The most effective ways to minimize the risk of infective endocarditis, a heart infection caused by bacteria in the mouth, are good oral hygiene and routine dental treatment. Just four types of heart patients are known to be at the greatest risk of infective endocarditis-related complications, and only these patients are advised to receive preventive antibiotic care.
Maintenance of good oral health is more important than use of antibiotics in dental procedures for some heart patients to prevent a heart infection caused by bacteria around the teeth, according to a new American Heart Association (AHA) scientific statement published today in the association’s flagship journal, Circulation.Sciencedaily.com
Infectious endocarditis (IE), also known as bacterial endocarditis, is a form of heart infection caused by bacteria that enter the bloodstream and lodge in the lining of the heart, a heart valve, or a blood vessel. People who have heart valve disease or have had prior valve surgery, congenital heart disease, or recurrent infective endocarditis are more likely to develop complications if they develop IE. Bacteria that accumulate in plaque on the tooth surface cause inflammation and swelling of the gums, resulting in Viridans community streptococcal infective endocarditis (VGS IE). Certain dental procedures have raised concerns that they may increase the risk of VGS IE in vulnerable patients.
Antibiotic resistance due to overprescribing has been a problem for over a decade, but guidelines for avoiding infective endocarditis have been revised. The American Heart Association’s 2007 guidelines, which marked the most significant change in the organization’s guidance on the prevention of infective endocarditis in more than 50 years, more precisely specified which patients should obtain preventive antibiotics before certain dental procedures to the four high-risk groups. As a result of this move, approximately 90% fewer patients needed antibiotics.
The American Heart Association’s Young Hearts Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, the Council on Lifelong Congenital Heart Disease and Heart Health in the Young, the Council on Cardiovascular and Stroke Nursing, and the Council on Quality of Care and Outcomes Research collaborated on the scientific statement.