antibiotics and teeth cleaning

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Antibiotics - Do I need them to get my teeth cleaned??

The bottom line on this issue, according to Dr. Chidyllo of Eatontown, NJ, is that there is no bottom line. Dr. Chidyllo is board certified by the American Board of Plastic Surgery and also has training in dentistry and a D.D.S. degree. Dr. Chidyllo feels that, intuitively, surgeons should obviously treat their patients with prophylactic oral antibiotics in the period directly after the placement of the implants. This should be done for any procedure which causes a transient bacteria, such as Dental Surgery, Colonoscopy, urological Treatment (cystoscopy), and gynecological treatment. Probably one dose, one hour prior to the treatment followed by one dose after the treatment should be sufficient, as long as the patient is not immunocompromised. This should be done for the first six months to one year after the implant placement. There is no data to support this - in that a study was never done in this country. However intuitively surgeons should treat breast implants like any foreign body implantable medical device, like pacemakers and total joint replacements. Concerning general dental cleaning, the issue is even more vague. We cause a bacteremia every time we brush our teeth. And a dental cleaning is only a more mechanical "brushing of the teeth". Although superficial dental cleaning should not require antibiotics, deep cleaning and periodontal treatment should get antibiotics therapy. There however have been anecdotal reports of increased capsular contracture after infections from dental treatment. Dr. Chidyllo does prescribe oral antibiotics prior to the above outlined treatment except for superficial cleanings or routine dental treatment (fillings), as long as the patient does not have evidence of an immunocompromised state. Other doctors recommend antibiotic pre-medication prior to all dental work. Best bet is to follow your particular surgeon's advice. If you wish to be more conservative, most doctors will agree that pre-medication prior to dental treatment is not going to hurtful. Call your dentist or your plastic surgeon, as you feel comfortable with, and ask for a prescription to be called in for you on the day before your treatment. Many thanks to Dr. A. Chidyllo, M.D., Eatontown, New Jersey for his contribution to this answer. Updated: 08/18/100