Your Dental Office News, July 27, 2023: Antibiotic Pre-Med, National Cleft Awareness Month, Best of the Best

We hope this newsletter finds you in the best of health and spirits. As summer is in full swing, it’s time to ensure your smiles shine as brightly as the sun! In this issue, we’ll explain the benefits of using an electric toothbrush vs a manual one, and share with you some tips for preventing cavities even while celebrating National Lollipop day. This month, we also acknowledge National Cleft and Craniofacial Awareness and Prevention. Finally, we bring you important updates regarding antibiotic prophylaxis before dental procedures, and how we are changing our practice’s policies surrounding these changes. 

In This Issue:

  • Antibiotic Pre-Med: Do You Still Need It?
  • Pre-Med Policy Change
  • Patient Education Updates
  • Vote for Us: Frederick News Post’s Best of the Best
  • Electric vs. Manual Toothbrushes
  • Cavity Prevention
  • National Cleft and Craniofacial Awareness Month
  • Honoring Our Team Members
  • Recipe of the Month: Chilled Roasted Tomato Soup
  • YouTube Channel
  • Please Leave us a Review!

Antibiotic Premed: Do You Still Need It?

By the Dental Team at Dr. Harvey Levy & Associates

If you’ve been prescribed antibiotics prior to going to the dentist (“antibiotic prophylaxis”), it’s likely that you no longer need to take them. Taking unnecessary antibiotics can actually be harmful, per studies summarized in this 2023 paper published by the NIH and this 2022 ADA article .

Here are the highlights:

Joint replacement (prosthetic surgery): 

  • If you have any kind of joint replacement (prosthetic) surgery, do not come to the dentist until 6 months after your surgery. We will not be able to perform any procedure that may cause bleeding, including a dental cleaning. Please call us if you’ve had joint replacement surgery within 6 months so we can reschedule your appointment. 
  • If you have a dental emergency before the 6 months are over, the dentist will have to contact your surgeon for clearance.
  • If you have not visited the dentist in some time, it’s a good idea to have your mouth checked before you have surgery. 
  • If it’s been six months since you’ve had prosthetic replacement surgery and are healthy, you do NOT need antibiotics. If you would feel more comfortable or your surgeon believes that a pre-med is recommended, you will need to have a discussion with them to get a prescription because we will not prescribe it.
  • If you have a history of failed joint replacement or infection at the site, please contact your surgeon for a prescription. 

Heart conditions:

  • There are five conditions that require antibiotics prior to your dental visit. They are mostly associated with heart surgery, infective endocarditis, and congenital heart disease (CHD).
  • Other heart conditions may lead your physician to prescribe antibiotics before you visit the dentist. Make sure to ask your physician for a prescription prior to your appointment.

Downsides of pre-medicating with antibiotics prior to dental procedures:

  • Antibiotics have been found to be mostly ineffective in reducing the risk of bacteremia (bacteria in the bloodstream) or infective endocarditis.
  • Antibiotics may cause adverse effects that can result in emergency room visits, such as anaphylaxis (life threatening allergic reaction) and C. Diff infection (which can cause severe damage to the colon).
  • Unnecessary antibiotics contribute to the growing problem of antibiotic resistance.

In summary, recommendations regarding antibiotic prescriptions prior to dental visits are now limited to specific criteria in patients with cardiac risks, and most likely not needed for patients with prosthetic joints more than 6 months after surgery.

Pre-Med Policy Change

Due to the updated antibiotic research and protocol recommending that antibiotic prophylaxis (pre-med) is often unnecessary, effective September 1, 2023, we will no longer be prescribing antibiotics for our patients.

If your cardiologist or surgeon still recommends that you take them, you will need to get a prescription from them. If you are unable to get a prescription in time for your appointment, please contact our office.

If you are enrolled in electronic patient communications, you will soon receive an additional confirmation text message prior to your dental appointment. This text message will remind you to speak to your physician regarding the need to premedicate with antibiotics prior to dental appointments, and to obtain the prescription from that physician if necessary.  (Not enrolled in text messages? Click HERE now (it’s easy!) to ensure that you receive the confirmation message for all future appointments).

