A contemporary view of infective endocarditis prevention - dentists among recommendations and protocols

In pathogenesis, there are two critical moments for infective endocarditis development. Firstly, the presence of injured or inflamed endocardium which serves as a substrate for bacterial adhesion and secondly, bacteremia which is the initiating factor for infective endocarditis occurring after irritation or tissue damage resulting in a portal of entry for bacteria to access the bloodstream. Unfortunately, bacteremia is not uncommon event and may even be initiated by everyday routine activities such as tooth brushing and chewing. The prominent role of oral bacteria in the development of endocarditis, which enter the bloodstream as part of routine daily activities but especially during certain dental procedures has been subject of debate for decades. Undoubtedly, the prevention of infective endocarditis is of immense importance to be considered by dental practitioners. However, what is the fact nowadays is that dentists are facing with different guidelines and recommendations published by professional societies and reputable associations which greatly vary from country to country. The aim of the lecture is to compare various recommendations proposed by respectable associations and point out advantageous and disadvantageous of it in accordance with evidence-based data. Participants will be given contemporary update of information related to dental procedures which require antibiotic prophylaxis, antibiotic prophylaxis regimens, which medical conditions require mandatory prophylaxis and how to act in specific situations requiring antibiotic prophylaxis.

Learning Objectives

Infective endocarditis is a serious and life-threatening disease associated with significant morbidity and mortality. Despite the fact that noteworthy progress has been made in improving the prognosis the mortality from infective endocarditis remains significant with an in-hospital rate of 20-30%.