Do your dentist appointments entail taking a round of antibiotics before you even open your mouth? If so, it’s time to question that extra step, because it turns out that in most cases, the drugs aren’t necessary.

In the past, guidelines from the American Dental Association (ADA) and other medical organizations recommended that millions of Americans get antibiotics before any dental treatment, including routine cleanings. That was because of the concern that people who had artificial joints or heart problems could be more vulnerable to infection from bacteria that enter the bloodstream through wounds in the mouth. The idea was that antibiotics would kill off any threatening bacteria.

But newer research shows that only a small group of heart patients are actually at higher risk for infection. Updated ADA treatment guidelines for dentists now advise antibiotics before dental procedures for only a few types of patients such as those with artificial heart valves, a history that includes a heart infection, or who were born with certain serious heart defects.

In other words, most people don’t need to take antibiotics before they go to the dentist.

That’s good news because antibiotics commonly cause side effects such as nausea, vomiting, and diarrhea and more rarely trigger serious allergic reactions. They can also kill off protective bacteria in your intestines, leaving you vulnerable to infections from bacteria such as clostridium difficile (C. diff), which can be life-threatening. 

Read more about the dangers of overuse and misuse of antibiotics in our special report.  

Major Change in Dental Practice

“There’s been a major change in practice and it’s led to some confusion on the part of both patients and practitioners,” says Thomas P. Sollecito, DMD, chair of oral medicine at the University of Pennsylvania School of Dental Medicine. Since the initial 2013 release of recommendations regarding treatment of patients with artificial joints, for example, the ADA Member Service Center reports that they've fielded more than 360 calls from dentists asking for clarification. Sollecito led the effort to craft more specific and practical guidelines, which the ADA published last year.

Sollecito says that new recommendations reflect the “growing recognition that antibiotics have risk and should only be used when necessary.” He points out that in addition to individual risks of side effects, overuse of dental antibiotics “contributes to the population-wide problem of antibiotic resistance.”

 “We all need to be better stewards of these life-saving drugs,” he says.

Consumer Reports' comprehensive Antibiotic Resistance Guide explains more about the problem and tells you what you need to know to protect yourself and your family.

Bottom line: Recommendations may have changed since the last time you saw your dentist. If you typically take dental antibiotics in advance of appointments, you should talk to your healthcare providers about whether that’s still necessary.

“It’s important for patients to have a dialog with not only their dentist, but also their other physicians such as their orthopedic doctor or cardiologist to talk about what’s best for their needs,” says Sollecito.    

Editor's Note: These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).