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There are certain medical conditions which one might have for which precautions have to be taken by the dentist before any dental work is started. Some of these conditions can lead to life-threatening consequences if adequate precautions are not taken. It is for this reason that we ask you to fill out our medical history form completely and not to forget to update us at your future appointments whenever changes have occurred in your medical history. Following are some examples of information we have to know:
Allergies
Heart Murmurs and Antibiotics
If you have allergies, you must let us know what they are. We use many materials and medications in dentistry and we have to know if any of them will adversely affect you.
Heart murmurs can be caused by a disease such as rheumatic fever or simply by the physical shape and incomplete closing of the heart valve. The first case is a pathological murmur as a result of scarring on the heart valve while the second case is functional. The two types of heart murmurs cannot be distinguished by a physician unless he has a special test done called an ''echogram''. The problem with pathological heart murmurs is that if bacteria colonize the scarred valve, they proliferate and eventually cause a life-threatening disease called subacute bacterial endocarditis. Antibiotics cannot reach a scarred area because a scar has no blood supply. Therefore, it is of extreme importance to prescribe antibiotics in advance of the bacteria reaching the scarred area on the heart valve. Most dental procedures, such as probing the gums, and certainly scaling and fillings, will cause transient bacteremias, or short-term bacterial invasion of the blood supply. Where there is a pathological heart murmur, therefore, prescribing and taking the recommended antibiotics in advance can be a life-saving precaution. As a matter of fact, because in many cases, rheumatic fever can occur in childhood as a mild case which goes undetected, whenever a heart murmur is present and an echogram has not been done, we will prescribe antibiotics for you prior to dental treatment. Other conditions for which prophylactic antibiotic coverage is required prior to dental work are mitral valve prolapse, and the presence of any artificial joints and hip replacement. Please feel free to discuss these conditions with us for your own well-being.
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