Medical questions & health advice by board certified doctors

"Why do I have to have antibiotics before a root canal if I have a heart murmur?"

ZocdocAnswersWhy do I have to have antibiotics before a root canal if I have a heart murmur?


I have a heart murmur, and my oral surgeon says I have to take a 3-day course of antibiotics prior to having my root canal. The tooth that needs this root canal is extremely painful, and he has given me pain killers help get through the next few days. However, I do not understand why I must take antibiotics like this and delay the procedure just because I have a heart murmur. I do not have to take any other medication for this problem because it is my understanding that it is considered just a ""slight"" murmur. I realize that this is considered an invasive procedure, and that the tooth itself could become infected, but why do I have to take antibiotics before a root canal if I have a heart murmur?


Antibiotics in a person with heart murmurs is a topic which many people debate. I would recommend you run this by your primary care doctor. He or she may be able to help clarify as they will know the exact nature of the heart murmur and the need for antibiotics. A heart murmur if often (although not always) caused by an abnormal heart valve. There are many types of abnormal heart valves. In many procedures, especially in oral procedures like a root canal, the normal bacteria that live in the mouth are disrupted and can enter the blood stream. This happens often, maybe even everytime you brush your teeth. The problem is that during a procedure there is a significant amount of bacteria in the blood. In people with an abnormal heart valve, the bacteria can "stick" to the abnormal heart valve and cause a serious infection known as endocarditis. Ten years ago we were far more aggressive with antibiotics in people with heart murmurs. Since then we've learned that there are only a few types of murmurs that actually require antibiotics. Please talk to your primary doctor about the type of murmur you have and if you need antibiotics. Good luck.

Zocdoc Answers is for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Medical professionals who provide responses to health-related questions are intended third party beneficiaries with certain rights under Zocdoc’s Terms of Service.