Imel,i don’t know what your professional qualifications are,but it seems odd that you “know of many patients whom have experienced problems from NOT using prophylactic antibiotics before dental proceedings”,but apparently,the panels of researchers who have studied and convened on these matters and have advised based upon science and evidence do not share your opinion. The overuse and misuse of antibiotics has been rampant for many years in the health professions and livestock farming and elsewhere,and the results of this folly are well-documented. Do you propose to perpetuate this mistake,and turn a blind eye to the evidence,because “that was how we used to do it”?

At my office we follow the recommendation of the orthopedic surgeon regarding prophylactic a/b. I do think that there should be consideration given to the patient’s oral health though. Someone with meticulous oral hygiene is much less likely to experience a significant bacteremia than someone with gingivitis or periodontitis.

Ideally all aspects of the patient’s health should be considered, with multidisciplinary approach, with the final informed consent made by the patient. Unfortunately the inability of health professionals to protect themselves against litigation, even in an obviously fully informed case, makes us very reluctant to operate this way.