Changes in care for Mitral Valve Prolapse

[drummerswife]

As most of you know, I avoided dentists for years but when I was a kid and up until my early adult years, whenever I did go I had to take a hefty dose of antibiotics like an hour before the appointment. I was told this was because I was born with a mitral valve prolapse. For those of you who dont know what that is, its a valve in the heart which can sometimes have a defect in it. I was told by a heart doctor that mine was hereditary (thanks dad) I was told that the meds were to prevent an infection in the heart.
When I fisrt began seeing Dr. Katy, she and my regular doctor researched this issue carefully because they thought the practice on this had changed and the antibiotics were no longer needed. And they in fact discovered they were right. So i have never had them for any of the work I have had done this past year. The oral surgeon also checked on this.
I was just wondering if anyone knows why this was changed?

 

[alleyp]

hey! Info here: NICE guidelines on antibiotic phophylaxis against infective endocarditis It's a long document so here's the good bit:

In summary, this guideline recommends that antibiotic prophylaxis solely to prevent IE should not be given to people at risk of IE undergoing dental and non-dental procedures. The basis to support this recommendation is:
• there is no consistent association between having an interventional procedure, dental or non-dental, and the development of IE
• regular toothbrushing almost certainly presents a greater risk of IE than a single dental procedure because of repetitive exposure to bacteraemia with oral flora
• the clinical effectiveness of antibiotic prophylaxis is not proven
• antibiotic prophylaxis against IE for dental procedures may lead to a greater number of deaths through fatal anaphylaxis than a strategy of no antibiotic prophylaxis, and is not cost effective.

sure a dentist will be along later but see if that gives you more info?

xx

 

[drummerswife]

WEll, golly gee who needs a dentist when I've got my own researchers! Well done and thank you!

 

[olivacs]

Very interesting Drummerswife... My own mother suffers from mitral valve prolapse and always till this day had had to do the antibiotic route before dental procedures. I will have to show her all of this great information.

 

[Stress Doc]

Great question. Antibiotics were prescribed because it was believed that antibiotics would prevent infective endocarditis (IE), previously referred to as bacterial endocarditis.

This is an infection of the heart’s inner lining or valves, which results when bacteria enter the bloodstream and travel to the heart.

As of 2007, The American heart Association recommends that
most people with this condition no longer need short-term antibiotics as a preventive measure before dental treatment.

The American Dental Association has adopted these guidelines.

The guidelines are based on a growing body of scientific evidence that shows the risks of taking preventive antibiotics outweigh the benefits for
most patients. The risks include adverse reactions to antibiotics that range from mild to potentially severe cases. Inappropriate use of antibiotics
can also lead to the development of drug-resistant bacteria like MRSA.

Scientists also found no compelling evidence that taking antibiotics prior to a dental procedure prevents IE in patients who are at risk of developing a
heart infection. Their hearts already are often exposed to bacteria from the mouth, which can enter their bloodstream during basic daily activities such as brushing or flossing.

The new guidelines are based on a comprehensive review of published studies that suggests IE is more likely to occur as a result of these everyday activities than from a dental procedure.

However, it is best to consult with your doctor and make a decision based upon your own case. Guidelines are general in nature and any medical decision needs to be based upon your data.

Blessings