Should Breast implant patients take antibiotics for dental cleaning or dental work?
It is your choice! But it might be a good idea.
One of the common causes of a “capsular contracture” which is a hardening of the implant which could become visible and or painful, is a Biofilm. When we go to the dentist to have our teeth cleaned, the Tartar that is removed is a Biofilm, a wall of sorts built by bacteria to protect it from your body’s defense mechanisms.
People who have a heart murmur or a medical device such as a pace-maker or a hip replacement are advised to take antibiotics before dental cleaning or gum surgery. The reason is that work around the gums can allow the bacteria that reside in our mouths to enter the bloodstream. Once there, they can go anywhere, and can sometimes cause an infection. If this infection were to start around a medical device it might have to be removed.
If this happened around your breast implant and a significant capsular contracture developed or even an actual infection, it might need to be removed.
The chance of this happening is rare, but does happen. Not all dentists or even plastic surgeons agree, but many, including myself, think that it may make good sense to take antibiotics in these situations. A single dose taken one hour before the dentist is probably enough, so one does not have to worry about a yeast infection occurring. This may seem to be excessively precautionary, but I would want the same done if it were me. I put my seatbelt on every time I get in my car.
So we have to balance the risk of taking a single dose of antibiotics one hour before a dental procedure, against the risk of developing an infection or capsular contracture around an implant.
The typical recommendation if someone is not allergic to penicillin is to take 4 500mg capsules of Amoxicillin one hour before a dental procedure or cleaning. In patients that are allergic to penicillin then either 2 gms of cephalexin or 600mg of Clindamycin is used instead.
This prophylaxis is recommended for any manipulation of the gum tissue, base of the tooth or perforation of the oral mucosa, but is not thought to be needed for routine injections, dental xrays or adjustment of orthodontic appliances.
So, is it worth taking a single dose of antibiotics to prevent something that may only happen rarely? You need to decide for yourself. There is no set answer, and intelligent and educated people can disagree. For myself, if a single dose of antibiotics can decrease the chance of needing to return to surgery, I would recommend it, and would choose to do it.