In a new statement from the American Heart Association, researchers suggest that maintenance of good oral health is more important than the use of antibiotics in dental procedures for some heart patients to prevent a heart infection caused by bacteria around the teeth.
Infective endocarditis (IE), also called bacterial endocarditis, is a heart infection caused by bacteria that enter the bloodstream and settle in the heart lining, a heart valve or a blood vessel.
It is uncommon, but people with heart valve disease or previous valve surgery, congenital heart disease or recurrent infective endocarditis have a greater risk of complications if they develop IE. Intravenous drug use also increases the risk for IE.
The disease can be caused by bacteria that collect in plaque on the tooth surface and cause inflammation and swelling of the gums.
The new guidance affirms previous recommendations that only four categories of heart patients should be prescribed antibiotics prior to certain dental procedures to prevent IE due to their higher risk for complications from the infection:
those with prosthetic heart valves or prosthetic material used for valve repair;
those who have had a previous case of infective endocarditis;
adults and children with congenital heart disease; or
people who have undergone a heart transplant.
It has been over a decade since recommendations for preventing infective endocarditis were updated amid concerns of antibiotic resistance due to overprescribing.
The American Heart Association’s 2007 guidelines, more tightly defined which patients should receive preventive antibiotics before certain dental procedures to the four high-risk categories. This change resulted in about 90% fewer patients requiring antibiotics.
The scientific statement writing group reviewed data since the 2007 guidelines and supported the 2007 recommendation that only the highest risk groups of patients receive antibiotics prior to certain dental procedures.
In the presence of poor oral hygiene and gingival disease, heart infection is far more likely to develop from bacteria attributable to routine daily activities such as toothbrushing than from a dental procedure.
Maintenance of good oral hygiene and regular access to dental care are considered as important in preventing heart disease as taking antibiotics before certain dental procedures.
The study is published in Circulation. One author of the study is Walter R. Wilson, M.D.
Copyright © 2021 Knowridge Science Report. All rights reserved.