Patient Education Updates

Our practice has always been engaged with helping educate patients with our newsletters, but we’ve been working hard to create patient education articles and YouTube videos. We are providing homegrown content that we hope you find engaging and helpful. We share this knowledge and experience to help improve our patients’ oral and overall health!

Check out our newsletter archive here and you can find our new patient education articles under the For Patients header on our website. You can also subscribe to our YouTube channel here

Vote for Us: Frederick News Post’s Best of the Best

We appreciate the outpouring of support our community provides us when they vote for us as Best General Dentist. You put your trust in us and last year we won! You’ve nominated us again this year and we couldn’t be more grateful!  Mark your calendars, because voting begins again August 16th through the 22nd. You can vote daily to help spread the word that we’re Best of the Best!

Electric Toothbrush vs. Manual Toothbrush: Which is Better?

When it comes to maintaining good oral hygiene, one of the most debated topics is whether electric toothbrushes are superior to manual ones. Let’s explore the differences between these two types of toothbrushes to help you make an informed decision.

Manual Toothbrush:

  • Traditional and widely available.
  • Requires manual brushing technique using back-and-forth or circular motions.
  • Effectiveness depends on the user’s brushing technique and consistency.
  • Less expensive compared to electric toothbrushes.
  • Available in various bristle types, sizes, and hardness levels.

Electric Toothbrush:

  • Powered by batteries or rechargeable, providing automated brushing motions.
  • Some models come with built-in timers to ensure adequate brushing time.
  • Can be more effective in removing plaque and reducing gum inflammation.
  • Especially beneficial for those with limited dexterity, such as children or individuals with arthritis.
  • May be more expensive initially, but some models offer long-term cost savings with replaceable brush heads.

Which One is Better?

Both manual and electric toothbrushes can effectively clean your teeth if used correctly. The choice between the two depends on personal preference, oral health needs, and lifestyle.

Manual toothbrushes are affordable, portable, and you have more control of the way you brush your teeth. You can decide what speed and pressure to use. This is helpful if you have particularly sensitive areas in the mouth. They are a good option for those who brush diligently with proper technique.

Electric toothbrushes offer automated brushing motions which provide between 6,000 and 30,000 strokes per minute. They are also easier to use, which can be beneficial for people who have difficulty brushing thoroughly with a manual toothbrush. They can be especially useful in reaching difficult-to-access areas and may be recommended by dentists for certain individuals with gum disease or other oral health issues.

Regardless of the toothbrush type, it is crucial to brush for at least two minutes, twice a day, and to use fluoride toothpaste. If you’re thinking about making the switch to an electric toothbrush, Good Housekeeping has some recommendations which can be found here.

Cavity Prevention

July 20th was National Lollipop Day and we couldn’t let the holiday pass without spreading some tips on how to keep away the cavities even while enjoying a sticky sweet treat!

Cavities are caused when bacteria in the mouth feeds off of the food we eat and makes acid. Over time, this acid wears down our tooth enamel and the tooth starts to decay. Eventually the decay leads to cavities. 

How to prevent cavities?

  • Brush at least 2x/day – this is obvious, but brushing disrupts the bacteria from creating acid that damages your tooth enamel
  • Rinse after eating – if you’re not able to brush, this is the next best thing
  • Limit sugary food and drink – sugar in particular helps oral bacteria thrive. It also tends to stick to your teeth and get into small crevices that are difficult to clean
  • Drink more water – yes, water. Coffee, tea, soda and juice all have acid (and sugar) that eat away at your enamel
  • Visit your dentist regularly.

National Cleft and Craniofacial Awareness Month

July is National Cleft and Craniofacial Awareness and Prevention Month, a time to raise awareness and improve understanding of orofacial clefts (clefts of the lip and palate) and other conditions of the head and face.

Each year in the United States, approximately 2,600 babies are born with a cleft palate and 4,400 babies are born with a cleft lip, with or without a cleft palate (CDC). Other craniofacial birth defects include craniosynostosis (skull sutures fusing prematurely), anotia/microtia (ear is missing or underdeveloped), and anophthalmia/microphthalmia (missing or abnormally small eye).

