Dentists mistakenly believe that antibiotics, including fluoroquinolones, will prevent infection from bacteria in most patients if given prophylactically prior to dental procedures. However, a federally funded study showed that more than three-quarters of these drugs prescribed before dental procedures were unnecessary.  Dentists are the fourth most frequent prescribers of oral antibiotics in the U.S., accounting for one in 10 pharmacy prescriptions.

A U.S. database of medical claims from 2011 to 2015 identified 168,000 dental visits in which 91,000 patients had received an antibiotic within seven days before the dental visit despite the patients having shown no history of hospitalization or infection outside of the mouth.  Median age of these patients was 63 years, 57% of them were female and 43% were male. 

The study, reported in the Worst Pills Best Pills Newsletter, noted that inappropriate use of antibiotics for dental procedures not only contributes to the problem of antibiotic resistance but also exposes patients to increased risk of diarrhea and other adverse events. Conditions for which antibiotics are appropriate are 1) when the patient has an artificial joint or heart valve, has a heart transplant, a history of endocarditis, or has a certain type of congenital heart disease and 2) when the patient will undergo gum or root canal work or perforation of the mucous membrane.  

Advice:  Discuss this study with your dentist and cardiologist if you are considering invasive dental work and whether you really need that antibiotic.