Fact Sheet: Endocarditis


Understanding Endocarditis

Endocarditis is a rare, life-threatening inflammation of the lining of the heart muscle and its valves that is caused by a bacterial infection. Although it can occur in anyone, it is much more likely to occur in people who have certain heart conditions and in those who have had endocarditis previously. If you are at high risk for endocarditis, your doctor may recommend that you take antibiotics before dental procedures. Read on to learn more.

Who Should Take Preventive Antibiotics?

The American Heart Association (AHA) recommends antibiotics before certain dental procedures for patients with heart conditions that put them at the highest risk of developing endocarditis. The AHA recommends that patients receive antibiotics prior to dental treatment only if they have:

  • Had Bacterial Endocarditis Previously
  • A Prosthetic (artificial) Cardiac Valve or Prosthetic Material Used in Valve Repair
  • Cardiac Valve Disease and have had a Cardiac Transplant
  • Congenital (present at birth) Heart Disease (includes only people with the following conditions: non-repaired cyanotic congenital heart disease, including those with devices that relieve symptoms only; completely repaired congenital heart defect with prosthetic material or device during the first six months after the procedure; and repaired congenital heart disease with defects that remain at or near the site of a prosthetic patch or prosthetic device) With these recommendations in mind, you and your physician can determine whether or not preventive antibiotic treatment is recommended for your condition.

How are Preventive Antibiotics Taken?

Patients who require preventive treatment take a single dose of an antibiotic, typically about one hour prior to certain dental treatments.

For Which Dental Procedures are the Antibiotics Taken?

For patients at highest risk for endocarditis, the AHA guidelines suggest preventive antibiotic treatment for only the following:

  • Dental procedures that involve manipulation of gingival tissue (around bone and teeth) or the periodical region of teeth (tip of the tooth root)
  • Dental procedures in which the inside lining of the mouth is perforated The guidelines do not recommend that high-risk patients receive preventive antibiotics for the following dental procedures or events:
    • Routine anesthetic injections through non-infected tissue
    • Dental X-rays
    • Placement of removable prosthodontics or orthodontic appliances
    • Adjustment of orthodontic appliances
    • Placement of orthodontic brackets
    • Shedding of baby teeth
    • Bleeding from trauma to the lips or inside of the mouth If you have concerns about whether or not preventive antibiotics are needed for your condition, talk to your doctor.

What Can I Do to Lower My Risk for Infections?

To lower your risk for infection, it’s important that your dental team is up to date on your current health condition. Be sure to tell your dentist if your health has changed since your last visit, including if you have been diagnosed with a heart condition. Also, let your dentist know if you've had heart or vascular surgery or any other surgery or medical procedure, within the past six months.

In your patient record, make sure your dentist has a complete list of the names and dosages of all of your medications, both prescription and over-the-counter, including vitamins and herbal remedies. Also be sure that your dentist has all of the names and phone numbers of your current physicians, in case a consultation is necessary. Of course, it’s also important to practice regular good oral hygiene. Brush your teeth at least twice a day for 2 minutes each time, and floss daily. See your dentist every six months for regular exams and cleanings.

If you have questions about preventive antibiotic treatment, talk to your doctor and dentist.

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