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$Pretitle{Circulatory System}
$Title{Antibiotics Before Dental Work for a Mitral Valve Prolapse Patient}
$Subject{valve mitral prolapse dentistry antibiotic}
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Copyright (c) 1991   Tribune Media Services, Inc.


Antibiotics Before Dental Work for a Mitral Valve Prolapse Patient


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QUESTION:  While your recent answer about mitral valve prolapse (MVP) was
informative and for the most part correct, you failed to mention the need to
take antibiotics before dental work.  My cardiologist is always warning me
about this, and I think your readers should also be informed of the dangers.
Please include this information in your column soon.

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ANSWER:  Thank you for your suggestion and your concern.  And you certainly
make a good point.  The American Heart Association does suggest that
antibiotics be given to all individuals with mitral regurgitation or leakage
around the mitral valve before even minor surgery, including dental work.  In
about 95 percent of people who have some sort of dental treatments, bacteria
will enter the blood stream, for at least a short time.  However individuals
with normal heart valves and normal immune systems are able to combat this
invasion, and no serious illnesses develop.  People with faulty valves are
less able to resist, and antibiotics are given.  A recent article in the
Journal of the American Medical Association concludes that people over the age
of 60 were four times less likely to be advised to take these antibiotics by
their physicians than younger patients.  This could be due to the fact that
the number of patients with MVP becomes less as patients are older, or that
elderly people just don't receive preventive measures as often as younger
folks.  There is still some controversy about the need for this intervention,
as even the chance of infection among high risk patients is relatively low,
and data to support the recommendations is limited.  However, if you know you
have MVP and are about to undergo dental work, a little hint to your physician
requesting an appropriate antibiotic seems in order.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
