Q: My dentist recently told me that I no longer need to take antibiotics before I get my teeth cleaned. I've had a heart murmur and in the past always needed to take antibiotics. Do I need to worry?

A: For many years people with certain heart conditions were advised to take antibiotics before any invasive dental treatment was done. It was believed that the antibiotics would prevent an infection of the heart valves or heart lining (infective endocarditis) caused by the bacteria in the mouth introduced into the bloodstream during the dental procedure. One of the most invasive dental treatments was having the teeth cleaned, since the sharp dental scalers used beneath the gum line caused the gums to bleed. In 2007, the American Heart Association recommended that most patients no longer need to take the antibiotics before dental treatment. These include those with mitral valve prolapse, and rheumatic heart disease, which were commonly seen. Antibiotics are still advised for patients with artificial heart valves, a history of infective endocarditis, heart transplant that develops valve problems and certain serious congenital heart conditions. Patients with congenital heart disease should consult with their cardiologist before any decision regarding the use of antibiotic prophylaxis before dental procedures. You may obtain additional information from the American Heart Association (www.americanheart.org).

Molly P. Newlon, DDS, MA, graduated from UOP Dental School in 1982 and completed a GPR residency at the Veteran’s Administration Hospital in San Antonio, Texas. She was director of the Faculty Dental Practice for nine years, and 11 years ago became director of health and safety for the UCSF School of Dentistry. Molly provides training in infection control and health and safety to faculty, students and staff, and is an active member on numerous campuswide committees on health and safety and terrorism preparedness. Send your questions to molly@smartnow.com.