DENTISTS- Prevention and treatment of Endocarditis

  • Prevention of Endocarditis

    Download our leaflet about endocarditis here

    • For many years patients were advised to have antibiotic cover for dental treatment, this is no longer so.
    • Expert advice now is that what is most important is good oral health.
    • Similarly, antibiotic cover is no longer recommended routinely for procedures involving the airways, the gastrointestinal system or the urogenital system.

    You can read about the 2008 NICE recommendations in detail on the NICE website

    o Visit the NHS website which keeps a directory of local services
    o If you require urgent dental care and do not have a dentist then call NHS 111

  • Infective endocarditis and what you can do to avoid it

    • Endocarditis is a rare infection of the inside the heart or the main arteries.
    • It most commonly affects one or more of the heart valves but may also occur around holes between the heart chambers, at the site of abnormalities in the walls of arteries or at the site of previous heart or arterial surgery.
    • It is a serious condition and can cause major damage to the heart valves and may even cause stroke or death.
    • Most endocarditis occurs in patients already known to have heart abnormalities.
    • Most patients with congenital heart disease are at increased risk of getting endocarditis.
    • The only exceptions being isolated atrial septal defects or patients who have had completely curative treatment.

    Advice for dentists

    The safest option for dental work is via local anaesthetic but if the treatment cannot be performed with the adult awake a general anaesthetic will be necessary.

    Anaesthetic advice
    For patients who require a general anaesthetic for dental treatment, the patients with the following simple cardiac lesions can have their treatment performed in the local District General Hospital:

    • Patent Foramen Ovale (PFO) or Atrial Septal Defect (ASD) with no volume loading
    • Restrictive Ventricular Septal Defects (VSD) without failure
    • Patent Ductus Arteriosus (PDA) pre- or post-repair
    • Repaired Atrial Septal Defect or Ventricular Septal Defect
    • Mild Pulmonary Stenosis (<3m/s) (with ECHO in last 6 months)
    • Adult under screening with normal heart.

    If the patient has a more complicated cardiac condition, the advice as to whether the patient can be treated locally or at the specialist centre will have to be given on an individual basis based on the patient’s up to date medical condition.

    If you require advice about elective dental treatment then please contact Dr M Cross Adult Congenital Cardiac Anaesthetist based at Leeds General Infirmary for advice:
    Dr Cross email:

    If the patient requires urgent dental treatment with general anaesthetic please contact the congenital cardiac anaesthetist on call or the adult congenital cardiologists on call via the hospital switchboard at Leeds General Infirmary. Tel 0113 2432799