What type of patient requires antibiotic prophylaxis before dental procedures?

• A. Patients with controlled diabetes
• B. Patients with prosthetic heart valves
• C. Patients with dental anxiety
• D. Patients with hypertension

Answer: (B)

Patients with prosthetic heart valves require antibiotic prophylaxis before dental procedures due to the increased risk of infective endocarditis. This condition can occur when bacteria enter the bloodstream during invasive procedures, such as dental work, and adhere to abnormal heart valve structures like prosthetic valves. The American Heart Association (AHA) guidelines specifically recommend prophylactic antibiotics for these patients to prevent potential infections that could lead to serious complications.

In contrast, patients with controlled diabetes, dental anxiety, or hypertension do not typically have the same level of risk requiring prophylaxis for dental procedures. Controlled diabetes may warrant careful management of blood sugar levels during treatment, but it does not necessitate antibiotic prophylaxis. Similarly, dental anxiety might require sedation or anxiety management strategies but does not imply an infectious risk that antibiotics would mitigate. Lastly, while hypertension is a common condition, it does not inherently increase the risk for infectious complications during dental procedures, thus not requiring antibiotic prophylaxis.