My dentist says no antibiotics for a valve, my sister's dentist abroad insists on them. Which of them is right?

#1TwoNightsTerry(Joined Feb 2026 · 63 posts)August 18, 2026, 6:12 pm

Went for a scale and polish last week, told the dentist I have a replaced aortic valve as I have been told to do a hundred times, and braced myself for the antibiotic conversation. She checked my notes, said it is not routinely recommended here for a clean, and got on with it.

Then I mentioned it on the phone to my sister, who has been living abroad for years and had a valve done before I did, and she was horrified. She has never once had dental work without a dose beforehand and says her cardiologist was adamant about it. She is now convinced I have been let down by my dentist, and honestly she has got me second guessing the whole thing.

So which is it. Do people with a prosthetic valve need antibiotics before the dentist or not? It cannot be right that it depends on which country you happen to be sitting in. And if I do not need them for a clean, is there anything I DO need them for.

#2Marlene K(Joined Mar 2026 · 31 posts)August 19, 2026, 9:40 am

I asked this at my six month check because my hygienist raised an eyebrow at the same thing. What I was told was that the daily brushing and flossing and the regular check ups do far more to protect the valve than any single dose ever will, and that the dose question is genuinely a matter of local guidance rather than one of them being wrong.

Did not entirely satisfy me either, if I am honest.

#3Ron Castellano(Joined Feb 2026 · 47 posts)August 19, 2026, 8:03 pm

What I do regardless of the antibiotics argument is carry a card. Little laminated thing in the wallet saying prosthetic aortic valve, the date, and the type. Cost me nothing and it means I am not relying on remembering to say it while someone has their hand in my mouth.

Came in handy at a walk in centre when I had a chest infection too. The nurse read it and immediately asked a different set of questions.

#4Dr. Helena VossClinical reviewer(Joined Jan 2026 · 58 posts)August 21, 2026, 11:26 am

Terry, both dentists are following their own national guidance, and neither is being careless. This is one of the few areas in valve care where reputable bodies genuinely differ, and it helps to know that rather than assume someone has slipped up.

The direct answer: guidance differs by country. Some bodies recommend a single antibiotic dose before certain dental procedures for people with a prosthetic valve. The National Institute for Health and Care Excellence in the United Kingdom does not recommend routine antibiotic prophylaxis for most dental work, reserving it for specific situations. Your sister's cardiologist and your dentist can both be practising correctly within their own systems.

What everybody agrees on is more useful than the disagreement. Good daily dental hygiene and regular check ups matter more than any single dose, because the risk comes from repeated small showers of bacteria from unhealthy gums far more than from one appointment. Treat cuts properly, avoid unsterile piercings and tattoos, and tell every dentist and doctor that you have a prosthetic valve so the decision is made with the information in front of them rather than without it. Ron's card is a genuinely good habit.

The thing I would rather you took from this than the antibiotic question is the fever one. Infective endocarditis is uncommon but serious and can be difficult to treat once established, and the presentation is often vague: an unexplained fever that drags on for more than a few days, night sweats, feeling wrung out for no reason. In someone with a prosthetic valve that combination deserves prompt medical review rather than a week of paracetamol, and it is worth saying out loud that you have a valve when you present. The whole picture, including the parts nobody mentions on discharge, is in living with a heart valve.

Which rule applies to you specifically, given your valve and your history, is a question for your own cardiologist and dentist, who know both your notes and the guidance they work under. I would not want you acting on a general answer from me over a specific one from them.

#5TwoNightsTerry(Joined Feb 2026 · 63 posts)August 22, 2026, 8:55 am

Right, that lands better than either of the two answers I had. Not a right one and a wrong one, two systems.

The fever paragraph has genuinely changed something for me though. I would absolutely have sat at home for a fortnight with a low grade temperature telling myself it was a summer cold. Printing that bit out.

#6frankm1952(Joined Apr 2026 · 19 posts)August 25, 2026, 2:33 pm

Where does this leave those of us who had the keyhole one and are not sure whether we count as having a prosthetic valve in the way this all means. Nobody has ever said the word prosthetic to me. They said new valve and sent me home with a leaflet about the groin.

Not being difficult, I genuinely do not know whether these dental conversations apply to me or only to the open surgery lot.

#7Marlene K(Joined Mar 2026 · 31 posts)August 27, 2026, 10:07 am

Frank, it is an implanted artificial valve either way, so yes it applies. The route it went in by does not change what is sitting in your heart.

That confusion is the single most common thing I have heard on this board, and it makes me think the discharge leaflets could do with a rewrite. Mine talked about nothing but the leg for two pages.