If you have breast implants, should you take preventative antibiotics before visiting the dentist? Dental cleanings and other procedures can release bacteria from the mouth into the bloodstream, and in very rare cases, these bacteria can create infections in other parts of the body.

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Patients who have breast implants do not have a higher risk of developing infections than other dental patients, but if they do develop an infection around the implant, it may have to be removed. For this reason, a number of plastic surgeons recommend that implant patients receive antibiotics before dental work. However, many dentists feel this is not necessary, so ultimately the choice is up to you.

Why Taking Antibiotics Might Be Right For You

Dr. Richard Dowden, a plastic surgeon in Cleveland, OH, explains that the risk of developing a problem around a breast implant after dental work is very rare, yet real. In over 30 years of performing breast implants, Dr. Dowden has seen 11 women experience complications with their breast implants after dental procedures.

The problems included capsular contracture, infections that cleared up with antibiotics, and infections that led to the removal of an implant. Like many other plastic surgeons, Dr. Dowden considers the risk of taking a single dose of antibiotics before dental work to pale in comparison to the risk of developing irreparable problems with your implant.

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Disadvantages Of Taking Prophylactic Antibiotics

On the other hand, overusing antibiotics is associated with a host of public health problems. For example, overusing antibiotics can lead to the development of antibiotic resistant bacteria, such as methicillin-resistant Staphylococcu aureus (MRSA). For this reason, several health care associations, including the American Dental Association and the American Heart Association, have revised earlier guidelines regarding premedication with antibiotics before dental work.

While the American Heart Association previously recommended that a wide variety of patients with heart problems take antibiotics preventatively, the new 2008 guidelines are more restricted; including only patients who have artificial heart valves, have previously had endocarditis, have valve problems with a heart transplant or have certain congenital conditions. However, the American Association of Orthopedic Surgeons still recommends that patients with artificial joints take preventative antibiotics before dental work, because developing an infection around an artificial joint can be particularly devastating.

Many dental experts also do not recommend preventative antibiotics for patients with breast implants, arguing that little evidence-based research supports this practice. Exceptions include patients who have had trouble with infections around their implants in the past. In this case, the patient's plastic surgeon should write the prescription for the antibiotics.

How To Decide

If your plastic surgeon and dentist offer differing recommendations regarding preventative antibiotics, you should ask your dentist to call your surgeon to discuss your case.

If your surgeon insists that you ought to take the antibiotics, or if you feel most comfortable taking them, your surgeon should write the prescription for you. For the vast majority of women with implants, dental procedures with or without premedication prove to be safe and uneventful.