which found evidence showing that most preventive antibiotics prescribed by dentists are unnecessary.

What are preventive antibiotics?

Also called antibiotic prophylaxis, this occurs when antibiotics are given to a patient as a precaution. The antibiotics are used to prevent rather than treat an infection.

And the study, which analyzed a database that consisted of dental visits that occurred in the United States between 2011 and 2015, discovered that 81 percent of antibiotics prescribed by dentists for the purpose of preventing infections rather than treating them were unnecessary.

In addition to this, the report states that dentists are among the top prescribers in the U.S., accounting for about 10 percent of all antibiotic prescriptions. 

Why are dentists prescribing so many antibiotics?

Well, it actually has to do with heart disease. According to the report, per national guidelines high-risk cardiac dental patients are the only patients recommended to take antibiotics before a dental procedure. 

Why is this?

Two words: infective endocarditis. 

“Infective endocarditis (IE), also called bacterial endocarditis (BE), is an infection caused by bacteria that enter the bloodstream and settle in the heart lining, a heart valve or a blood vessel. IE is uncommon, but people with some heart conditions have a greater risk of developing it,” according to the American Heart Association.

But it appears that dentists may be erring on the side of caution a bit too much.

“In the past, patients with nearly every type of congenital heart defect needed to receive antibiotics one hour before dental procedures or operations on the mouth, throat, gastrointestinal genital, or urinary tract. However, in 2007 the American Heart Association simplified its recommendations. Today, antibiotics before dental procedures are only recommended for patients with the highest risk of IE…”

The study compared antibiotic prescriptions which were given out before 168,420 dental visits to the number of high-risk cardiac patients. Keep in mind these visits occurred between 2011 and 2015, well after the American Heart Association simplified its recommendation in 2007.

“They found that 81% of prescriptions did not align with the national guidelines and were provided for patients without high-risk cardiac conditions,” according to the report discussing the study.

So according to AHA, only patients with the highest risk of infective endocarditis should be given preventative antibiotics. And those with the highest risk include patients with the following:

• A prosthetic heart valve or who have had a heart valve repaired with prosthetic material.
• A history of endocarditis.
• A heart transplant with abnormal heart valve function
• Certain congenital heart defects including:
• Cyanotic congenital heart disease (birth defects with oxygen levels lower than normal), that has not been fully repaired, including children who have had a surgical shunts and conduits.

• A congenital heart defect that's been completely repaired with prosthetic material or a device for the first six months after the repair procedure.
• Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at or adjacent to a prosthetic patch or prosthetic device.

So if you do not fall into any of the above categories and your dentist gives you preventive antibiotics before a dental procedure, you may not need it. And if you take it unnecessarily, this adds to the major public health threat of antibiotic resistance. Not to mention, taking antibiotics can wreak havoc on your gut health. So you really only want to take these antibiotics if it is absolutely necessary. 

One message from all this precaution by the dental profession is that Americans are making the effort to be proactive about heart disease by taking antibiotics. It is the leading cause of death for both American men and women, and it is in many cases preventable. And if we don’t have heart disease, in most cases we will not have to worry about taking preventive antibiotics for dental procedures. 

Eat healthily, exercise, manage your stress levels and get regular check-ups to prevent heart disease. Avoid smoking and if you drink alcohol, do so in moderation. Read here to learn about specific nutrients that may help keep your heart healthy, and take routine nutrient tests to find out if you have any nutrient imbalances or deficiencies you need to address. If you do, a competent healthcare professional can work with you on making the necessary dietary changes and recommend quality supplements if necessary. Maintaining nutritional balance is key in maintaining a healthy heart.

Enjoy your healthy life!

The pH professional health care team includes recognized experts from a variety of healthcare and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products and services. To learn more about the pH Medical Advisory Board, click here.