Children with orofacial clefts and other craniofacial conditions often have impaired ability to feed and impaired language development, and might be at increased risk for a greater number of ear infections, hearing issues, and problems with their teeth.

Risk Factors

Several factors may increase the likelihood of a baby developing a cleft lip and cleft palate, including:

  • Family history: Parents with a family history of cleft lip or cleft palate face a higher risk of having a baby with a cleft.
  • Exposure to certain substances during pregnancy: Cleft lip and cleft palate may be more likely to occur in pregnant women who smoke cigarettes, drink alcohol or take certain medications.
  • Having diabetes: There is some evidence that women diagnosed with diabetes before pregnancy may have an increased risk of having a baby with a cleft lip with or without a cleft palate.
  • Being obese during pregnancy: There is some evidence that babies born to obese women may have increased risk of cleft lip and palate.
  • Gender differences: Males are more likely to have a cleft lip with or without cleft palate. Cleft palate without cleft lip is more common in females.
  • Race: In the United States, cleft lip and palate are reportedly most common in Native Americans and least common in African-Americans.


Best of the Best Nomination

Honoring our Team Members

To learn more about our team members, visit Our Team page on our website.

MVP – July

Every month we recognize a team member who has gone above and beyond, for our patients or other team members. This month the votes came in as a tie, honoring two team members: dental assistant Ana Paola, who joined us in March 2022, and dental hygienist Tyann, who joined us in January 2023. Fellow team members complimented Ana for being kind and compassionate to everyone, for always being willing to help, and for making sure nothing falls through the cracks.

Team members complimented Tyann for being a great team player who is always willing to help, for being “so good with her patients,” and for always having a smile on her face, as you can see in the photo below.

Invisible Worker Recognition

Every month at our All-Teams meetings we recognize a team member who makes our day-to-day operations run smoothly, despite their contribution not being obvious to many of us. 

In July, we recognized our Internal Handyperson Team, consisting (in alphabetical order) of Abbey, Ana, Brandon and Rodney.  They allow us to not have to call in an external support person for every single thing that malfunctions or breaks, or that needs to be assembled. They rock!

Chilled Italian Roast Tomato Soup

Who says soup is only for fall weather? This chilled tomato soup is the perfect refreshing starter or lunch for a hot summer day!


  • 1 kg ripe plum tomatoes washed and halved
  • 3 tbsp extra virgin olive oil
  • 3 garlic cloves unpeeled
  • Sea salt and freshly ground black pepper
  • 2 tsp light brown sugar
  • 150 ml fresh homemade vegetable stock should you need it
  • few quartered tomatoes to roast for garnishing


  • 1 generous handful basil leaveschi
  • 1 clove garlic
  • 1 tbsp pine nuts heaped* 
  • 2 tbsp extra virgin olive oil

*can be omitted for a nut free pesto


  1. Pre-heat oven to 180 C
  2. Place the tomatoes cut side up in a baking tray, add the whole garlic cloves and season well, sprinkle with the sugar and drizzle over the olive oil.
  3. Roast for about 45 minutes, until the tomatoes are lightly browned and beginning to ooze juice and then remove the tray from the oven and allow to cool for a few minutes.
  4. Pick out the roasted garlic cloves and squeeze the soft flesh out of the husks onto a saucer.
  5. Place all the tomatoes and the squeezed out garlic pulp in a blender with all the juices from the roasting tray.
  6. Blend very well until the tomatoes are velvety smooth, add a little vegetable stock if the soup feels too thick and then check and correct the seasoning but remember the flavor will alter once it’s chilled so you’ll have to check again.
  7. Pour into a bowl and chill for about 5 hours, at least.
  8. Make the pesto in a pestle and mortar by combining the basil, the garlic and the pine nuts, until you have a fine grained pulp and stir this into the olive oil – it has to be quite runny. Follow the instructions on how to make pesto here.
  9. Leaving it to stand for a few hours will remove the sharpness of the garlic.
  10. Serve the soup with a quarter of lightly roasted tomato and some pesto drizzled over each serving.
Scroll to Top