EUH Resident Report: What are the guidelines for prophylaxis for dental procedures in patients with congenital heart disease?

The Bottom Line: Infective endocarditis (IE) prophylaxis for dental procedures should be recommended only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from IE. For patients with these underlying cardiac conditions, prophylaxis is recommended for all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa. Prophylaxis is not recommended based solely on an increased lifetime risk of acquisition of IE (AHA, 2007).

References: American Heart Association. Prevention of infective endocarditis. Guidelines from the American Heart Association. Circulation. 2007.

European Society of Cardiology. Infective endocarditis (Guidelines on prevention, diagnosis, and treatment of): ESC clinical practice guidelines. 2015.

Summary: Recommendations for prophylaxis of IE in the highest-risk patients according to the type of at-risk procedure (Table 5, ESC, 2015).

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TOE = transoesophageal echocardiography.

aClass of recommendation.

bLevel of evidence.

cFor management when infections are present, please refer to Section 3.5.3.

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