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Prevention and treatment of Endocarditis

    • 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

  • 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.
  • Recognising endocarditis

    • Patients with endocarditis develop a temperature and feel generally unwell, with symptoms very similar to having the flu.
    • Flu is very common and usually resolves after about a week.
    • Flu like symptoms with a temperature which persists for longer than a week should be reported to your cardiologist, not just to your GP, so that specialist tests can be carried out to check for endocarditis.
  • Reducing the risk of getting endocarditis

    • Endocarditis can only occur if bacteria get into the bloodstream (called bacteraemia). Although it is not possible to prevent all bacteria getting into the bloodstream, there are some things you can do to reduce the risk of getting endocarditis.
    • Everybody carries bacteria in the mouth. These are usually harmless, but if the teeth or gums become diseased it becomes much easier for large numbers of bacteria to get into the blood, with the risk they may settle in the heart and cause endocarditis.
    • Good dental care and oral hygiene are therefore particularly important to reduce risk of endocarditis.
    • Apart from regular tooth brushing, regular check ups at the dentist are essential to minimise the risk of endocarditis.
    • The dental hygienist at your dental surgery will give advice on how to look after teeth and gums.
  • If you have difficulties finding a dentist

    • Call NHS Direct Tel. 0845 4647, who keep a list of local dentists or
    • Visit the NHS website which keeps a directory of local services www.nhs.uk/servicedirectories

    Other things that risk endocarditis

    • Ear piercing, other body piercings or tattooing can lead to infections which may cause endocarditis.
    • Patients at increased risk of endocarditis are safest avoiding these procedures.