PMID: 6360190Dec 1, 1983

The teeth and infective endocarditis

British Heart Journal
R BaylissA G Whitfield

Abstract

During 1981 and 1982 544 cases of infective endocarditis were investigated retrospectively by means of a questionnaire. Only 13.7% had undergone any dental procedure within three months of the onset of the illness, and in 42.5% there was no known cardiac abnormality before the onset of the disease. Furthermore, the number of cases occurring annually was about the same as or more than it was before the introduction of penicillin. The mouth and nasopharynx were the most likely sources of the commonest organism, Streptococcus viridans, and it is suggested that it is not dental extractions themselves which are of importance but good dental hygiene. In most patients with infective endocarditis the portal of entry of the organism whatever its nature cannot be identified. If this is so antibiotics are being given to only a small proportion of those at risk, and this would explain why the number of cases is much the same as it was before the introduction of penicillin. Furthermore, the large proportion of patients with no known previous cardiac abnormality adds to the difficulty of providing effective prophylaxis. The evidence suggests that antibiotic prophylaxis should still be given before dental procedures, and a schedule is appende...Continue Reading

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Related Concepts

Antibiotics
Bacterial Infections
Dental Prophylaxis
Dental Restoration, Permanent
Dentistry
Bacterial Endocarditis
Heart Diseases
Retrospective Studies
Scaling, Supragingival
Tooth Diseases

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