Dental practitioners take steps to minimize the risk of illness from certain procedures that can allow bacteria from the mouth to enter the bloodstream. Antibiotic premedication is a prophylactic measure that prevents the release of bacteria into the bloodstream. The bacteria can infect the lining of the heart, as well as the valves or blood vessels, causing them to become inflamed. Infective endocarditis (IE), the name given to the inflammation, can be life-threatening or debilitating. The risk of developing IE may result from a combination of high-risk patients and dental procedures. Although this is not a problem for most patients, some require protection. The American Heart Association recommends antibiotic premedication before dental procedures. But only for those whose heart problems as well as some other problems are associated with the highest risk of adverse outcome.3 To know who and why a patient will need premedical antibiotic treatment, the hygienist must keep an accurate history and up to date with the patient. . This is important because oral conditions reflect the patient's overall health, common health factors influence response to treatment, and the patient's health is constantly changing.1 Preventative antibiotics before dental procedures are recommended for patients with underlying cardiac problems, history of IE and total joint replacements whose immune system is weakened. Conditions that require premedication include: 3A. Congenital heart disease, but only the following types:a. Unrepaired Cyanotic Congenital Heart Disease Cyanotic heart disease is a heart defect, present at birth, that results in low levels of oxygen in the blood. With a series of surgical interventions, this condition is usually very rarely prescribed to people with an immediate type hypersensitivity reaction (urticaria, angioedema or anaphylaxis) to penicillins or ampicillin.iAs As noted above, The risk of developing IE may result from a combination of high-risk patients and certain dental procedures. Antibiotic premedication is valuable for those who need it. The clinician will work with the patient's doctor and closely review the up-to-date medical history and the type of dental treatment that will be performed to ensure that the appropriate safety information can be used. Works Cited1Wilkins, Esther M. (2013). Clinical Practice of the Dental Hygienist2American Dental Association3 American Heart Association (2013) Retrieved from http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Infective-Endocarditis_UCM_307108_Article.jsp