How Does the New American Heart Association Ruling Affect Me?
The American Heart Association (AHA) and its advisory committee recently came out with new guidelines for prevention of heart valve infections after certain procedures including dental work.
The AHA guidelines now state that antibiotics prior to procedures prevent an exceedingly small amount of endocarditis (infection of the heart valves) and actually may cause more harm than good. Common heart valve defects, like mitral valve prolapse, no longer require antibiotic prophylaxis prior to dental procedures. In fact, the only heart abnormalities that require pre-procedure antibiotics are prosthetic (implanted) heart valves, previously infected heart valves, certain heart birth defects, and heart transplant patients with valve abnormalities.
IF YOU HAVE HHT, this new ruling may or may not apply to you. With HHT, the concern for infection is not about the heart valves specifically, but rather it is about bacteria getting into the blood stream and passing through the lungs which can then be placed anywhere within the body. This is true for all “dirty procedures”, not just dental work and teeth cleaning. Therefore, it is very important that you talk to your HHT doctor about your specific situation.
Basically, there are two categories of HHT patients with regards to needing antibiotics prior to any “dirty procedures”, like dental work.
DO NOT NEED prophylactic (preventive) antibiotics if your lungs have been screened at an HHT Treatment Center and you do not have any PAVMs.
NEED prophylactic antibiotics if you have PAVMs OR if you haven’t been formally screened by an HHT Treatment Center and you aren’t sure if you have PAVMs.
If you have been screened / treated at an HHT Treatment Center within the last 3-5 years, and you have questions about your specific prophylactic antibiotic needs, then you should call the HHT Center directly.
If you’ve never been to an HHT Treatment Center or it’s been more than five years since you’re last visit and you have questions about prophylactic antibiotics, you should have your local physician contact the center.