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Dental Health and Endocarditis Prevention

Endocarditis is a rare, life-threatening inflammation of the lining of the heart muscle and its valves. It is caused by a bacterial infection. Although it can occur in anyone, it is much more common in people with certain heart conditions and in those who've had it before. If your risk is high, you can take steps to lower it.

How Have Endocarditis Prevention Guidelines Changed?

In 2007, the American Heart Association Endocarditis Committee -- together with other experts -- issued guidelines to help prevent endocarditis. These replaced guidelines issued in 1997. After reviewing published studies, the committee found that only a small number of cases of infective endocarditis might be prevented by antibiotics for dental procedures. In patients with heart conditions associated with the highest risk of serious complications from endocarditis, it says that antibiotic treatment before dental procedures involving manipulation of the gums seems reasonable.

In very rare cases, bacteria in the mouth may trigger endocarditis in people at higher risk. Here's what happens: Bacteria found in tooth plaque may multiply and cause gingivitis (gum disease). If not treated, this may become advanced. The gums become inflamed (red and swollen) and often bleed during tooth brushing, flossing, or certain dental procedures involving manipulation of the gums. When gums bleed, the bacteria can enter the bloodstream and can infect other parts of the body. In the case of endocarditis, this affects the inner lining of the heart and the surfaces of its valves. The bacteria stick to these surfaces and create growths or pockets of bacteria.

Because this is so rare, the new guidelines suggest antibiotics prior to dental procedures only for patients who are at highest risk for serious complications from endocarditis. In fact, in most cases, the risk of problems from antibiotics exceeds the benefits from preventive antibiotics. These attract blood products that may lead to clots.

Who Should Receive Antibiotics Before Having a Dental Treatment?

To prevent endocarditis, patients with certain heart conditions receive a single dose of an antibiotic. You receive it about one hour prior to certain dental treatments.

The American Heart Association and American Dental Association now suggest that you receive antibiotics prior to dental treatment only if you have:

  • Had bacterial endocarditis before
  • A prosthetic (artificial) cardiac valve or prosthetic material used in valve repair
  • Cardiac valve disease and have had a cardiac transplant
  • Congenital (present at birth) heart disease. This includes only people with the following:
    • Unrepaired cyanotic congenital heart disease (including those with devices that relieve symptoms only)
    • Completely repaired congenital heart defect with prosthetic material or device during the first six months after the procedure
    • Repaired congenital heart disease with defects that remain at or near the site of a prosthetic patch or prosthetic device

WebMD Medical Reference

How Do I Measure Up? Get the Facts Fast!

Number of Days Per Week I Floss

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Only 18.5% of Americans never floss. You are missing out on a simple way to make a big difference in the health of your mouth. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Floss removes food trapped between the teeth and removes the film of bacteria that forms there before it turns to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Try flossing just one tooth to get started.

You are one of 31% of Americans who don't floss daily. You are missing out on a simple way to make a big difference in the health of your mouth. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Aim for 3 more days!

You are one of 31% of Americans who don't floss daily, but you're well on your way to making a positive impact on your teeth and gums. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Aim for all 7 days!

Only 50.5% of Americans floss daily, and good for you that you are one of them! Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Congratulations on your good oral health habit!

SOURCES:

American Dental Association, Healthy People 2010

This tool is intended only for adults 18 and older.

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