Murmurs of the Heart (at the Dentist)? What are your thoughts on mitral valve prolapse and the need to take antibiotics before dental procedures? Which danger is greater: the potential heart valve infection or the risk of antibiotic abuse/adverse reactions? The mitral valve controls blood flow between the left atrium and left ventricle - the two chambers on the left side of the heart. It directs blood flow from one to the other when the heart contracts. The valve is said to prolapse when it bulges abnormally, allowing some backflow of blood. Most people who have this problem don't notice any effects, but some may experience chest pain, fatigue, or shortness of breath when they exercise or consume a lot of caffeine. Around 5 percent of the population (mostly women) have this problem. In the vast majority of cases, probably 95 percent, mitral valve prolapse is a completely benign condition and shouldn't even be diagnosed as a problem. But people with this condition are usually told that they should take preventive antibiotics if they have any dental work done. The reason is that dental work can release bacteria into the bloodstream, and an abnormal heart valve can be a site where bacteria can lodge and cause serious infection. Such infections are dangerous, often requiring intensive care in a hospital. But as long as you're in good health and the dental work is not major, the risk of infection in these situations is very low. I personally wouldn't take antibiotics for run-of-the-mill teethcleaning, but for an extraction or root canal, I'd consider them. If you have a concern for more minor procedures, skip the antibiotics and brace your immune system with echinacea and increased doses of vitamin C. Take a dropperful of echinacea in water four times a day, and 1,000 to 2,000 milligrams of vitamin C three times a day. Start the day before the dental work, and continue the echinacea for a day afterwards.