• Endocarditis is a rare infection of the inside of 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 some patients who have had completely curative treatment.
How might I get infective 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.
• 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.
How might I feel if I were developing infective endocarditis?
• Patients with endocarditis develop a temperature and feel generally unwell, with symptoms similar to having the flu.
• Flu is very common and usually resolves after about a week.
• Flu like symptoms with a temperature which persist for longer than a week with no identified cause should be reported to your cardiology team, not just your GP, so that specialist tests can be carried out to check for endocarditis.
• Sometimes endocarditis can cause quite mild symptoms which grumble on for a number of months. These include loss of appetite, weight loss, fever, sweats, rash.
What can I do to avoid infective endocarditis?
• Good dental care and oral hygiene are important to reduce the risk of infective endocarditis.
• Attend your dentist on a regular basis. They will give you advice on how to look after your teeth and gums.
• Tooth brushing twice a day, using a fluoride toothpaste.
• A healthy diet avoiding sugary snacks and drinks.
How can I find a family dentist?
• Visit the NHS website which keeps a directory of local services https://www.nhs.uk/
• If you require urgent dental care and do not have a family dentist then call NHS 111
What if I require dental treatment?
The safest way for any dental care to be carried out is generally using local anaesthetic (an injection in the gum). Sometimes sedation, usually intravenous sedation (injection in the back of your hand) or inhalation sedation ( gas and air), can also be used to help you have dental care completed. If the care cannot be carried out while you are awake, then a general anaesthetic (going to sleep) will be necessary
When might I need to see a specialist/ consultant in Special Care Dentistry?
Your family dentist may be able to provide dental care for you at your family practice using local anaesthetic +/- sedation. If this is not feasible then your dentist will refer you to your local Specialist/Consultant in Special Care Dentistry for specialist level care using local anaesthetic/ sedation /general anaesthetic.
Also, individuals who require cardiac surgery will often be referred by the Cardiology team for a dental review prior to surgery.