Antibiotic Prophylaxis for Dental Procedures: Are We Drilling in the Wrong Direction?
Open accessAbstract
T he possibility that bacteremia from the mouth could cause infective endocarditis (IE) was first suggested Ͼ100 years ago, and it was later reinforced by others who targeted the viridans group streptococci from poor oral hygiene and dental extractions.[1][2][3] These observations, along with the advent of antibiotics, eventually led to the first guidelines from the American Heart Association (AHA) in 1955.Antibiotic prophylaxis (AP) became the primary focus for prevention of IE and a standard of care for countries around the world.Controversy concerning efficacy and safety issues has existed for Ͼ30 years, and there has been a progressive reduction in the patient populations and the procedures suggested for AP since that time.Of concern, and in spite of a decreasing emphasis on AP for cardiac patients, upwards of 25 noncardiac patient populations are recommended for AP by some clinicians out of concern for systemic infections that might originate from dental procedures (eg, prosthetic joints).
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Current evidence suggests that poor oral hygiene and periodontal diseases, not dental office procedures, are likely responsible for the vast majority of cases of IE that originate in the mouth.
“Current evidence suggests that poor oral hygiene and periodontal diseases, not dental office procedures, are likely to be responsible for the vast majority of cases of IE that originate in the mouth.328”
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Cites
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Cited by
Sorted by citations
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- Authors
- Lockhart, P. B.
- Affiliations
- Carolinas Medical Center (US)
- Corresponding author
- Lockhart, Peter B.
- ORCID
- Lockhart, Peter B.
- Venue
- Circulation
- Published
- 2012-07-03
- Volume
- 126
- Issue
- 1
- Pages
- 11-12
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1996289835
- Cited by
- 19
- References
- 16
- Citations by year
- 2024: 1 · 2023: 1 · 2021: 1 · 2020: 3 · 2019: 2 · 2017: 1 · 2016: 2 · 2015: 3 · 2014: 3 · 2013: 1 · 2012: 1
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Health Sciences › Medicine › Surgery › Surgical site infection prevention
- Health Sciences › Medicine › Surgery › Orthopedic Infections and Treatments
- Keywords
- antibiotic prophylaxis, dental treatment, infective endocarditis, bacteremia, Streptococcus viridans, artificial joints, systemic infection, prevention guidelines, treatment efficacy and safety
- MeSH terms
- American Heart Association, Endocarditis, Endocarditis, Bacterial, Female, Humans, Male, Streptococcal Infections, Practice Guidelines as Topic, Viridans Streptococci
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