Infective Endocarditis And Dental Treatment: What Patients Need To Know

Infective endocarditis is an inflammatory disease that affects the heart. The disease is relatively uncommon, but the condition can become life threatening. People who are at risk of infective endocarditis must take precautions to avoid the disease, which means they must take care before any medical procedure, including dentistry. Find out how dental treatment affects the risk of infective endocarditis, and learn more about the precautions that some people can take.

About infective endocarditis

The endocardium is a layer of tissue that lines the inside of the heart. This tissue contains several small blood vessels and helps control the muscular function of this vital organ. Bacteria can sometimes spread from other parts of the body to the endocardium, and if germs get into this lining, infective endocarditis can occur.

The disease rarely occurs in people with healthy hearts. Patients with artificial heart valves or heart defects are at higher risk of contracting the disease. Without treatment, infective endocarditis can cause serious complications and even death.

Endocarditis affects people in different ways. In some patients, the disease slowly progresses, where other people experience the symptoms suddenly. These symptoms can include fever, chills, a heart murmur, weight loss and shortness of breath. Some patients also experience Osler's nodes, which are small, red spots under the skin on the fingers.

How dental treatment affects endocarditis

Bacteria thrive inside your mouth, even when you have healthy teeth and gums. Many types of dental treatment lead to gum injuries, which create open wounds for bacteria to invade. In theory, harmful bacteria in your mouth can get into the bloodstream during dental treatment, leading to infections elsewhere, including infective endocarditis.

The risk of infection during dental treatment means that dentists have traditionally prescribed antibiotics for many patients who are about to undergo serious treatment. Doctors have believed for some time that this process (called antibiotic prophylaxis) kills germs and pathogens before they enter the bloodstream, stopping any type of infection throughout the body.

More recently, research indicates that antibiotic prophylaxis is less effective than doctors once believed. Indeed, some studies show that this process does not completely cut the risk of infective endocarditis. The American Heart Association now advises that the disease is more likely to occur from frequent, daily exposure to bacteria. In fact, studies now suggest that only 15 to 20 percent of infective endocarditis cases occur as a result of an invasive procedure.

Precautions at-risk patients should take

The American Dental Association's guidelines still say that antibiotic prophylaxis is a reasonable precaution for some people undergoing dental treatment. At-risk patients who should consider this step include those with:

  • A prosthetic cardiac valve or other prosthetic material used for valve repair
  • Any history of the disease
  • Certain types of cardiac transplant

Doctors still recommend preventive antibiotics for people with prosthetic heart valves because it can take up to six months for endothelial tissue to form around the material. During this time, the risk of infection is higher.

That aside, the Association now only recommends antibiotic prophylaxis before certain types of dental treatment. These antibiotics can help before any procedure where a dentist manipulates gingival tissue or perforates the mucosa in your mouth. Routine treatments at places like Family Dental Center TriCities, PC do not present a significant risk.

Patients should take the antibiotics before the dental treatment commences. That aside, the Association guidelines state that you can also take the medication up to two hours after the procedure if you forget to do so beforehand.

The importance of good dental hygiene

Good dental hygiene is still an important way to cut the risk of infective endocarditis, and it's clear that daily brushing is still essential. Some experts believe that poor oral hygiene can allow germs to develop that can still get into your bloodstream. As such, some heart doctors will refer patients to a dentist a few weeks before surgery, to control any underlying dental problems.

Infective endocarditis is a rare but serious condition that can cause life-threatening systems. Patients with prosthetic heart valves are at higher risk of the condition, and it is vital that these people maintain meticulous dental hygiene to stop the spread of bacteria.