In Dr. Freedman’s opinion, the literature appears split on preventive antibiotic medication before dental treatment to prevent bacterial endocarditis. Although, approximately half the people with lupus have heart valve abnormalities. In this light, patients should consult their physician about whether antibiotics should be taken before any dental treatment that can cause bleeding. This includes regular cleanings, scaling, periodontal procedures, dental implant placement, root canal treatment, and extractions.
Learn more about the SLE Workshop , a free support and education group held monthly as HSS.
AB - Thirty-six pediatric patients (age range, 6 to 18 years; mean, 15 years) undergoing mandibular and/or maxillary osteotomies were examined in a randomized double-blind study to determine objectively whether steroids are therapeutic in such operations. Dexamethasone or a saline placebo was administered immediately preoperatively ( mg/kg) and for 48 hours postoperatively ( mg/kg/day). Standardized surgical techniques and fluid administration were used. Photographs of the patient taken on admission and 24 hours postoperatively were compared by three independent observers familiar with maxillofacial surgery to rate facial swelling. Mean intubation period (until an audible leak around the endotracheal tube was present), time until oral intake was satisfactory, and facial swelling ratings were compared between the two groups. The results seemed better for the patients receiving steroids but the difference was not significant. This study did not confirm the subjective belief of many surgeons that steroid administration reduces facial swelling after maxillofacial surgery.