Q: Who should take antibiotics before going to the dentist?
A: Far fewer people than were advised to do so in the past should take antibiotics before going to the dentist. The idea of taking antibiotics before dental procedures is to prevent bacterial endocarditis, a life-threatening heart infection. But very few people develop endocarditis after dental work, and antibiotics would prevent only a tiny fraction of cases.
According to the American Heart Association (AHA), the overall risks from taking antibiotics before dental procedures as a preventive (these include allergic reactions and the development of drug-resistant bacteria) outweigh the small benefits.
However, the AHA (along with the American Dental Association) still recommends prophylactic antibiotics for people at highest risk for endocarditis—those with an artificial heart valve, valve problems after a heart transplant, previous endocarditis, or specific congenital heart conditions. People with mitral valve prolapse are not considered at high risk.
Routine use of antibiotics for dental patients who have had a total joint replacement is no longer recommended.
Also see Fluoride Treatments: Do or Don't?