Do patients at risk of infective endocarditis need antibiotics before dental procedures?

What you need to know: - Patients with prosthetic heart valves, previous infective endocarditis, and some types of congenital heart disease are at highest risk of infective endocarditis

- Invasive dental procedures cause bacteraemia, which can be complicated by infective endocarditis in those at increased risk of the disease

- Antibiotic prophylaxis reduces the incidence of bacteraemia, but high level studies confirming that this reduces the incidence of infective endocarditis are lacking

- Warn high risk patients undergoing high risk dental interventions of the risk of infective endocarditis. Offer these patients antibiotic prophylaxis, and discuss with them the risks and benefits of this option

- Where patients are at moderate risk, encourage preventative measures, such as maintaining good oral hygiene and infection control, and discourage tattooing or piercing