Antibiotics before teeth cleaning

Dear Dr. Roach: I have had two angioplasty procedures completed, one in 1999 and the second in 2014. Stents were inserted during each procedure. As a preventive measure, my dentist wants me to take four antibiotic pills (amoxicillin) before I see the hygienist. What is the reason for this? Do you feel it is necessary to take antibiotics before each visit to the hygienist? — E.L.S.

Answer: Antibiotic prophylaxis is not routinely recommended for people with cardiac stents. The risk of infection is very low, probably lower than the small risk of an adverse event from the antibiotics. It’s not clear that taking antibiotics would even reduce this already small risk.

People with some cardiac problems, such as a prosthetic heart valve, some types of congenital heart disease or a prior history of infection of the heart valve should take antibiotics. But, in general, antibiotics for a low-risk person is not recommended.

Of course, I would get assurance from your cardiologist that there is not something distinct about your case, but from what you have told me, I wouldn’t recommend antibiotics.