Do you have to take antibiotics prior to all dental work after Breast Augmentation?

Hi CP,No one knows for sure, but we order a preventative antibiotic for all postop BA patients before a dental procedure.  We are concerned about the bacteria causing  a capsule.  Excellent answer below by Dr. Zubowicz.  All the best,  Dr. Joe

 This may very well be a recommendation the future. If speculation about the role of biofilm in capsular contracture is verified antibiotics might be recommended prior to situations were bacteria could enter the bloodstream such as teeth cleaning, colonoscopy, etc.

This is a very interesting question and there are no studies which show antibiotics prior to dental work necessary for those who have breast implants. It seems like such a sensible idea, though there is no science behind the recommendation. 

I recommend that my patients start antibiotics one day prior dental procedures that are fairly invasive, like root canals, or if they are prone to bleed during cleaning. I suggest they take the antibiotics twice a day for 3 days. Studies do show that there is an increased risk of capsular formation after dental procedures because bacteria can be stirred up during the procedure.

There is not definitive evidence to support prophylactic antibiotics for dental work if you have breast implants.  In fact, I think the recommendations for joint replacements may have recently removed the recommendation for prophylactic antibiotics with dental work.  I do not require my patients to use antibiotics when they get dental work after having breast implants.

The question of whether or not you should take antibiotics for dental procedures if you have breast implants is a very interesting question. In short, I would probably say yes. There is some evidence that this can be of benefit to some women. When you have a dental procedure like teeth cleaning, bacteria can enter your blood stream for a brief period of time. Generally you are never aware of this, nor does it create a problem. However, if you have breast implants, it is possible for some of the bacteria to come to rest in the capsular tissue around the breast implants. This will not cause an overt infection, but can create what might be considered a sub-clinical infection which can cause an increase in the thickness of the capsule creating a capsular contracture and firmness of the breast. As you alluded to in your question, a similar thing could happen with a prosthetic heart valve.Clearly this does not happen to everyone, but there is no way to know who will be affected by this.  All of us who do a lot of breast enlargements have had the experience of seeing someone several years out from a breast augmentation who all of the sudden has firmness in one of her breasts. Frequently this has been preceded by an event like teeth cleaning, or some other infection like a urinary tract infection.My recommendation to women with breast implants is that they consider a dose of antibiotics two hours prior to such a procedure, and another does 8 and 16 hours afterwards. It is pretty low cost, with very little down side. So, yes, this is something I would think about doing.All the best,David B. Reath, MD

Yes, I advise my patients to tell there oral surgeons about their implants and ask for peri-operative antibiotics.  Bacteria from your mouth can enter your blood stream and cause an infection around the implant that can lead to pericapsular hardening.