Medical Conditions Requiring Prophylaxis

Patients with the following medical conditions require antibiotic prophylaxis for many dental procedures.

  • Prosthetic heart valves, including homografts and allografts
  • Previous bacterial endocarditis
  • Congenital heart disease:
    • Unrepaired
    • Partially repaired with residual defects
    • Completely repaired (first six months only)
  • Posttransplant valvulopathy
Hemera Technologies/
Hemera Technologies/

If repaired defects are expected to remain exposed and not covered by endothelium, then antibiotic prophylaxis is warranted. If prosthetic material used in a repair is expected to become covered with endothelium, antibiotic prophylaxis can cease six months after the repair.

Most patients do NOT require antibiotic prophylaxis

ADA Guideline


Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007; 116:1736-54.

Nishamura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017; 135(25): e1159-e1195.

ADA. Antibiotic prophylaxis prior to dental procedures. Oral Health Topics 2022; Available from: