Dentistry Today: Prevention of Infective Endocarditis – Guidelines from the American Heart Association April 2007

American Dental Association: Infective Endocarditis

For decades, the American Heart Association (AHA) recommended that patients with certain heart conditions take antibiotics shortly before dental treatment. This was done with the belief that antibiotics would prevent infective endocarditis (IE), previously referred to as bacterial endocarditis. The AHA’s latest guidelines were published in its scientific journal, Circulation, in April 2007 and there is good news: the AHA recommends that most of these patients no longer need short-term antibiotics as a preventive measure before their dental treatment.

The American Dental Association participated in the development of the new guidelines and has approved those portions relevant to dentistry. The guidelines were also endorsed by the Infectious Diseases Society of America and by the Pediatric Infectious Diseases Society.

The complete report is here.

The summary of major changes in the April 2007 updated document:

Cardiac Conditions Associated with the Highest Risk of Adverse Outcome from Endocarditis for Which Prophylaxis with Dental Procedures Is:

Dental Procedures for which Endocarditis Prophylaxis is Recommended for Patients in Table 3:

Regimens for a Dental Procedure:

This is a radical change of paradigm of LESS not DIFFERENT or MORE in treatment of prophylactic treatment of infective endocarditis in the dental office.

Flap foresees much confusion between the medical and dental communities unless communication is open, shared and quickly implemented.

For Total Joint Replacements these guidelines remain in place.

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