 [ Symptoms ] i have a heart murmur and was told that pre medication is no longer necessary before dental treatment is this true [ Disease ] the american heart association guidelines have changed only the people at the greatest risk for bad outcomes from infective endocarditis    an infection of the heart valves    should receive short term preventive antibiotics before common routine dental and medical procedures i generally request that patients have a screening by a cardiologist and a specific recommendation to go along with it