Mitral Valve Prolapse and Dental Treatment: Do You Need Antibiotics?

Mild mitral valve prolapse and dental treatment?

Hello, I was diagnosed with mild mitral valve prolapse during middle school, and sometimes I experience slight regurgitation.
I have read online that many people say that those with mitral valve prolapse must take antibiotics before dental treatments to prevent endocarditis.
I would like to know if this is really necessary, or if there are different levels of severity.
Before I was aware of this information, I had visited the dentist many times without being informed about this condition.
Although I have been fine, I still want to understand this clearly for peace of mind.

Xiao Zhe, 10~19 year old female. Ask Date: 2018/05/01

Dr. He Dongjin reply Cardiology

Hello, if you have mitral valve prolapse, there is a risk of developing infective endocarditis.
If you are concerned, you can inform your physician to consider adding antibiotics for extra reassurance.
Changhua Hospital cares about your well-being.

Reply Date: 2018/05/01

More Info

Mitral Valve Prolapse (MVP) is a common heart condition where the mitral valve does not close properly, which can sometimes lead to mitral regurgitation. Patients with MVP often have concerns about the potential risk of infective endocarditis, especially when undergoing dental procedures. Infective endocarditis is an infection of the inner lining of the heart chambers and valves, which can occur when bacteria enter the bloodstream and attach to damaged areas of the heart.

Historically, it was recommended that patients with certain heart conditions, including MVP, take prophylactic antibiotics before dental procedures to prevent infective endocarditis. However, recent guidelines have evolved based on emerging evidence. According to the American Heart Association (AHA) and other medical organizations, antibiotic prophylaxis is no longer routinely recommended for patients with MVP unless they have a history of infective endocarditis, a prosthetic heart valve, or specific congenital heart defects.

In your case, since you mentioned having mild mitral valve prolapse with occasional mild regurgitation, it is unlikely that you would need antibiotics before dental treatment. The key factors that would necessitate antibiotic prophylaxis include:
1. History of Infective Endocarditis: If you have previously had infective endocarditis, you are at a higher risk, and prophylactic antibiotics may be recommended.

2. Prosthetic Heart Valve: If you have had a valve replacement or repair with prosthetic material, antibiotics are typically advised.

3. Certain Congenital Heart Conditions: Some congenital heart defects require prophylaxis, but MVP alone does not fall into this category unless there are other complicating factors.

4. Severe Mitral Valve Regurgitation: If your condition progresses to severe regurgitation or if there are other significant cardiac issues, your healthcare provider may reassess the need for prophylaxis.

It is essential to communicate your medical history to your dentist or oral surgeon before any dental procedure. They will evaluate your specific situation and determine whether antibiotic prophylaxis is necessary based on current guidelines and your overall health status.

Regarding your concern about having undergone dental treatments without being informed about your MVP, it is crucial to have open communication with your healthcare providers. If you have any doubts or concerns, do not hesitate to bring them up during your dental visits. Your dentist can consult with your cardiologist if needed to ensure that all precautions are taken.

In summary, for most patients with mild mitral valve prolapse, especially those without a history of infective endocarditis or significant heart issues, antibiotic prophylaxis before dental procedures is generally not required. However, always consult with your healthcare provider for personalized medical advice tailored to your specific condition.

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