PLZ Pediatrics Dentists Help what dental precautions should be done of a child with congenital heart defect???

what dental precautions should be done for a child with congenital heart defect??? the child is 4 years old and he needs invasive dental treatment ..
Thnx

The need for antibiotics to protect against bacterial endocarditis is determined by your child's congenital heart defect. The AHA recommends antibiotics before invasive dental procedures for those in the high and moderate risk categories.

High-risk category:
* Prosthetic cardiac valves, including bioprosthetic and
homograft valves
* Previous bacterial endocarditis
* Complex cyanotic congenital heart disease (e.g., single ventricle states, transposition of the great arteries, tetralogy of Fallot)
* Surgically constructed systemic pulmonary shunts or conduits

Moderate-risk category
* Most other congenital cardiac malformations (other than above)
* Acquired valvar dysfunction (e.g., rheumatic heart disease)
* Hypertrophic cardiomyopathy
* Mitral valve prolapse with valvar regurgitation and/or thickened leaflets

The recommended antibiotics and dosages (from AHA) for dental procedures are:

I. Standard general prophylaxis for patients at risk:
Amoxicillin: Adults, 2.0 g (children, 50 mg/kg) given orally one hour before procedure.

II. Unable to take oral medications:
Ampicillin: Adults, 2.0 g (children 50 mg/kg) given IM or IV within 30 minutes before procedure.

III. Amoxicillin/ampicillin/penicillin allergic patients:
Clindamycin: Adults, 600 mg (children 20 mg/kg) given orally one hour before procedure. -OR-
Cephalexin* or Cefadroxil*: Adults, 2.0 g (children 50 mg/kg) orally one hour before procedure. -OR-
Azithromycin or Clarithromycin: Adults, 500 mg (children 15 mg/kg) orally one hour before procedure.

IV. Amoxicillin/ampicillin/penicillin allergic patients unable to take oral medications:
Clindamycin: Adults, 600 mg (children 20 mg/kg) IV within 30 minutes before procedure. -OR-
Cefazolin*: Adults, 1.0 g (children 25 mg/kg) IM or IV within 30 minutes before procedure.

*Cephalosporins should not be used in patients with immediate-type hypersensitivity reaction to penicillins.

Anyone with a cardiac condition is given a prophylactic antibiotic against bacterial endocarditis. Obtain the prescription from the dentist.

It depends on the kind of defect. If there is an higt risk of endocarditis your son should take an appropriate antibiotic (in appopriate dose for his age and weight) prophylax 1 hour before the invasive treatment.

All above are correct. Just giving you a dentist's opinion.

Vote for Jim W as the most comprehensive, since we just don't know what kind of defect you are dealing with.